PRELIMS Practice Tests Pointers

1. A patient with pericarditis reports severe chest pain. Which position should the nurse recommend to help decrease the pain? A. Lying flat B. Sitting up and leaning forward C. Lying on the right side D. Trendelenburg position

B. Sitting up and leaning forward — Sitting up and leaning forward helps decrease the pain associated with pericardial inflammation.

2. A patient with suspected cardiac tamponade has hypotension, jugular venous distention, and muffled heart sounds. What is the nurse’s priority concern? A. Increased cardiac output B. Decreased ventricular filling C. Increased pulmonary ventilation D. Increased systemic vascular resistance

B. Decreased ventricular filling — Fluid accumulating in the pericardial sac compresses the heart and prevents adequate ventricular filling, reducing cardiac output.

3. A patient with cardiac tamponade is scheduled for pericardiocentesis. The nurse explains that the primary purpose of the procedure is to

A. Increase blood volume

B. Remove fluid from the pericardial sac

C. Repair the coronary arteries

D. Increase myocardial contractility

B. Remove fluid from the pericardial sac

4. A patient with left-sided heart failure is most likely to develop which finding? A. Peripheral edema B. Jugular venous distention C. Pulmonary congestion D. Ascites

C. Pulmonary congestion — Left-sided heart failure causes blood to back up into the pulmonary circulation, resulting in pulmonary congestion and respiratory symptoms.

5. Which finding is most consistent with right-sided heart failure? A. Pulmonary crackles B. Peripheral edema C. Hemoptysis D. Orthopnea only

B. Peripheral edema — Right-sided heart failure causes systemic venous congestion, commonly producing peripheral edema, JVD, and ascites.

6. A patient with heart failure develops acute pulmonary edema. Which position should the nurse place the patient in? A. Supine B. High Fowler’s C. Trendelenburg D. Prone

B. High Fowler’s — High Fowler’s improves lung expansion and decreases venous return to the heart, helping reduce pulmonary congestion.

7. A patient taking digoxin should have which assessment performed before administration? A. Respiratory rate B. Apical pulse C. Temperature D. Oxygen saturation only

B. Apical pulse — The apical pulse should be assessed before giving digoxin because the medication can cause bradycardia.

8. Which finding may indicate digoxin toxicity? A. Increased appetite B. Visual disturbances C. Hypertension D. Increased urine output

B. Visual disturbances — Digoxin toxicity may cause visual changes, nausea, vomiting, anorexia, and dysrhythmias.

9. A patient reports headache after taking nitroglycerin for angina. How should the nurse interpret this finding? A. It is a possible medication side effect. B. It indicates severe hypoglycemia. C. It indicates digoxin toxicity. D. It means the medication has failed.

A. It is a possible medication side effect. — Nitroglycerin causes vasodilation, which can produce headache.

10. A patient reports chest pain that consistently occurs after climbing stairs and disappears after resting. Which condition is most consistent with this presentation? A. Unstable angina B. Stable angina C. Variant angina D. Cardiac tamponade

B. Stable angina — Stable angina is predictable, usually triggered by exertion, and relieved by rest or nitroglycerin.

11. A patient develops chest pain at rest that is new and unpredictable. Which condition should the nurse suspect? A. Stable angina B. Unstable angina C. Chronic bronchitis D. Pericarditis

B. Unstable angina — New, worsening, or unpredictable chest pain, especially at rest, is characteristic of unstable angina.

12. Variant or Prinzmetal angina is primarily associated with

A. Coronary artery vasospasm

B. Complete valve destruction

C. Pericardial fluid accumulation

D. Pulmonary infection

A. Coronary artery vasospasm

13. A patient presents with prolonged severe chest pain caused by myocardial ischemia. Which condition should the nurse suspect? A. Myocardial infarction B. Varicose veins C. Raynaud disease D. Chronic bronchitis

A. Myocardial infarction — A myocardial infarction occurs when prolonged ischemia causes myocardial tissue injury or death.

