PAD
A statement by the patient indicates a need for further teaching about PVD.
A. "I should elevate my legs when sitting for long periods."
B. "I will wear compression stockings as prescribed."
C. "I will soak my feet in warm water daily to improve circulation."
D. "I need to inspect my feet daily for any cuts or sores."
What is "I will soak my feet in warm water daily to improve circulation?"
Rationale:
Soaking feet in warm water can lead to maceration, increasing the risk of infection, especially in patients with poor circulation. Instead, patients should wash their feet daily with lukewarm water and dry them thoroughly.
A foot care practice a patient with PVD should follow is.
A. Trim toenails straight across and file sharp edges
B. Cut toenails as short as possible to prevent ingrown nails
C. Walk barefoot at home to toughen the skin
D. Use over-the-counter corn removers for calluses
What is trim toenails straight across and file sharp edges?
Rationale: Cutting nails straight across prevents ingrown toenails. Walking barefoot increases the risk of injury, and OTC corn removers can cause skin breakdown.
A patient presents to the emergency department with chest pain. A characteristic that suggests a musculoskeletal cause rather than a cardiac cause is
A. Pain is described as a deep, crushing sensation in the chest
B. Pain is worsened by movement or palpation of the chest wall
C. Pain radiates to the jaw and left arm
D. Pain is associated with shortness of breath and diaphoresis
What is pain is worsened by movement or palpation of the chest wall?
Rationale: Musculoskeletal pain is often localized, reproducible with movement, and worsened with palpation, whereas cardiac pain is typically pressure-like, radiating, and associated with systemic symptoms like diaphoresis.
A patient with peripheral arterial disease (PAD) reports leg pain. A description is most consistent with PAD pain is.
A. Pain worsens when legs are elevated and improves when dependent
B. Pain improves with elevation and worsens when dangling the legs
C. Pain is described as aching and relieved with rest
D. Pain is associated with warm, swollen legs
What is pain worsens when legs are elevated and improves when dependent?
Rationale: PAD pain is due to poor arterial blood flow, which worsens with elevation and improves when the legs are dependent (hanging down) due to gravity-assisted blood flow.
The most significant modifiable risk factor for peripheral arterial disease (PAD) is.
A. Advanced age
B. Smoking
C. Gender
D. Family history
What is smoking?
Rationale: Smoking is the most significant modifiable risk factor for PAD because it promotes atherosclerosis, reduces blood flow, and increases the risk of clot formation. Quitting smoking can significantly reduce the progression of PAD.
A patient with PAD is experiencing pain in the legs while walking. The nurse should advise the patient to:
A. Avoid walking and rest as much as possible
B. Walk until the pain occurs, rest, then resume walking
C. Keep the legs elevated to relieve pain
D. Perform only upper body exercises to avoid leg pain
What is walk until the pain occurs, rest, then resume walking?
Rationale: This method, known as "graded exercise therapy," helps improve circulation by promoting collateral blood vessel development. Avoiding walking worsens symptoms over time.
A nurse is educating a patient with PVD about proper skin care. A statement that indicates the patient understands the teaching is.
A. "I will apply lotion between my toes daily to prevent dryness."
B. "I should avoid tight socks that leave marks on my legs."
C. "I will check my feet once a week for any skin changes."
D. "I should massage my legs if I notice swelling."
What is "I should avoid tight socks that leave marks on my legs?"
Rationale: Tight socks can restrict circulation and worsen venous insufficiency. Lotion should not be applied between the toes to prevent fungal infections.
A patient reports left arm pain that is relieved by rest. The nurse understands this could indicate:
A. A muscle strain
B. Angina
C. A pinched nerve
D. Tendonitis
What is angina?
Rationale: Angina is a cardiac-related pain that occurs with exertion and improves with rest. Musculoskeletal pain (e.g., strain or tendonitis) is usually persistent and worsened with movement.
A patient with peripheral venous disease (PVD) is most likely to describe their leg pain as:
A. Sharp, cramping pain that worsens with walking and improves with rest
B. Aching, heavy feeling in the legs that improves with elevation
C. Sudden, intense pain with pale, cold skin
D. Burning sensation that worsens with leg dependency
What is aching, heavy feeling in the legs that improves with elevation.
Rationale: PVD is characterized by venous pooling, leading to a heavy, aching sensation that improves with elevation because it helps return blood to the heart.
