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PVD & PAD Practice Questions with
correct answers
The nurse is preparing a patient for a segmental pressure measurement test. Which equipment will be needed to complete the test? Treadmill and cardiac monitor Blood pressure cuff and Doppler IV insertion Ultrasound and Doppler - CORRECT ANSWERS ✔✔Blood pressure cuff and Doppler While all options may be used in the collaborative treatment of a patient with PVD, only segmental pressure measurements use blood pressure cuffs and a Doppler device to compare blood pressures (BPs) of the upper and lower extremities. A stress test uses a treadmill and cardiac monitor to assess the functional limitations. A duplex Doppler ultrasound uses Doppler ultrasound with ultrasound imaging to detect
arterial or venous alterations. Angiography requires IV access for dye injection to locate and evaluate the extent of vascular obstruction. The nurse is caring for a patient with peripheral vascular disease (PVD) who asks, "Is there anything other than medication to help slow this disease?" How should the nurse respond? "Aromatherapy has been shown to slow the progression of PVD." "Garlic supplements have been shown to slow the progression of PVD." "Yoga has been shown to slow the progression of PVD." "A diet high in protein has been shown to slow the progression of PVD."
- CORRECT ANSWERS ✔✔"Garlic supplements have been shown to slow the progression of PVD." Garlic supplements have been shown to slow the progression of PVD. A very low-fat or vegetarian diet, not a high-protein diet, decreases cholesterol and atherosclerosis. Aromatherapy and yoga may be used in the collaborative care of the patient with PVD. However, these therapies are used to improve circulation and to reduce stress, not to slow the progression of the disease.
Scleroderma Varicose veins Congestive heart failure (CHF) Deep vein thrombosis (DVT) - CORRECT ANSWERS ✔✔Deep vein thrombosis (DVT) Deep vein thrombosis (DVT) is the most common cause of chronic venous insufficiency (CVI). Scleroderma is an autoimmune disease affecting the collagen of the body. Varicose veins result from CVI, but they do not cause it. This condition usually affects the skin and is not a common cause of CVI. Congestive heart failure (CHF) is the failure of the heart pump. It is not the most common cause of CVI. A patient is completing a health history questionnaire. Which patient response indicates the need for assessment for peripheral atherosclerosis? "My legs are dark red when elevated."
"I have hairless lower legs." "I have strong peripheral pulses in both legs." "My toenails are thin and brittle." - CORRECT ANSWERS ✔✔"I have hairless lower legs." Lack of hair on the lower legs is a clinical manifestation of low oxygen levels due to peripheral atherosclerosis. Thin toenails, dark red legs with elevation, and strong peripheral pulses are not clinical manifestations of low oxygen levels or peripheral atherosclerosis. A patient with peripheral vascular disease (PVD) states, "I want to stay active, but I am having a hard time getting motivated because every time I try to exercise my legs hurt." How should the nurse respond? "It is best to maintain activity with your condition, but make sure to rest if you develop pain during activity." "It is best to maintain activity with your condition. You should continue activity if you have pain to increase your endurance."
Diminished risk of deep vein thrombosis (DVT) Decreased shearing force - CORRECT ANSWERS ✔✔Improved capillary blood flow The bed cradle suspends bed linens over the legs, preventing them from placing pressure on extremities and injured tissues. Minimizing pressure on the tissues promotes capillary blood flow. The bed cradle does not minimize the risk of DVT or infection. The bed cradle does not affect shearing force. The home health nurse is helping a patient with atherosclerosis and peripheral vascular disease (PVD) write a grocery list with foods to reduce cholesterol. Which should the nurse recommend be removed from the shopping list? Red wine Broccoli Low-fat coffee creamer Stick butter - CORRECT ANSWERS ✔✔Stick butter
Patients with PVD should try to reduce cholesterol to improve their PVD and atherosclerosis. Stick butter is high in saturated fat and should be avoided. Broccoli is high in fiber and is a healthy option. Low-fat diets are indicated for patients with PVD. The antioxidants in red wine may lower low-density lipoprotein (LDL), and red wine may raise good high-density lipoprotein (HDL) levels. A patient is scheduled for an endarterectomy due to severe peripheral vascular disease (PVD). When reviewing this procedure with the patient, which statement should the nurse include? "The plaque from your occluded vessel will be removed by heat." "The plaque from your occluded vessel will be surgically removed." "This procedure reroutes blood flow around your occluded vessel." "This is considered a nonsurgical procedure that treats your occluded vessel." - CORRECT ANSWERS ✔✔"The plaque from your occluded vessel will be surgically removed."
ordered is a dependent, not independent, nursing intervention. The nurse will place the lower extremities in a dependent position, not elevate them. The nurse will keep the lower extremities warm; however, a heating pad should not be used due to the risk of the patient being burned. The nurse is caring for a patient with peripheral vascular disease (PVD) who has an ulcer on their great toe. Which additional assessment finding should the nurse expect to find? There is stasis dermatitis. The skin of the extremity is cool to the touch. There is brown pigmentation of the extremity. There is pitting edema on the extremity. - CORRECT ANSWERS ✔✔The skin of the extremity is cool to the touch. Since the wound is on the toe, the nurse should identify arterial problems, of which cool extremities is characteristic. Venous problems are characterized by brown pigmentation of the skin of the lower extremity, edema, and stasis dermatitis.