14. Which laboratory marker is commonly used to assess myocardial injury? A. Troponin B. Hemoglobin C. Platelet count D. Serum iron

A. Troponin — Troponin is a highly specific biomarker for cardiac muscle injury.

15. A patient with infective endocarditis is being assessed. Which diagnostic test is particularly important for identifying the causative organism? A. Blood cultures B. Pulmonary function test C. Spirometry D. Venography

A. Blood cultures — Blood cultures help identify the organism responsible for infective endocarditis and guide antibiotic therapy.

16. Which physical finding is associated with infective endocarditis? A. Janeway lesions B. Barrel chest C. Clubbing only D. Peripheral cyanosis only

A. Janeway lesions — Janeway lesions are painless lesions found on the palms or soles and can occur with infective endocarditis.

17. Which heart sound is produced by closure of the atrioventricular valves? A. S1 B. S2 C. S3 D. S4

A. S1 — S1 results from closure of the mitral and tricuspid valves at the beginning of ventricular systole.

18. Which heart sound is produced by closure of the semilunar valves? A. S1 B. S2 C. S3 D. Murmur

B. S2 — S2 is produced by closure of the aortic and pulmonic valves at the end of ventricular systole.

19. A nurse hears a loud cardiac murmur accompanied by a palpable thrill. Which murmur grade is most likely? A. Grade I B. Grade II C. Grade III D. Grade IV

D. Grade IV — A grade IV murmur is loud and is associated with a palpable thrill.

20. The nurse is reviewing respiratory anatomy. Where does most gas exchange occur? A. Trachea B. Bronchi C. Alveoli D. Larynx

C. Alveoli — The alveoli are the primary site of oxygen and carbon dioxide exchange between air and blood.

21. A patient with chronic bronchitis reports a long history of productive cough. Which description is consistent with chronic bronchitis? A. Productive cough for at least 3 months in 2 consecutive years B. Dry cough for 1 week C. Sudden cough after exercise D. Cough occurring only at night

A. Productive cough for at least 3 months in 2 consecutive years — Chronic bronchitis is clinically defined by a productive cough occurring for at least 3 months in each of 2 consecutive years.

22. Which factor is strongly associated with chronic bronchitis and COPD? A. Smoking B. Increased water intake C. Low-fat diet D. Regular exercise

A. Smoking — Cigarette smoking is a major risk factor for COPD, including chronic bronchitis and emphysema.

23. A patient with emphysema has difficulty exhaling. Which intervention can help prevent airway collapse during expiration? A. Rapid shallow breathing B. Pursed-lip breathing C. Breath holding D. Supine positioning

B. Pursed-lip breathing — Pursed-lip breathing slows expiration and helps maintain positive airway pressure, reducing small-airway collapse.

24. Which pathophysiologic change is characteristic of emphysema? A. Destruction of alveolar walls B. Increased platelet production C. Pericardial inflammation D. Increased venous valve function

A. Destruction of alveolar walls — Emphysema involves destruction of alveolar walls and loss of elastic recoil, causing air trapping.

25. A patient with asthma develops acute bronchospasm. Which medication is commonly used as a bronchodilator? A. Albuterol B. Warfarin C. Digoxin D. Ferrous sulfate

A. Albuterol — Albuterol is a short-acting beta2-agonist that produces bronchodilation and is commonly used for acute asthma symptoms.

26. Which medication is classified as a bronchodilator? A. Salbutamol B. Aspirin C. Alteplase D. Warfarin

A. Salbutamol — Salbutamol, also known as albuterol, is a bronchodilator used to relieve bronchospasm.

27. The nurse explains that corticosteroids are useful in asthma primarily because they

A. Dissolve blood clots

B. Reduce airway inflammation

C. Increase platelet production

D. Increase hemoglobin

B. Reduce airway inflammation

28. A patient undergoes pulmonary function testing. What does FEV1 measure? A. Total amount of oxygen in the blood B. Air forcibly exhaled during the first second C. Amount of blood pumped by the heart D. Total blood volume

B. Air forcibly exhaled during the first second — FEV1 measures the volume of air that can be forcibly exhaled during the first second of a forced expiratory maneuver.