A nurse is educating a patient about the relationship between hypertension and peripheral arterial disease (PAD). A statement by the patient that indicates a need for further teaching is.
A. "High blood pressure damages the arteries, making them narrow and stiff."
B. "Keeping my blood pressure under control will lower my risk of PAD."
C. "If I have PAD, my blood pressure is not important."
D. "Hypertension can contribute to the progression of PAD."
What is "if I have PAD, my blood pressure is not important?"
Rationale: Hypertension is a major risk factor for PAD as it damages the arterial walls, promoting atherosclerosis. Proper management of blood pressure is crucial to prevent complications.
The reason why a patient with chronic venous insufficiency should wear compression stockings is.
A. "Compression stockings help improve circulation by promoting blood return to the heart."
B. "They will keep your legs warm and prevent muscle cramps."
C. "You should only wear them when you feel leg pain."
D. "They will prevent blood clots from forming in your legs."
What is "compression stockings help improve circulation by promoting blood return to the heart?"
Rationale:
Compression stockings help reduce venous stasis and swelling by promoting venous return. They should be worn consistently as prescribed, not just when pain is present.
A patient with PVD is advised to stop smoking. The patient asks why this is necessary. The best response by the nurse is.
A. "Smoking decreases blood flow and worsens circulation problems."
B. "Smoking increases your risk of lung infections."
C. "Smoking causes your heart to beat faster, leading to high blood pressure."
D. "Smoking only affects lung health, not circulation."
What is "smoking decreases blood flow and worsens circulation problems?"
Rationale: Nicotine causes vasoconstriction, reducing blood flow and worsening PVD. Smoking cessation is one of the most effective interventions to slow disease progression.
A patient states, "My chest pain worsens when I take a deep breath or lie down." The nurse suspects which cause?
A. Myocardial infarction
B. Costochondritis
C. Unstable angina
D. Aortic dissection
What is costochondritis?
Rationale: Costochondritis is an inflammation of the cartilage in the chest wall, and its pain is often sharp, localized, and worsened by deep breathing or movement. Cardiac pain is typically not affected by respiration.
A nurse is assessing a patient with suspected PAD. A finding is most concerning is.
A. Warm, reddened skin with mild edema
B. Brown discoloration around the ankles
C. Pale, cool skin with weak pulses and ulcer formation on the toes
D. Varicose veins with moderate swelling
What is pale, cool skin with weak pulses and ulcer formation on the toes.
Rationale: These findings suggest severe arterial insufficiency, which can lead to tissue necrosis and gangrene. PAD ulcers are typically found on the toes, whereas PVD ulcers occur on the lower legs and ankles
A patient diagnosed with PAD asks how diabetes affects the condition. The best response by the nurse is.
A. "Diabetes increases your risk of PAD by causing nerve damage."
B. "Diabetes can lead to poor circulation by damaging blood vessels."
C. "Diabetes has no significant impact on PAD development."
D. "Diabetes only affects small blood vessels, not large arteries."
What is diabetes can lead to poor circulation by damaging blood vessels?"
Rationale: Diabetes is a major risk factor for PAD because high blood sugar levels cause endothelial damage, increase inflammation, and contribute to plaque buildup, leading to narrowed arteries and reduced circulation.
A patient with PVD asks how to prevent complications related to poor circulation. A statement by the patient that requires further teaching is.
A. "I should avoid crossing my legs when sitting."
B. "I should apply heating pads to my legs to improve circulation."
C. "I will inspect my feet daily for cuts or sores."
D. "I should keep my feet clean and dry at all times."
What is "I should apply heating pads to my legs to improve circulation?"
Rationale: Heating pads can cause burns due to reduced sensation in PVD patients. Instead, they should use warm socks for comfort and avoid direct heat sources.
The nurse is discussing dietary modifications with a patient who has PVD. The dietary change that is most beneficial would be.
A. Increasing sodium intake to maintain fluid balance
B. Eating more fiber-rich foods and lean proteins
C. Consuming processed foods to increase energy
D. Drinking less water to prevent swelling
What is eating more fiber-rich foods and lean proteins?
Rationale: A heart-healthy diet high in fiber and lean proteins helps manage cholesterol and blood pressure, reducing the risk of worsening PVD. Sodium should be limited to prevent fluid retention.
