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NSG 210 Clotting Questions With Complete Solutions

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nsg 210 clotting questions with complete solutions

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NSG 210 Clotting Questions With Complete Solutions

A 28-year-old female patient inquires about options for
contraception. The nurse recognizes that if the patient takes an
estrogen-based oral contraceptive, her risk for venous
thromboembolism (VTE) doubles based on what statement that
is made by the patient?
a. "I smoke 1 ½ packs of cigarettes a day."
b. "I have a job as a waitress."
c. "I like to sit in my hot tub in the evenings."
d. "It's been three years since my last child was born." Correct
Answer A

Women of childbearing age who take estrogen-based oral
contraceptives or postmenopausal women on oral hormone
therapy (HT) are at increased risk for VTE. Women who use
oral contraceptives and tobacco double their risk. Smoking
causes hypercoagulability by increasing plasma fibrinogen and
homocysteine levels and activating the intrinsic coagulation
pathway. Occupations in which a patient is mobile, hot tub use,
and previous childbirth do not indicate increased risk of VTE.

A 46-year-old service-counter worker undergoes sclerotherapy
for treatment of superficial varicose veins at an outpatient
center. Which instructions should the nurse provide to the
patient before discharge?
a. Sitting at the work counter, rather than standing, is
recommended.
b. Exercise, such as walking or jogging, can cause recurrence of
varicosities.

,c. Elastic compression stockings should be applied before
getting out of bed.
d. Taking an aspirin daily will help prevent clots from forming
around venous valves. Correct Answer ANS: C
Elastic compression stockings are applied with the legs elevated
to reduce pressure in the lower legs. Walking is recommended to
prevent recurrent varicosities. Sitting and standing are both risk
factors for varicose veins and venous insufficiency. An aspirin a
day is not adequate to prevent venous thrombosis and would not
be recommended for the patient who had just had sclerotherapy.

A 67-year-old patient is admitted to the hospital with a diagnosis
of venous insufficiency. Which patient statement is most
supportive of the diagnosis?
a. "I can't get my shoes on at the end of the day."
b. "I can't seem to ever get my feet warm enough."
c. "I have burning leg pains after I walk two blocks."
d. "I wake up during the night because my legs hurt." Correct
Answer ANS: A
Because the edema associated with venous insufficiency
increases when the patient has been standing, shoes will feel
tighter at the end of the day. The other patient statements are
characteristic of peripheral artery disease (PAD).

A 73-year-old patient with chronic atrial fibrillation develops
sudden severe pain, pulselessness, pallor, and coolness in the
right leg. The nurse should notify the health care provider and
immediately
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.

, d. keep the patient in bed in the supine position. Correct Answer
ANS: D
The patient's history and clinical manifestations are consistent
with acute arterial occlusion, and resting the leg will decrease
the oxygen demand of the tissues and minimize ischemic
damage until circulation can be restored. Elevating the leg or
applying an elastic wrap will further compromise blood flow to
the leg. Exercise will increase oxygen demand for the tissues of
the leg.

A patient at the clinic says, "I have always taken a walk after
dinner, but lately my leg cramps and hurts after just a few
minutes of starting. The pain goes away after I stop walking,
though." The nurse should
a. check for the presence of tortuous veins bilaterally on the
legs.
b. ask about any skin color changes that occur in response to
cold.
c. assess for unilateral swelling, redness, and tenderness of either
leg.
d. assess for the presence of the dorsalis pedis and posterior
tibial pulses. Correct Answer ANS: D
The nurse should assess for other clinical manifestations of
peripheral arterial disease in a patient who describes intermittent
claudication. Changes in skin color that occur in response to
cold are consistent with Raynaud's phenomenon. Tortuous veins
on the legs suggest venous insufficiency. Unilateral leg swelling,
redness, and tenderness indicate venous thromboembolism
(VTE).

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