29. A patient suddenly develops dyspnea, tachypnea, and chest pain after a period of immobility. Which condition should the nurse suspect? A. Pulmonary embolism B. Stable angina C. Varicose veins D. Pericarditis

A. Pulmonary embolism — Sudden dyspnea, tachypnea, and chest pain following immobilization are concerning for pulmonary embolism, often caused by DVT.

30. Pulmonary embolism commonly develops as a complication of

A. Deep vein thrombosis B. Asthma C. Pneumonia D. Raynaud disease

A. Deep vein thrombosis

31. A patient with a chest tube has continuous bubbling in the water-seal chamber. What should the nurse suspect? A. Normal lung expansion B. Possible air leak C. Complete lung re-expansion D. Increased blood pressure

B. Possible air leak — Continuous bubbling in the water-seal chamber may indicate an air leak in the system.

32. A chest tube becomes disconnected from the drainage system. What should the nurse do temporarily? A. Clamp the tube for several hours B. Place the end of the tube in sterile water C. Remove the chest tube D. Leave the tube open to air

B. Place the end of the tube in sterile water — Temporarily placing the tube end in sterile water creates a water seal until the drainage system can be reconnected.

33. A patient has a tension pneumothorax. Which action is the priority? A. Delay treatment until the next chest X-ray B. Recognize it as a medical emergency C. Encourage oral fluids D. Place the patient flat

B. Recognize it as a medical emergency — Tension pneumothorax can rapidly compromise ventilation and circulation and requires immediate intervention.

34. A patient with ARDS has severe difficulty maintaining adequate oxygenation. ARDS is best described as

A. A chronic venous disorder

B. Severe acute respiratory impairment with poor oxygenation

C. A cardiac valve infection

D. A type of anemia

B. Severe acute respiratory impairment with poor oxygenation

35. A patient with recurrent pleural effusion undergoes pleurodesis. The purpose of the procedure is to

A. Increase airway diameter

B. Make the pleural layers adhere

C. Remove the appendix

D. Increase red blood cell production

B. Make the pleural layers adhere - Pleurodesis is a medical procedure that intentionally creates inflammation between two pleural layers, which then causes the pleural layers to adhere (stick together). This prevents fluid from building up again.

36. A patient with pneumonia is admitted with fever, cough, sputum production, and dyspnea. Pneumonia primarily involves

A. Infection and inflammation of lung tissue

B. Inflammation of the pericardium

C. Occlusion of peripheral arteries

D. Destruction of heart valves

A. Infection and inflammation of lung tissue

37. Before bronchoscopy, which nursing intervention is appropriate? A. Encourage a large meal B. Maintain NPO status as ordered C. Encourage vigorous coughing D. Give oral fluids immediately before the procedure

B. Maintain NPO status as ordered — NPO status reduces the risk of aspiration during the procedure.

38. After bronchoscopy, the nurse should withhold oral intake until

A. The patient’s temperature decreases

B. The gag reflex returns

C. The patient begins coughing

D. The patient walks independently

B. The gag reflex returns — During bronchoscopy, a local anesthetic spray is used to numb the throat. This completely suppresses the patient’s protective gag reflex

39. A patient with acute airway obstruction arrives in the emergency department. What should the nurse prioritize? A. Airway B. Nutrition C. Skin assessment D. Sleep pattern

A. Airway — Airway is the first priority because obstruction can rapidly cause hypoxia and death.

40. A patient with anemia reports fatigue and activity intolerance. These symptoms are primarily related to

A. Decreased oxygen-carrying capacity

B. Increased platelet production

C. Increased cardiac valve function

D. Excessive oxygen delivery

A. Decreased oxygen-carrying capacity — A lack of hemoglobin means decreased oxygen-carrying capacity in the blood. This leaves tissue and muscles starved if oxygen, resulting directly in fatigue and activity intolerance.

