Cardiovascular System | Peripheral Vascular Diseases NCLEX Quiz 19

1. A significant cause of venous thrombosis is:

Altered blood coagulation

Stasis of blood

Vessel wall injury

All of the above

Venous thrombosis occurs when a blood clot forms within a vein. The correct answer is "All of the above" because all three factors mentioned - altered blood coagulation, stasis of blood, and vessel wall injury - contribute to the development of venous thrombosis. Altered blood coagulation refers to any condition or factor that disrupts the normal balance of clotting and anticoagulant mechanisms in the blood. Stasis of blood occurs when blood flow slows down or becomes stagnant, allowing clotting factors to accumulate. Vessel wall injury can result from trauma, inflammation, or certain medical conditions, which can trigger clot formation. Therefore, all three factors play a significant role in the development of venous thrombosis.

Explanation

Venous thrombosis occurs when a blood clot forms within a vein. The correct answer is "All of the above" because all three factors mentioned - altered blood coagulation, stasis of blood, and vessel wall injury - contribute to the development of venous thrombosis. Altered blood coagulation refers to any condition or factor that disrupts the normal balance of clotting and anticoagulant mechanisms in the blood. Stasis of blood occurs when blood flow slows down or becomes stagnant, allowing clotting factors to accumulate. Vessel wall injury can result from trauma, inflammation, or certain medical conditions, which can trigger clot formation. Therefore, all three factors play a significant role in the development of venous thrombosis.

2. Mike. a 43-year old construction worker. has a history of hypertension. He smokes two packs of cigarettes a day. is nervous about the possibility of being unemployed. and has difficulty coping with stress. His current concern is calf pain during minimal exercise that decreased with rest. The nurse assesses Mike's symptoms as being associated with peripheral arterial occlusive disease. The nursing diagnosis is probably:

Alteration in tissue perfusion related to compromised circulation

Dysfunctional use of extremities related to muscle spasms

Impaired mobility related to stress associated with pain

Impairment in muscle use associated with pain on exertion.

The correct answer is "Alteration in tissue perfusion related to compromised circulation." This is because Mike's symptoms, such as calf pain during minimal exercise that decreases with rest, are indicative of peripheral arterial occlusive disease. This condition is characterized by compromised circulation, which can lead to a decrease in tissue perfusion.

Explanation

The correct answer is "Alteration in tissue perfusion related to compromised circulation." This is because Mike's symptoms, such as calf pain during minimal exercise that decreases with rest, are indicative of peripheral arterial occlusive disease. This condition is characterized by compromised circulation, which can lead to a decrease in tissue perfusion.

3. A nurse has the order to begin administering warfarin sodium (Coumadin) to a client. While implementing this order. the nurse ensures that which of the following medications is available on the nursing unit as the antidote for Coumadin?

Vitamin K

Aminocaproic acid

Potassium chloride

Protamine sulfate

The antidote to warfarin (Coumadin) is Vitamin K and should be readily available for use if excessive bleeding or hemorrhage should occur.

Explanation

The antidote to warfarin (Coumadin) is Vitamin K and should be readily available for use if excessive bleeding or hemorrhage should occur.

4. Intravenous heparin therapy is ordered for a client. While implementing this order. a nurse ensures that which of the following medications is available on the nursing unit?

Vitamin K

Aminocaproic acid

Potassium chloride

Protamine sulfate

The antidote to heparin is protamine sulfate and should be readily available for use if excessive bleeding or hemorrhage should occur

Explanation

The antidote to heparin is protamine sulfate and should be readily available for use if excessive bleeding or hemorrhage should occur

5. A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot. A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess the client for:

Familial tendency toward peripheral vascular disease

Smoking history

Recent exposures to allergens

History of insect bites

The mixture of arterial and venous manifestations (claudication and phlebitis. respectively) in the young male client suggests Buerger’s disease. This is an uncommon disorder characterized by inflammation and thrombosis of smaller arteries and veins. This disorder typically is found in young adult males who smoke. The cause is not known precisely but is suspected to have an autoimmune component.

Explanation

The mixture of arterial and venous manifestations (claudication and phlebitis. respectively) in the young male client suggests Buerger’s disease. This is an uncommon disorder characterized by inflammation and thrombosis of smaller arteries and veins. This disorder typically is found in young adult males who smoke. The cause is not known precisely but is suspected to have an autoimmune component.

6. The most important factor in regulating the caliber of blood vessels. which determines resistance to flow. is:

Hormonal secretion

Independent arterial wall activity.

The influence of circulating chemicals

The sympathetic nervous system

The sympathetic nervous system is the correct answer because it plays a crucial role in regulating the caliber of blood vessels. It controls the constriction and dilation of blood vessels through the release of neurotransmitters, such as norepinephrine. This regulation of blood vessel diameter directly affects resistance to blood flow. When the sympathetic nervous system is activated, blood vessels constrict, increasing resistance and reducing blood flow. Conversely, when it is inhibited, blood vessels dilate, decreasing resistance and increasing blood flow. Therefore, the sympathetic nervous system is the most important factor in determining resistance to flow in blood vessels.

