Question 1 of 6
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Which sign or symptom may indicate a thoracic aortic dissection with possible rupture? Select all that apply. One, some, or all responses may be correct.
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- Excruciating chest painThe patient would have excruciating chest pain with an aortic dissection.
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- Diminished peripheral pulsesThe patient would have diminished peripheral pulses with an aortic dissection.
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- Visible pulsation in the abdomenA patient would have a visible pulsation in an abdominal aortic aneurysm.
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- Vomiting bright red bloodVomiting bright red blood is not expected because the blood loss would be occurring outside of the gastrointestinal tract.
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- Precipitous drop in blood pressureA sudden drop in blood pressure suggests a rupture.
Question 2 of 6
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Which environmental modification would the home health nurse suggest for a patient who has Raynaud disease?
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- Place frequently used personal items within easy reach.Decreased perfusion and oxygenation can cause fatigue, and placing items within easy reach helps to conserve energy, but fatigue is not anticipated in Raynaud disease.
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- Control room temperature, and limit use of air conditioner.Blood vessels normally constrict in cold environments; however, with Raynaud disease, this process is excessive. The affected body part may display a series of color changes from white to blue to red; these changes are evident on the dorsal surface of the hands and feet.
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- Sit in a recliner chair, and keep legs slightly elevated.Elevation of legs is recommended to reduce swelling in venous disorders, such as varicose veins or deep vein thrombosis.
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- Install safety bars in the bathroom and handrails in walkways.Safety bars and handrails may be recommended for patients who have orthostatic hypotension or dizziness related to carotid artery disease.
Question 3 of 6
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The nurse in the emergency department is caring for a patient with severe back pain and a suspected aortic dissection. Which is the priority action by the nurse?
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- Check peripheral pulses.The nurse should check the peripheral pulses because they may be diminished with aortic dissection, but this is not the priority action.
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- Apply oxygen via nasal cannula.It is unclear in this scenario whether the patient requires oxygen, so this is not the priority action by the nurse.
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- Administer analgesics as ordered.Though the patient will need pain medication, this is not the priority intervention because it is not addressing the cause of the pain, which is the aortic dissection.
- Correct
- Initiate intravenous fluids as ordered.Intravenous fluids should be initiated immediately for a patient with an aortic dissection to prevent hypotensive shock.
Question 4 of 6
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The nurse is caring for a patient newly diagnosed with a 4-cm thoracic aneurysm. Which intervention would the nurse anticipate?
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- Maintain the patient on strict bedrest.Strict bedrest is not indicated for a patient with a small thoracic aneurysm.
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- Administer a β-blocker as prescribed.Antihypertensives are often prescribed for patients with small aneurysms to reduce the pressure on the arterial walls and prevent dissection.
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- Prepare the patient for emergency surgery.Surgery is considered for thoracic aneurysms that are 5.5 to 6.5 cm in diameter.
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- Schedule a follow-up visit in 1 year to check growth of the aneurysm.Patients with small aneurysms that do not require surgery will need monitoring every couple of months to check the growth of the aneurysm.
Question 5 of 6
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Which type of medication would the nurse anticipate administering to a patient diagnosed with Raynaud disease? Select all that apply. One, some, or all responses may be correct.
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- β-blockersβ-Blockers are not indicated for the treatment of Raynaud disease.
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- α-blockersα-Blockers can be used to achieve vasodilation in the small vessels of the hands to improve Raynaud disease symptoms.
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- Angiotensin-converting enzyme (ACE) inhibitorsACE inhibitors are not used to treat Raynaud disease.
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- Synthetic prostaglandinsSynthetic prostaglandins such as iloprost works by dilating arterial beds throughout the body and extremities.
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- Calcium channel blockersCalcium channel blockers are used to treat Raynaud disease; they work by dilating the capillaries of the hand and feet.
Question 6 of 6
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Which patient statement indicates an understanding of teaching about Raynaud disease?
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- “I should take cool showers.”Patients with Raynaud disease need to stay warm to prevent symptoms, so warm or hot showers should be taken.
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- “I should try to find ways to decrease my stress.”Stress can result in symptoms of Raynaud disease, so it is important for the patient to engage in stress-reducing activities.
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- “It is fine to continue smoking if done in moderation.”Patients with Raynaud disease should stop smoking completely to decrease their symptoms.
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- “There is no need to wear gloves in the winter if I am only outside for a short time.”Gloves should be worn any time the patient with Raynaud disease is outside in the cold, as the cold temperatures can cause symptoms.