41. Which finding is characteristic of vitamin B12 deficiency? A. Neurologic changes and paresthesias B. Increased platelet count C. Hypertension D. Excessive clot formation

A. Neurologic changes and paresthesias — Vitamin B12 deficiency can cause neurologic manifestations such as paresthesias, numbness, and impaired sensation.

42. Pernicious anemia develops because of impaired absorption of

A. Iron

B. Vitamin B12

C. Vitamin C

D. Vitamin D

B. Vitamin B12 — Pernicious anemia is a specific type of autoimmune disorder where the body lacks intrinsic factor, a protein made in the stomach lining. Without intrinsic factors, the small intestines cannot properly absorb vitamin B12 from the diet.

43. A patient with iron-deficiency anemia is prescribed oral ferrous sulfate. Which substance can improve iron absorption? A. Vitamin C B. Calcium C. Antacid D. Sodium bicarbonate

A. Vitamin C — Vitamin C enhances the absorption of non-heme iron.

44. Which finding is commonly associated with iron-deficiency anemia? A. Pica B. Jaundice only C. Hypertension D. Increased muscle strength

A. Pica — Pica, or craving nonfood substances, is a common finding associated with iron-deficiency anemia.

45. A patient taking oral iron reports dark stools. The nurse should recognize this as

A. A possible expected effect

B. A sign of improved circulation

C. A sign of pulmonary embolism

D. A sign of digoxin toxicity

A. A possible expected effect - Oral iron are notorious for turning stools dark green or black.

46. A patient with DIC develops bleeding from IV sites and petechiae. What is occurring? A. Excessive production of healthy platelets B. Consumption of platelets and clotting factors C. Increased red blood cell production D. Increased vitamin B12 absorption

B. Consumption of platelets and clotting factors — DIC causes widespread coagulation, consuming platelets and clotting factors and eventually producing bleeding.

47. Which laboratory finding is expected in DIC? A. Increased platelet count B. Low fibrinogen C. Increased hemoglobin D. Shortened PT

B. Low fibrinogen — DIC consumes clotting factors and fibrinogen, resulting in decreased fibrinogen levels and prolonged coagulation studies.

48. A patient with thrombocytopenia is at increased risk for

A. Bleeding

B. Hyperoxygenation

C. Hypertension only

D. Increased bone density

A. Bleeding — Thrombocytopenia is a medical condition characterized by a low platelet count in the blood. Without a sufficient amount of platelets, the body cannot clot blood effectively, placing the patient at an increased risk for bleeding.

49. Which nursing intervention is appropriate for a patient with thrombocytopenia? A. Use a soft toothbrush B. Encourage contact sports C. Give frequent IM injections D. Encourage vigorous flossing

A. Use a soft toothbrush — A soft toothbrush reduces trauma and bleeding risk in patients with thrombocytopenia.

50. A patient with peripheral artery disease reports cramping calf pain after walking that improves with rest. What is this symptom called? A. Rest pain B. Intermittent claudication C. Orthopnea D. Pleuritic pain

B. Intermittent claudication — Intermittent claudication is reproducible muscle pain caused by inadequate arterial blood flow during activity and relieved by rest.

51. A patient with severe peripheral arterial disease reports burning pain in the toes that awakens the patient at night. This is known as

A. Intermittent claudication B. Rest pain C. Stable angina D. Venous pain

B. Rest pain — In PAD, blood flow to the lower extremities becomes so compromised that tissues do not get enough oxygen even when the body is completely at rest. When the patient lies flat in bed, they lose the helpful effects of gravity that pulls blood into the extremities.

52. Which pulse is considered a sensitive and specific indicator of arterial function in the lower extremity? A. Radial pulse B. Posterior tibial pulse C. Carotid pulse D. Apical pulse

B. Posterior tibial pulse — The posterior tibial pulse is useful for assessing arterial circulation in the lower extremity.

