Nokea
A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display?
- A. Fatty deposits in the lumen of arteries
- B. Cholesterol plugs in the lumen of veins
- C. Blood clots in the arteries
- D. Emboli in the veins
Correct Answer: A
Rationale: Atherosclerosis is a condition in which the lumen of arteries fill with fatty deposits called plaque. Therefore, the other options are incorrect.
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The nurse is caring for a client who is post-varicose vein surgery. The nurse would include which teaching measure(s)? Select all that apply.
- A. Exercise
- B. Cool compresses
- C. Elastic stockings
- D. Lower the extremities
- E. Stand rather than sit
- F. Take warm showers in the morning
Correct Answer: A,C
Rationale: Movement/exercise and use of elastic stocking aid in venous return. Cool compresses can cause vasoconstriction, which can diminish arterial blood flow. Elevation of legs can be helpful in aiding venous return. Standing or sitting for prolonged periods of time should be avoided. Showers in the morning can dilate blood vessels and contribute to venous congestion and edema.
Which of the following factors would the nurse identify as a modifiable risk factor for the development of varicose veins?
- A. Mother and maternal grandmother had varicose veins
- B. Employed as an over-the-road truck driver
- C. Weight gained during past pregnancies
- D. History of thrombophlebitis in both extremities
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.
A client comes to the emergency department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client?
- A. Coronary artery disease
- B. Raynaud syndrome
- C. Cardiogenic shock
- D. Venous occlusive disease
Correct Answer: A
Rationale: The classic symptom of CAD is chest pain (angina) or discomfort during activity or stress. Such pain or discomfort typically is manifested as sudden pain or pressure that may be centered over the heart (precordial) or under the sternum (substernal). Raynaud syndrome in the hands presents with symptoms of hands that are cold, blanched, and wet with perspiration. Cardiogenic shock is a complication of an MI. Venous occlusive disease occurs in the veins, not the arteries.
The nurse provides care for a client following a percutaneous transluminal coronary angioplasty (PTCA). Which is the priority action by the nurse?
- A. Monitor the gag reflex
- B. Evaluate for signs of infection
- C. Monitor for signs of fluid volume deficit
- D. Palpate distal pulses in bilateral extremities
Correct Answer: D
Rationale: The PTCA is an invasive nonsurgical procedure in which a balloon-tipped catheter is inserted and threaded through a peripheral artery. The nurse monitors the client for bleeding postprocedure in addition to palpating distal, bilateral pulses in the appropriate extremity. Fluid volume deficit is not a primary concern. This procedure does not require general anesthesia; therefore, monitoring for an impaired gag reflex is not a priority nursing action. Signs of infection should be monitored post-PTCA, but this is not an immediate concern.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) immediately following confirmed diagnosis of acute myocardial infarction. The client is overtly anxious and crying. Which response by the nurse is most appropriate?
- A. Everything will be fine. Your family is here for you
- B. Don't cry; you have the best team of doctors
- C. Would you like something to calm your nerves?
- D. Tell me what concerns you most
Correct Answer: D
Rationale: Allowing the client to share feelings tends to relieve or reduce emotional distress. Telling a client that everything is fine negates the feelings they are expressing. Telling a client not to cry can be viewed as insensitive to the feelings being expressed. Providing a prescribed sedative may be helpful but does not address the fears and concerns of the client.