Chapter 26 Drugs Used to Treat Peripheral Vascular Disease

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Chapter 26  Drugs Used to Treat Peripheral Vascular Disease

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The nurse is assessing the patient’s leg for peripheral vascular disease (PVD) and is unable to palpate the pedal pulse in either foot. Which action will the nurse take first?
a.
Contact the health care provider for further orders.
b.
Request x-ray studies of the lower extremities.
c.
Request that the patient lie flat.
d.
Obtain a Doppler ultrasound device for auscultation.

ANS: D
The Doppler ultrasound device may aid in determining peripheral blood flow. This is not a sufficient cause to notify the health care provider and does not warrant radiologic examination without further assessment. Positioning will not affect the assessment of pedal pulses.

DIF: Cognitive Level: Application REF: p. 418 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

2. What is the action of pentoxifylline (Trental), a hemorheologic agent used to treat chronic occlusive arteriole disease?
a.
Vasodilates the peripheral arteries
b.
Potentiates the blood clotting mechanism
c.
Increases erythrocyte flexibility
d.
Increases blood viscosity

ANS: C
Pentoxifylline enhances red blood cell (erythrocyte) flexibility, which reduces blood viscosity. This allows for more blood to perfuse into the tissues. Muscle tissues become better oxygenated and intermittent claudication is reduced. Pentoxifylline does not cause vasodilation. Pentoxifylline acts to decrease clotting and decreases blood viscosity.

DIF: Cognitive Level: Comprehension REF: p. 420 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

3. Which assessment verifies increased blood perfusion to the lower extremities?
a.
Toes cool to the touch
b.
Decreased sensation below the knees
c.
Increased amplitude of pedal pulses
d.
Paleness of the foot

ANS: C
The pressure of blood as it is pushed against an artery is detected as a pulse. Increased pulse amplitude indicates increased blood flow. Coolness and decreased sensation usually correlate with decreased blood perfusion. Paleness or blanching does not indicate increased blood perfusion.

DIF: Cognitive Level: Comprehension REF: p. 420 OBJ: 2
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

4. Which patient statement indicates to the nurse that the patient has a good understanding of PVD?
a.
“Symptoms are warning signs of the increased potential to develop diseases.”
b.
“Pharmacologic treatments can reverse the disease process.”
c.
“Surgical interventions will cure the disease.”
d.
“Controlling contributing factors may affect the progression of the disease.”

ANS: D
Patients must be taught the interrelationships between the PVD and other related diseases that they may have, such as diabetes, hypertension, angina, and hyperlipidemia. Control or lack of control of the contributing factors of these related diseases will significantly affect the progression of the PVD. PVD is usually a development that is related to other diseases already present in the body. PVD can be controlled but not cured or completely reversed. Surgical interventions will not cure the disease, although it may somewhat control the vascular damage.

DIF: Cognitive Level: Comprehension REF: pp. 416-417 OBJ: 4 | 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

5. The nurse is assessing a patient on papaverine therapy and notes tachycardia, which is a compensatory effect of which condition?
a.
Hypoventilation
b.
Hypotension
c.
Excessive sympathetic stimulation
d.
Adrenergic suppression

ANS: B
An adverse effect of papaverine therapy is hypotension. When blood pressure drops, cardiac output decreases, and there is less available oxygenated blood flowing to the periphery. Baroreceptors trigger the heart to increase the rate, which causes tachycardia to maintain cardiac output and the perfusion of oxygenated blood to the tissues. Tachycardia is not compensatory for hypoventilation, sympathetic stimulation, or adrenergic suppression.

DIF: Cognitive Level: Application REF: p. 421 OBJ: 5
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

 

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