53. A patient has an ankle-brachial index of 0.7. How should the nurse interpret this result? A. It is diagnostic of peripheral artery disease. B. It indicates normal arterial circulation. C. It confirms pulmonary embolism. D. It indicates severe anemia.

A. It is diagnostic of peripheral artery disease. — An ABI below 0.9 is considered abnormal and supports a diagnosis of peripheral arterial disease.

54. Which position should generally be avoided in severe peripheral arterial disease because it may decrease arterial flow? A. Sitting with the affected leg dependent B. Elevating the legs above heart level C. Sitting upright D. Allowing the legs to hang down

B. Elevating the legs above heart level — Elevating an ischemic extremity above heart level may decrease arterial blood flow. A dependent position can improve arterial flow through gravity.

55. Which activity is generally recommended to improve collateral circulation in peripheral arterial disease? A. Walking B. Prolonged bed rest C. Avoiding all exercise D. Continuous sitting

A. Walking — Regular walking exercise, when appropriate, can improve functional capacity and promote collateral circulation.

56. A patient with peripheral arterial disease asks how to protect the affected limb from injury. Which instruction is appropriate? A. Apply direct heat to the limb. B. Avoid prolonged cold exposure. C. Cross the legs frequently. D. Wear restrictive clothing.

B. Avoid prolonged cold exposure. — Cold causes vasoconstriction and can further decrease arterial circulation to an already ischemic extremity.

57. Why should direct heat be avoided in patients with peripheral arterial disease? A. It can cause burns because sensation may be reduced. B. It always causes hypertension. C. It causes blood clots immediately. D. It prevents oxygen delivery completely.

A. It can cause burns because sensation may be reduced. — Reduced sensation and poor circulation increase the risk of burns and tissue injury from direct heat.

58. A patient with peripheral artery disease is prescribed pentoxifylline. The medication helps primarily by

A. Improving red blood cell flexibility and blood flow

B. Increasing platelet aggregation

C. Dissolving pericardial fluid

D. Increasing blood clot formation

A. Improving red blood cell flexibility and blood flow — it is a hemoreologic agent used to treat PAD.

59. A patient undergoes percutaneous transluminal angioplasty. The procedure uses

A. A balloon catheter to dilate a narrowed artery

B. A needle to remove pericardial fluid

C. A bronchoscope to examine the lungs

D. A catheter to remove pleural fluid

A. A balloon catheter to dilate a narrowed artery — PTA, often simply called angioplasty, is a minimally invasive procedure that used to open blocked arteries or narrowed vessels.

60. A patient with Buerger disease continues to smoke despite repeated education. Which instruction is most important? A. Reduce smoking to one cigarette daily. B. Completely stop tobacco use. C. Increase caffeine intake. D. Apply direct heat to the feet.

B. Completely stop tobacco use. — Complete tobacco cessation is essential because continued smoking causes progressive vascular inflammation and ischemia in Buerger disease.

61. Buerger disease primarily affects

A. Small and medium blood vessels

B. Heart valves only

C. Pulmonary alveoli only

D. Large cerebral arteries only

A. Small and medium blood vessels — Bueger’s Disease aka thromboangiitis obliterans is a rare disease characterized by inflammation and clotting in the blood vessels.

62. A patient with Raynaud disease experiences an episode of finger discoloration. Which sequence is characteristic? A. Red → blue → white B. White/pale → blue → red C. Blue → red → white D. Yellow → green → blue

B. White/pale → blue → red — Raynaud episodes commonly progress from pallor or white, to cyanosis or blue, followed by redness as blood flow returns.

63. Which medication is commonly considered the drug of choice for Raynaud disease? A. Calcium channel blocker B. Warfarin C. Digoxin D. Ferrous sulfate

A. Calcium channel blocker — Calcium channel blockers reduce vasospasm and improve blood flow during Raynaud episodes.

64. A patient with Raynaud disease should be instructed to

A. Avoid extreme cold.

B. Smoke to promote relaxation.

C. Use prolonged direct heat.

D. Restrict all physical activity.

A. Avoid extreme cold — Exposure to cold causes sudden vessel constriction, leading to numbness, color changes (white, blue, then red), and pain. Avoiding extreme cold is the key lifestyle intervention to prevent these vasospastic attacks.

