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Which medication should the nurse expect the health-care provider to order for a client diagnosed with arterial occlusive disease?
- A. An anticoagulant medication.
- B. An antihypertensive medication.
- C. An antiplatelet medication.
- D. A muscle relaxant.
Correct Answer: C
Rationale: Antiplatelet medications (e.g., aspirin, clopidogrel) (C) prevent clot formation in PAD. Anticoagulants (A) are for DVT, antihypertensives (B) for BP, and muscle relaxants (D) are irrelevant.
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The client with aortic stenosis asks why they feel tired. What is the best response?
- A. Your heart is not pumping enough blood.
- B. Your lungs are retaining fluid.
- C. Your blood pressure is too high.
- D. Your heart rate is too slow.
Correct Answer: A
Rationale: Aortic stenosis restricts blood flow from the heart, reducing cardiac output and causing fatigue.
When assessing the client's lower leg, which findings characteristic of venous stasis ulcers is the nurse most likely to find? Select all that apply.
- A. Purulent drainage from lesions
- B. Blanched patches around open areas
- C. Dark brown, dry, and crusty skin
- D. Fluid-filled blisters
- E. Edema in the lower legs
- F. Fine red rash below the knee
Correct Answer: C,E
Rationale: Venous stasis ulcers are typically characterized by dark brown, dry, crusty skin due to hemosiderin deposition and edema in the lower legs due to venous insufficiency.
The client with heart failure reports fatigue. Which action should the nurse take first?
- A. Encourage bedrest all day.
- B. Assess oxygen saturation.
- C. Administer a diuretic.
- D. Increase fluid intake.
Correct Answer: B
Rationale: Fatigue in heart failure may indicate hypoxemia, so assessing oxygen saturation is the priority.
Which instruction should the nurse discuss with the client diagnosed with Raynaud's phenomenon?
- A. Explain exacerbations will not occur in the summer.
- B. Use nicotine gum to help quit smoking.
- C. Wear extra-warm clothing during cold exposure.
- D. Avoid prolonged exposure to direct sunlight.
Correct Answer: C
Rationale: Cold triggers Raynaud’s; wearing warm clothing (C) prevents vasospasm. Exacerbations occur in summer (A), nicotine gum (B) still delivers nicotine (harmful), and sunlight (D) is irrelevant.
Which assessment finding indicates a worsening condition in a client with valvular heart disease? Select all that apply.
- A. Shortness of breath at rest
- B. Weight gain of 4 pounds in 3 days
- C. Fatigue with minimal activity
- D. Blood pressure of 130/80 mmHg
- E. Bilateral crackles in lungs
- F. Heart rate of 80 beats per minute
Correct Answer: A,B,C,E
Rationale: Shortness of breath, weight gain, fatigue, and crackles indicate worsening heart failure due to valvular dysfunction.