Nokea
A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD). Which of the following medication categories should the nurse plan to include when providing patient teaching about PAD management?
- A. Statins
- B. Vitamins
- C. Thrombolytics
- D. Anticoagulants
Correct Answer: A
Rationale: Current research indicates that statin use by patients with PAD improves multiple outcomes. There is no research that supports the use of the other medication categories in PAD.
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The nurse is caring for a patient with a right calf venous thromboembolism. Which of the following information requires immediate action by the nurse?
- A. Complaint of left calf pain
- B. New onset shortness of breath
- C. Red skin colour of left lower leg
- D. Temperature of 38°C (100.4°F)
Correct Answer: B
Rationale: New onset dyspnea suggests a pulmonary embolus, which will require rapid actions such as oxygen administration and notification of the health care provider. The other findings are typical of VTE.
A patient tells the health care provider about experiencing cold, numb fingers when running during the winter and is diagnosed with Raynaud's phenomenon. Based upon this diagnosis, the patient should be investigated for which of the following conditions?
- A. Hypertension
- B. Hyperlipidemia
- C. Autoimmune disorders
- D. Coronary artery disease
Correct Answer: C
Rationale: Secondary Raynaud's phenomenon may occur in conjunction with autoimmune diseases such as rheumatoid arthritis, and patients should be screened for autoimmune disorders. Raynaud's phenomenon is not associated with hyperlipidemia, hypertension, or coronary artery disease.
Which of the following patients in the emergency department should the nurse assess first?
- A. 62-year-old who has gangrenous ulcers on both feet
- B. 50-year-old who is complaining of 'tearing' chest pain.
- C. 45-year-old who is taking anticoagulants and has bloody stools
- D. 36-year-old who has right calf tenderness, redness, and swelling
Correct Answer: B
Rationale: The patient's presentation is consistent with aortic dissection, which will require rapid intervention. The other patients do not need urgent interventions.
A patient with a venous thromboembolism (VTE) is started on enoxaparin and warfarin. The patient asks the nurse why two medications are necessary. Which of the following responses by the nurse is accurate?
- A. Administration of two anticoagulants reduces the risk for recurrent venous thrombosis.
- B. Enoxaparin will start to dissolve the clot, and warfarin will prevent any more clots from occurring.
- C. The enoxaparin will work immediately, but the warfarin takes several days to have an effect on coagulation.
- D. Because of the potential for a pulmonary embolism, it is important for you to have more than one anticoagulant.
Correct Answer: C
Rationale: Low-molecular-weight heparin (LMWH) such as enoxaparin has an immediate effect on coagulation and is used until warfarin reaches therapeutic levels, which takes several days.
The nurse is developing a teaching plan for a patient newly diagnosed with peripheral artery disease (PAD). Which of the following information should the nurse include?
- A. Exercise only if you do not experience any pain.
- B. It is very important that you stop smoking cigarettes.
- C. Try to keep your legs elevated whenever you are sitting.
- D. Put on support hose early in the day before swelling occurs.
Correct Answer: B
Rationale: Smoking cessation is essential for slowing the progression of PAD to critical limb ischemia and reducing the risk of myocardial infarction and death. Circulation to the legs will decrease if the legs are elevated. Patients with PAD are taught to exercise to the point of feeling pain, rest, and then resume walking. Support hose are not used for patients with PAD.