65. A patient develops DVT after prolonged immobilization. Which complication is the major concern? A. Pulmonary embolism B. Asthma C. Pneumonia only D. Raynaud disease

A. Pulmonary embolism — A DVT can dislodge and travel to the lungs, producing a potentially life-threatening pulmonary embolism.

66. Virchow’s triad includes endothelial injury, venous stasis, and

A. Hypercoagulability B. Hypertension C. Anemia D. Bronchospasm

A. Hypercoagulability

67. A patient with suspected DVT has unilateral leg swelling and calf pain. Which action should the nurse avoid? A. Elevating the extremity B. Assessing the affected limb C. Massaging the affected extremity D. Monitoring for pulmonary symptoms

C. Massaging the affected extremity — Massage can dislodge the thrombus and cause it to travel to the lungs, resulting in pulmonary embolism.

68. Why should a suspected DVT not be massaged? A. It may cause hypertension. B. It may dislodge the clot and cause an embolus. C. It increases red blood cell production. D. It causes bronchospasm.

B. It may dislodge the clot and cause an embolus. — Manipulation of the affected limb may dislodge the clot, allowing it to travel through the bloodstream.

69. Which medication is used to prevent further clot formation in DVT? A. Heparin B. Albuterol C. Digoxin D. Nitroglycerin

A. Heparin — Heparin is an anticoagulant used to prevent extension of an existing thrombus and formation of additional clots.

70. What medication reverses the effects of heparin? A. Vitamin K B. Protamine sulfate C. Alteplase D. Aspirin

B. Protamine sulfate — Protamine sulfate is the reversal agent for unfractionated heparin.

71. Warfarin works primarily by

A. Increasing platelet aggregation

B. Inhibiting production of vitamin K-dependent clotting factors

C. Dissolving existing clots immediately

D. Increasing red blood cell flexibility

B. Inhibiting production of vitamin K-dependent clotting factors — Warfarin (Coumadin) is an oral anticoagulant that works as a Vitamin K antagonist.

72. A patient receiving thrombolytic therapy should be closely monitored for

A. Intracerebral bleeding

B. Increased appetite

C. Improved platelet production

D. Hypertension only

A. Intracerebral bleeding

73. Which diagnostic test is considered the gold standard for diagnosing DVT according to the lecture? A. Contrast venography B. Chest X-ray C. Bronchoscopy D. Pulmonary function testing

A. Contrast venography — Contrast venography can directly visualize venous obstruction and has historically been considered the reference standard for DVT diagnosis.

74. A patient with varicose veins reports heavy, tired legs after prolonged standing. Which intervention may help? A. Elevating the legs when resting B. Avoiding all walking C. Sitting continuously D. Crossing the legs

A. Elevating the legs when resting — Elevation decreases venous pooling and promotes venous return.

75. Varicose veins commonly result from

A. Incompetent venous valves

B. Increased alveolar pressure

C. Coronary vasospasm

D. Low platelet count

A. Incompetent venous valves — Veins contain one-way valves that prevent blood from flowing backwards as it travels up to the heart. When these valves become weak or damaged, they fail to close properly.

76. Which intervention is appropriate for a patient with mild varicose veins? A. Regular walking B. Prolonged standing C. Avoidance of leg movement D. Restrictive clothing

A. Regular walking — Walking activates the calf-muscle pump, helping return venous blood toward the heart.

77. A patient is recovering from vein surgery. Which nursing action promotes venous return? A. Elevating the foot of the bed B. Keeping the legs dependent continuously C. Avoiding ambulation D. Crossing the legs

A. Elevating the foot of the bed — Elevation helps decrease venous pooling and edema and promotes venous return.

78. A patient with an abdominal aortic aneurysm is preparing for surgery. Which postoperative instruction is especially important? A. Perform forceful coughing frequently. B. Avoid activities that increase intra-abdominal pressure. C. Lift heavy objects immediately. D. Strain during bowel movements.