The nurse is caring for a patient with peripheral atherosclerosis. Which report from the patient is most important for the nurse to know about? "My legs start to hurt when I walk a lot." "I have started using slippers for when I get out of bed." "I have a cut and a bad bruise on the top of my foot that still hurts." "I have some pain in my legs when I sleep at night." - CORRECT ANSWERS ✔✔"I have a cut and a bad bruise on the top of my foot that still hurts." Patients with peripheral vascular disease (PVD) should report any leg and foot problems to their healthcare provider. It is normal for patients with PVD to experience resting pain at night, which can be alleviated by dangling the legs off the bed. Patients can also experience intermittent claudication (crampy leg pain). The nurse is teaching a patient with atherosclerosis about their condition. Which patient statement indicates the teaching was successful?
"The pain you're referring to is called intermittent claudication. Does it improve with movement?" "The pain you're referring to is called intermittent claudication. Is it usually worse with activity?" "The pain you're referring to is called rest pain. Does it improve when you hang your legs off the couch?" "The pain you're referring to is called rest pain. Does it improve if you elevate your legs above your heart?" - CORRECT ANSWERS ✔✔"The pain you're referring to is called rest pain. Does it improve when you hang your legs off the couch?" The patient is describing rest pain, which is pain that occurs at rest and is often described as a burning sensation. This pain is worse when the patient's legs are elevated and is often alleviated when the patient's legs are in the dependent position (as in when hanging off the side of the bed). The other answer choices are incorrect. The nurse is caring for a patient with peripheral vascular disease (PVD) who reports burning pain in the legs at night in bed. Which response by the nurse is appropriate?
"This known as intermittent claudication. Elevating your legs may help your pain." "This is known as intermittent claudication. Wearing compression socks to bed may help your pain." "This is known as rest pain. Dangling your legs off your bed may help your pain." "This is known as rest pain. Elevating your legs may help your pain." - CORRECT ANSWERS ✔✔"This is known as rest pain. Dangling your legs off your bed may help your pain." The patient reports burning pain in the legs, which occurs at night in bed. This is known as rest pain, which occurs at rest. The nurse should instruct the patient to place the lower extremities in a dependent position, such as dangling them off the side of the bed (see the image below). Elevation of the legs will increase, not decrease, pain by reducing blood flow to the lower extremities. A patient with PVD or chronic venous insufficiency (CVI) should not wear compression socks to bed because this decreases circulation to the lower extremities and can worsen the patient's condition.
Which nursing intervention should the nurse recommend to promote tissue perfusion in a patient with peripheral vascular disease (PVD)? Advise patient to cross their legs when they sit. Encourage patient to exercise. Direct patient to ice lower extremities. Tell patient to elevate their lower extremities above their heart. - CORRECT ANSWERS ✔✔Encourage patient to exercise. To promote tissue perfusion in the patient with PVD, the nurse should encourage exercise to increase circulation to the lower extremities. Patients should keep lower extremities warm to prevent vasoconstriction associated with cold temperatures. Patients should not cross their legs when they sit because this reduces blood flow. The patient should not elevate their lower extremities because this decreases circulation to them. The nurse is evaluating the effectiveness of a treatment plan for a patient with peripheral vascular disease (PVD). Which statement by the patient indicates progress toward healing PVD?
"I wear support hose every day." "The first thing I do when I get home after a long day is put my feet up." "I have started a smoking cessation program." "I check my feet and legs once a week on all sides for signs of injury." - CORRECT ANSWERS ✔✔"I have started a smoking cessation program." Starting a smoking cessation program is vital to improving PVD because smoking worsens atherosclerosis. The feet and legs should be checked every day for signs of injury, not once a week. Patients should not wear support hose unless ordered by their healthcare provider. Patients should not elevate their feet because it reduces blood flow. The community health nurse is preparing a bulletin board for Vascular Disease Awareness Month. Which should the nurse identify as inappropriate in an infographic about foods to improve or prevent the condition? A cup of coffee with low-fat creamer
Assess patient pain every 12 hours using standard scale. Teach the patient guided imagery. - CORRECT ANSWERS ✔✔Teach the patient guided imagery. Teaching the patient guided imagery is an independent nursing intervention for the patient with PVD. Administering pain medications as ordered is a dependent nursing intervention. The nurse should assess the patient's pain at least every 4 hours and as needed. The nurse should encourage the patient to ambulate or exercise after the pain has subsided. The nurse is evaluating a patient with chronic peripheral venous disease (PVD) and claudication following a change in treatment plan. The patient reports that for the past several nights burning pain is waking them from sleep. How should the nurse interpret these findings? The new treatment plan is effective. The disease is progressing and tissue perfusion is altered. A new problem is developing that requires further evaluation.
The claudication is resolving. - CORRECT ANSWERS ✔✔The disease is progressing and tissue perfusion is altered. Pain at rest is a sign that the disease is progressing and that perfusion is altered. The new treatment plan is not effective and the claudication is not resolving. The symptoms indicate a worsening of the chronic peripheral venous disease, not a new problem. The nurse is caring for a patient who has been admitted with severe claudication secondary to peripheral vascular disease (PVD). Due to the patient's manifestations, an angiogram has been ordered. Which assessment question should the nurse ask as a priority prior to the patient's angiogram procedure? "Do you have any embedded metal shrapnel or artificial implants?" "Do you have an allergy to barium?" "Do you have chronic liver problems?" "Do you have an allergy to contrast dye?" - CORRECT ANSWERS ✔✔"Do you have an allergy to contrast dye?"