A nurse is assessing a patient with suspected cardiac pain. The finding that would require immediate intervention is.
A. Pain that worsens with palpation
B. Sharp, stabbing pain on deep inspiration
C. Chest pain that radiates to the jaw and left arm with nausea
D. Pain that resolves with repositioning
What is chest pain that radiates to the jaw and left arm with nausea.
Rationale: This is a classic presentation of a myocardial infarction (MI) and requires immediate intervention. Musculoskeletal or pleuritic pain is usually positional or affected by movement.
A patient who is most at risk for developing PAD.
A. A 30-year-old pregnant woman with varicose veins
B. A 50-year-old smoker with uncontrolled diabetes and hypertension
C. A 45-year-old teacher with chronic venous insufficiency
D. A 25-year-old athlete with intermittent leg cramps
What is a 50-year-old smoker with uncontrolled diabetes and hypertension?
Rationale: Smoking, diabetes, and hypertension are major risk factors for PAD because they contribute to arterial narrowing and reduced blood flow.
A patient who is at the highest risk for developing PAD is.
A. A 25-year-old female who does not smoke and exercises regularly
B. A 40-year-old male with a total cholesterol level of 160 mg/dL
C. A 65-year-old male with hypertension, diabetes, and a 40-year smoking history
D. A 50-year-old female with a family history of PAD but no other risk factors
Who is a 65-year-old male with hypertension, diabetes, and a 40-year smoking history?
Rationale: Older age, smoking, hypertension, and diabetes are all significant risk factors for PAD. This patient has multiple risk factors that increase his likelihood of developing the disease.
The nurse is teaching a patient with peripheral artery disease (PAD) about lifestyle modifications. The lifestyle modifications recommendation that is most important for the patient is.
A. "Increase your intake of high-fat foods to maintain energy levels."
B. "Engage in a supervised walking program to improve circulation."
C. "Avoid all physical activity to prevent leg pain."
D. "Elevate your legs to improve arterial circulation."
What is "engage in a supervised walking program to improve circulation?"
Rationale: Walking programs improve circulation by promoting collateral vessel formation. Patients should rest when pain occurs, then continue walking.
A footwear choice that is best for a patient with PVD is
A. Tight-fitting shoes to provide support
B. Loose sandals to allow air circulation
C. Well-fitting, closed-toe shoes with cushioned soles
D. High-heeled shoes to prevent blood pooling
What is a well-fitting, closed-toe shoes with cushioned soles.
Rationale: Properly fitting shoes protect the feet from injury and pressure points, reducing the risk of ulcers. Tight or loose shoes increase the risk of blisters, and high heels may impair circulation.
A patient describes pain in the upper back after lifting heavy objects. The finding that would suggest a musculoskeletal cause rather than a cardiac cause is.
A. Pain is relieved by nitroglycerin
B. Pain worsens with deep breathing and movement
C. Pain radiates down the left arm
D. Pain is associated with dizziness and sweating
What is pain worsens with deep breathing and movement?
Rationale: Musculoskeletal pain is usually aggravated by movement, while cardiac pain is typically unaffected by movement and relieved by nitroglycerin.
A nurse is educating a patient about differences between PAD and PVD. A statement that indicates a need for further teaching is.
A. "PAD pain gets worse when I walk and improves when I rest."
B. "With PAD, my legs should be elevated to improve circulation."
C. "With PVD, I might experience swelling and brown discoloration on my lower legs."
D. "With PAD, my feet might be cool to the touch due to poor blood flow."
What is "with PAD, my legs should be elevated to improve circulation?"
Rationale: In PAD, elevation worsens pain because it reduces arterial blood flow. In contrast, in PVD, elevation helps by reducing venous pooling and edema.
A nurse is counseling a patient with PAD about dietary changes. A recommendation that is most appropriate is.
A. Increase sodium intake to improve blood pressure regulation
B. Consume a diet high in saturated fats to maintain energy levels
C. Reduce cholesterol intake and consume more fiber-rich foods
D. Avoid all carbohydrates to prevent blood sugar spikes
What is reduce cholesterol intake and consume more fiber-rich foods?
Rationale: A diet low in cholesterol and high in fiber helps manage blood lipid levels and reduces the risk of atherosclerosis, which is a key factor in PAD progression.