B. Avoid activities that increase intra-abdominal pressure. — Increased intra-abdominal pressure can place stress on the surgical area and should be avoided after AAA repair.

79. After abdominal aortic aneurysm surgery, the nurse should carefully assess

A. Peripheral pulses

B. Gag reflex only

C. Bowel sounds only

D. Visual acuity

A. Peripheral pulses - During AAA repair, blood vessels are clamped and a synthetic graft is sewn in place. A major complication post-surfer is a blood clot forming at the graft site or a small piece of plaque breaking off and traveling down into the legs.

80. Which instruction is appropriate for a patient after AAA repair? A. Avoid coughing and activities that increase intra-abdominal pressure. B. Perform vigorous abdominal exercises. C. Lift heavy objects daily. D. Remain completely immobile for several weeks.

A. Avoid coughing and activities that increase intra-abdominal pressure. — Activities that sharply increase intra-abdominal pressure can place stress on the repaired aorta and surgical area.

81. A patient develops a thrombus inside a blood vessel. Which term describes the clot itself? A. Embolus B. Thrombus C. Aneurysm D. Murmur

B. Thrombus — A thrombus is a blood clot that forms and remains attached within a blood vessel.

82. A clot breaks away from its original location and travels through the bloodstream. It is now called a/an

A. Thrombus B. Embolus C. Aneurysm D. Plaque

B. Embolus — An embolus is any detached mass that breaks away from its original site and travels through the blood stream.

83. A patient is prescribed heparin for DVT. Which adverse effect should the nurse monitor for most closely? A. Bleeding B. Hyperglycemia C. Increased appetite D. Bronchospasm

A. Bleeding — Heparin increases the risk of bleeding, so the nurse should monitor for bruising, bleeding, and abnormal laboratory results.

84. A patient receiving anticoagulant therapy asks what activity should be avoided. Which response is appropriate? A. Contact sports that increase trauma risk B. Walking C. Light daily activity D. Normal bathing

A. Contact sports that increase trauma risk — Anticoagulants increase bleeding risk, so activities that can cause significant trauma should be avoided.

85. A patient with PAD has an arterial ulcer. Which location is most characteristic? A. Around the ankle B. Ends or between the toes C. Upper abdomen D. Sacral area

B. Ends or between the toes — Arterial ulcers commonly occur on the toes, between the toes, or other distal areas with poor arterial circulation.

86. Which finding is more characteristic of an arterial ulcer than a venous ulcer? A. Poor peripheral pulses B. Normal peripheral pulses C. Ankle discoloration only D. Severe venous pooling

A. Poor peripheral pulses — Arterial ulcers are associated with reduced arterial blood flow and diminished or absent peripheral pulses.

87. A patient with peripheral arterial disease has cold, pale, cyanotic skin and hair loss on the affected leg. These findings are primarily associated with

A. Reduced arterial blood flow

B. Increased venous return

C. Increased platelet production

D. Pulmonary congestion

A. Reduced arterial blood flow — PAD is caused by the narrowing or blockage of arteries, which carry oxygen-rich blood away from the heart to the limbs

88. A patient with DVT asks why bed rest and elevation may be prescribed initially. The primary goal is to

A. Reduce the risk of embolization and promote venous return

B. Increase arterial vasospasm

C. Increase clot formation

D. Increase pulmonary pressure

A. Reduce the risk of embolization and promote venous return — Elevating the affected leg uses gravity to help pulled pooled blood back out the lower extremities toward the heart, which promotes venous return and reduces swelling, pain, and edema.

