Nokea
Which of the following patient statements indicates a need for further teaching about management of peripheral artery disease (PAD)?
- A. I will have to buy some loose clothing that does not bind across my legs or waist.
- B. I will use a heating pad on my feet at night to increase the circulation and warmth in my feet.
- C. I will walk to the point of pain, rest, and walk again until I develop pain for a half hour daily.
- D. I will change my position every hour and avoid long periods of sitting with my legs down.
Correct Answer: B
Rationale: Because the patient has impaired circulation and sensation to the feet, the use of a heating pad could lead to burns. The other patient statements are correct and indicate that teaching has been successful.
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The nurse is assessing a patient in the emergency department with a history of an abdominal aortic aneurysm with severe back pain and absent pedal pulses. Which of the following actions should the nurse take first?
- A. Obtain the blood pressure.
- B. Ask the patient about tobacco use.
- C. Draw blood for ordered laboratory testing.
- D. Assess for the presence of an abdominal bruit.
Correct Answer: A
Rationale: Since the patient appears to be experiencing aortic dissection, the nurse's first action should be to determine the hemodynamic status by assessing blood pressure. The other actions also may be done, but they will not provide information that will determine what interventions are needed immediately for this patient.
The nurse is providing teaching to a patient with newly diagnosed Raynaud's phenomenon about how to manage the condition. Which of the following behaviours by the patient indicates that the teaching has been effective?
- A. The patient avoids the use of Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
- B. The patient exercises indoors during the winter months.
- C. The patient places the hands in hot water when they turn pale.
- D. The patient takes pseudoephedrine for cold symptoms.
Correct Answer: B
Rationale: Patients should avoid temperature extremes by exercising indoors when it is cold. To avoid burn injuries, the patient should use warm, rather than hot, water to warm the hands. Pseudoephedrine, a vasoconstrictor, should be avoided. There is no reason to avoid taking Aspirin and NSAIDs with Raynaud's phenomenon.
The nurse is discussing risk factor modification for a patient who has a 4-cm abdominal aortic aneurysm. The nurse should focus patient teaching on which of the following risk factors?
- A. Male gender
- B. Marfan syndrome
- C. Abdominal trauma history
- D. Uncontrolled hypertension
Correct Answer: D
Rationale: All of the factors contribute to the patient's risk, but only the hypertension can potentially be modified to decrease the patient's risk for further expansion of the aneurysm.
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 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.