Explanation

The sympathetic nervous system is the correct answer because it plays a crucial role in regulating the caliber of blood vessels. It controls the constriction and dilation of blood vessels through the release of neurotransmitters, such as norepinephrine. This regulation of blood vessel diameter directly affects resistance to blood flow. When the sympathetic nervous system is activated, blood vessels constrict, increasing resistance and reducing blood flow. Conversely, when it is inhibited, blood vessels dilate, decreasing resistance and increasing blood flow. Therefore, the sympathetic nervous system is the most important factor in determining resistance to flow in blood vessels.

7. When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). the nurse knows not to expect therapeutic benefits for:

At least 12 hours

The first 24 hours

2-3 days

1 week

Warfarin (Coumadin) is an anticoagulant medication that works by inhibiting the synthesis of clotting factors in the liver. It takes time for the levels of these clotting factors to decrease, so therapeutic benefits of warfarin are not expected for 2-3 days. During this time, the patient is still at risk for blood clots and should be closely monitored. It is important for the nurse to educate the patient about the need for regular monitoring of their international normalized ratio (INR) levels to ensure proper dosing and effectiveness of the medication.

Explanation

Warfarin (Coumadin) is an anticoagulant medication that works by inhibiting the synthesis of clotting factors in the liver. It takes time for the levels of these clotting factors to decrease, so therapeutic benefits of warfarin are not expected for 2-3 days. During this time, the patient is still at risk for blood clots and should be closely monitored. It is important for the nurse to educate the patient about the need for regular monitoring of their international normalized ratio (INR) levels to ensure proper dosing and effectiveness of the medication.

8. With peripheral arterial insufficiency. leg pain during rest can be reduced by:

Elevating the limb above heart level

Lowering the limb so it is dependent

Massaging the limb after application of cold compresses

Placing the limb in a plane horizontal to the body

Lowering the limb so it is dependent can reduce leg pain during rest in individuals with peripheral arterial insufficiency. This is because lowering the limb allows for increased blood flow to the affected area, improving oxygen and nutrient delivery to the tissues. Elevating the limb above heart level would decrease blood flow to the area, potentially worsening symptoms. Massaging the limb after application of cold compresses may provide temporary relief, but it does not address the underlying issue of inadequate blood flow. Placing the limb in a plane horizontal to the body would not have any significant impact on blood flow or pain reduction.

Explanation

Lowering the limb so it is dependent can reduce leg pain during rest in individuals with peripheral arterial insufficiency. This is because lowering the limb allows for increased blood flow to the affected area, improving oxygen and nutrient delivery to the tissues. Elevating the limb above heart level would decrease blood flow to the area, potentially worsening symptoms. Massaging the limb after application of cold compresses may provide temporary relief, but it does not address the underlying issue of inadequate blood flow. Placing the limb in a plane horizontal to the body would not have any significant impact on blood flow or pain reduction.

9. Buerger's disease is characterized by all of the following except:

Arterial thrombosis formation and occlusion

Lipid deposits in the arteries

Redness or cyanosis in the limb when it is dependent

Venous inflammation and occlusion

Buerger's disease, also known as thromboangiitis obliterans, is a condition that primarily affects the small and medium-sized arteries and veins in the limbs. It is characterized by arterial thrombosis formation and occlusion, redness or cyanosis in the limb when it is dependent, and venous inflammation and occlusion. However, lipid deposits in the arteries are not a characteristic feature of Buerger's disease. Instead, this condition primarily involves inflammation and clotting of the blood vessels, leading to reduced blood flow and tissue damage in the affected limbs.

Explanation

Buerger's disease, also known as thromboangiitis obliterans, is a condition that primarily affects the small and medium-sized arteries and veins in the limbs. It is characterized by arterial thrombosis formation and occlusion, redness or cyanosis in the limb when it is dependent, and venous inflammation and occlusion. However, lipid deposits in the arteries are not a characteristic feature of Buerger's disease. Instead, this condition primarily involves inflammation and clotting of the blood vessels, leading to reduced blood flow and tissue damage in the affected limbs.

10. A client who has been receiving heparin therapy also is started on warfarin sodium (coumadin). The client asks the nurse why both medications are being administered. In formulating a response. the nurse incorporates the understanding that warfarin sodium:

Stimulates production of the body’s own thrombolytic substances. but it takes 2-4 days for it to begin.

Warfarin sodium works in the liver and inhibits synthesis of four vitamin K-dependent clotting factors (X. IX. VII. and II). but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.

Explanation

Warfarin sodium works in the liver and inhibits synthesis of four vitamin K-dependent clotting factors (X. IX. VII. and II). but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.