Nokea
The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation the nurse can give to the client?
- A. Both terms refer to the same disorder and can be used interchangeably
- B. Both are disorders in which the lining of the vessels become narrowed due to plaque
- C. Arteriosclerosis is when the vessels become dilated and weakened, whereas atherosclerosis is the deposit of fatty substances in the vessel lining
- D. Arteriosclerosis is a loss of elasticity of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the arteries fill with plaque
Correct Answer: D
Rationale: Arteriosclerosis refers to the loss of elasticity or hardening of the arteries that accompanies the aging process, whereas atherosclerosis is a condition in which the lumen of arteries fills with fatty deposits called plaque. The two terms do not refer to the same disorder, nor can they be used interchangeably. The other responses provide the client with inaccurate information.
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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.
Clients taking vasodilator drugs have a greater risk for postprandial hypotension. Which of the following is the best nursing explanation for this phenomenon?
- A. Gravity pulls blood to the lower extremities while sitting
- B. Blood is being diverted to the gastrointestinal tract
- C. Decreased peripheral blood flow results
- D. Bronchospasms are increased when food enters the stomach
Correct Answer: B
Rationale: During digestion, blood is diverted to the GI tract which decreases cerebral blood flow and increases potential of orthostatic hypotension. Although gravity does pull blood to the lower extremities while sitting, this is not the primary concern with postprandial hypotension. Decreased peripheral blood flow does not result in postprandial hypotension. Bronchospasms are associated more with asthma not diversion of blood flow.
Which assessment finding by the nurse is the most significant finding suggestive of aortic aneurysm?
- A. High blood pressure
- B. Severe back pain
- C. Abdomen bruit
- D. Nausea and vomiting
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.
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.
Which nursing assessment finding(s) suggests increased risk for coronary artery disease? Select all that apply.
- A. Arcus senilis
- B. Pear-shaped body
- C. Plump ear lobes
- D. Xanthelasma
- E. Sensory loss
- F. Motor changes
Correct Answer: A,D
Rationale: Arcus senilis is the opaque ring seen around the cornea that results from deposit of fat granules, and xanthelasma is raised yellow plaque on the eyelids. Both of these findings are suggestive of lipid accumulation that can increase the risk of CAD. An apple-shaped body carries a higher risk. Diagonal creases in the earlobe have been suggestive of CAD. Sensory and motor changes are more associated with CVA than CAD.