89. Which of the following is one component of Virchow’s triad? A. Venous stasis B. Bronchospasm C. Alveolar destruction D. Pericardial inflammation

A. Venous stasis — Virchow’s triad includes venous stasis, endothelial injury, and hypercoagulability.

90. A patient with COPD has difficulty exhaling because of loss of elastic recoil. Which condition is most consistent with this finding? A. Emphysema B. Pericarditis C. DIC D. Endocarditis

A. Emphysema — Emphysema involves destruction of alveolar walls and loss of elastic recoil, resulting in air trapping and difficulty exhaling.

91. A client with varicose veins is being discharged after treatment. Which instruction should the nurse include to promote venous return? A. Keep the legs dependent for long periods. B. Elevate the feet and legs when resting. C. Avoid walking. D. Sit continuously throughout the day.

B. Elevate the feet and legs when resting — Elevating the legs helps promote venous return and decreases venous pooling and edema.

92. A client with varicose veins is prescribed elastic support stockings. When should the nurse recommend putting them on? A. After standing for several hours B. After the legs become swollen C. Before prolonged standing or activity D. Only while sleeping

C. Before prolonged standing or activity — Support stockings help prevent venous pooling and should be applied before prolonged standing or activity, when the legs are less swollen.

93. A client with varicose veins asks why walking is encouraged. Which response by the nurse is best? A. “Walking helps improve venous return through muscle contraction.” B. “Walking eliminates damaged valves.” C. “Walking immediately removes the varicose veins.” D. “Walking prevents all future vascular disease.”

A. “Walking helps improve venous return through muscle contraction.” — Contraction of the lower-leg muscles helps push venous blood back toward the heart and improves venous return.

94. A nurse is caring for a client following vein surgery. Which assessment is the priority? A. Hair growth B. Distal circulation C. Appetite D. Bowel sounds

B. Distal circulation — After vascular surgery, the nurse should closely assess circulation, including peripheral pulses, skin color, temperature, sensation, and swelling.

95. A client with an abdominal aortic aneurysm is preparing for surgical repair. Which nursing instruction is especially important? A. Encourage vigorous coughing. B. Encourage activities that increase intra-abdominal pressure. C. Teach deep-breathing exercises while avoiding coughing. D. Encourage heavy lifting.

C. Teach deep-breathing exercises while avoiding coughing — Deep breathing is encouraged, but coughing should be avoided because it increases intra-abdominal pressure and tension at the surgical site.

96. A client recovering from abdominal aortic aneurysm repair asks why heavy lifting should be avoided. What is the best response? A. It may increase intra-abdominal pressure. B. It decreases blood glucose. C. It causes venous valves to close. D. It improves arterial circulation too quickly.

A. It may increase intra-abdominal pressure. — Increased intra-abdominal pressure can place stress on the surgical area and should therefore be avoided after AAA repair.

97. A nurse is assessing a client with an abdominal aortic aneurysm. Which assessment is particularly important? A. Peripheral pulses B. Pupil size C. Bowel frequency only D. Hearing acuity

A. Peripheral pulses — Peripheral pulses help the nurse assess tissue perfusion and detect changes in circulation.

98. A client with peripheral arterial disease has pale skin when the leg is elevated. What does this finding suggest? A. Normal venous circulation B. Arterial insufficiency C. Improved arterial flow D. Normal tissue perfusion

B. Arterial insufficiency — Pallor when the extremity is elevated is a characteristic finding associated with decreased arterial blood flow.

99. A nurse assesses a client with suspected arterial disease. Which skin finding would support the diagnosis? A. Warm, moist skin with normal hair growth B. Dry, scaly skin with hair loss C. Soft, pink skin with increased circulation D. Generalized flushing only

B. Dry, scaly skin with hair loss — Arterial insufficiency can cause hair loss, dry or scaly skin, pallor, mottling, and a cold extremity.

100. A client with peripheral arterial disease develops an ulcer between the toes. The nurse notes thickened toenails and poor peripheral pulses. Which type of ulcer is most likely? A. Arterial ulcer B. Venous ulcer C. Pressure ulcer D. Surgical ulcer

A. Arterial ulcer — Arterial ulcers commonly occur at the ends or between the toes and are associated with poor peripheral pulses and thickened toenails.