Venous Thromboembolism:
Question 1 of 10
Why is a patient who leads a sedentary lifestyle at increased risk for developing a venous
thromboembolism (VTE)?
Platelet aggregation is increased during inactivity.
A sedentary lifestyle causes damage to the vein endothelium.
Muscles that are inacti...
BSN 266 SHERPATHS QUESTIONS AND
ANSWERS 2024/2025
Venous Thromboembolism:
Question 1 of 10
Why is a patient who leads a sedentary lifestyle at increased risk for developing a venous
thromboembolism (VTE)?
Platelet aggregation is increased during inactivity.
A sedentary lifestyle causes damage to the vein endothelium.
Muscles that are inactive have a higher incidence of venous stasis.
Inactivity leads to dysfunctional valves and a change in the unidirectional blood flow.
→ Muscles that are inactive have a higher incidence of venous stasis.
→ Venous stasis can occur when the muscles of the extremities are inactive. Venous stasis
is a risk factor in Virchow's triad.
Question 2 of 10
Which patient is showing clinical manifestations of a lower extremity venous thromboembolism
(VTE)?
The patient with a palpable subcutaneous cordlike vein with itchiness
The patient with unilateral leg edema with tenderness and warm skin
The patient with lower extremity pain during walking that is relieved by rest
The patient with shortness of breath, chest pressure, and low oxygen saturation
→ The patient with unilateral leg edema with tenderness and warm skin
→ Not all patients with lower extremity VTE will experience symptoms. However, when
present, patients will present with unilateral leg edema, pain, paresthesia erythema,
and warm skin and fever.
Question 3 of 10
A patient presents to the emergency department with shortness of breath. Which laboratory
finding would be most concerning to the nurse?
D-dimer 441 mcg/L
WBC 7800 cells/mcL
Troponin <0.01 ng/mL
Brain Natriuretic Peptide (BNP) 10 pg/mL
→ D-dimer 441 mcg/L
→ This D-dimer level would be most concerning. An elevated D-dimer can aid in the
diagnosis of suspected pulmonary embolism (PE). Further assessment is needed for this
patient immediately.
Question 4 of 10
The patient with a history of venous thromboembolism (VTE) has been taking warfarin long-
term and presents to the clinic with frequent nosebleeds. Which laboratory value should cause
the nurse to contact the ordering health care provider?
Platelet count 275,000/mm3
Prothrombin time (PT) 18.2 seconds
International normalized ratio (INR) 6.3
Activate Partial Thromboplastin Time (aPTT) 34 seconds
→ International normalized ratio (INR) 6.3
→ This finding would indicate the warfarin dosing needs adjustment. An INR level of 4.3 is
above the therapeutic range, putting the patient at risk for hemorrhage. The nurse
should communicate this finding to the ordering health care provider.
Question 5 of 10
The patient with a lower extremity venous thromboembolism (VTE) is receiving heparin sodium
intravenously (IV) and is scheduled for emergency surgery. Which action will the nurse
anticipate?
Administer intravenous protamine.
Administer intramuscular (IM) Vitamin K.
Monitor international nationalized ratio (INR) level.
Communicate with perioperative nurse to monitor for bleeding.
→ Administer intravenous protamine.
→ Protamine is the reversal agent of heparin and should be administered as ordered to
prepare the patient for surgery. If the aPTT remains high during surgery, the patient is
at risk for hemorrhage.
Question 6 of 10
The nurse is caring for a patient with venous thromboembolism (VTE) on bedrest. Which nursing
intervention is most appropriate?
Assess the patient's mobility status with the physical therapist.
Teach the patient to flex and extend their legs and feet every four to six hours.
Apply small graduate compression stockings to ensure appropriate compression.
Delegate to the unlicensed assistant personnel (UAP) to reposition the patient every two hours.
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