ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 25 : Caring for Clients With Disorders of Coronary and Peripheral Blood Vessels Questions
Question 1 of 5
A client who is diagnosed with Raynaud syndrome reports cold and numbness in the fingers. Which finding should the nurse identify as an early sign of vasoconstriction?
Correct Answer: A
Rationale: Pallor is the initial symptom in Raynaud syndrome followed by cyanosis and aching pain. Gangrene and ulceration can occur with persistent attacks and interference of blood flow.
Question 2 of 5
A client with venous insufficiency is instructed to exercise, apply elastic stockings, and elevate the extremities. Which is the primary benefit for this nursing management regimen?
Correct Answer: D
Rationale: The major goal in management of venous insufficiency is to promote venous circulation. Arterial flow improvement is not the goal of treatment for this disorder. Venous valves that are incompetent cannot be strengthened. Venous congestion is a complication of venous insufficiency.
Question 3 of 5
Which of the following factors would the nurse identify as a modifiable risk factor for the development of varicose veins?
Correct Answer: B
Rationale: Over-the-road truckers sit for long periods of time, and because prolonged sitting should be avoided, employment change could modify the risk associated with varicose vein aggravation. Varicose veins have a familial tendency, but this cannot be modified. Weight gained during previous pregnancies and history of thrombophlebitis cannot be changed.
Question 4 of 5
Which assessment finding by the nurse is the most significant finding suggestive of aortic aneurysm?
Correct Answer: C
Rationale: A pulsating mass or a bruit in the abdomen over the mass is most suggestive of aortic aneurysm. Severe back pain, nausea, and high blood pressure are all symptoms associated with aortic aneurysm but not as independently suggestive.
Question 5 of 5
The nurse is caring for a client with abdominal aortic aneurysm (AAA). Which assessment finding is most likely to indicate a dissection of the aneurysm?
Correct Answer: A
Rationale: Pressure from an enlarging or dissecting abdominal aortic aneurysm is likely to be exhibited as severe pain. A decrease in blood pressure will result as the client goes into shock from hemorrhaging. Blood in emesis or rectal bleeding is not associated with rupture of AAA.