PVD NCLEX Practice Questions Question What is a priority nursing intervention in the care of a patient with a diagnosis of chronic venous insufficiency (CVI)? A. Applying topical antibiotics to venous ulcers B. Maintaining the patient’s legs in a dependent position C. Administering oral and/or subcutaneous anticoagulants D. Teaching the patient the correct use of compression stockings Answer Correct Answer: Teaching the patient the correct use of compression stockings Rationale: CVI requires conscientious and consistent application of compression stockings. Anticoagulants are not necessarily indicated and antibiotics, if required, are typically oral or IV, not topical. The patient should avoid prolonged positioning with the limb in a dependent position. Question Which assessment finding would alert the nurse that a postoperative patient is not receiving the beneficial effects of enoxaparin (Lovenox)? A. Crackles bilaterally in the lung bases B. Pain and swelling in a lower extremity C. Absence of arterial pulse in a lower extremity D. Abdominal pain with decreased bowel sounds Answer Correct Answer: Pain and swelling in a lower extremity Rationale: Enoxaparin is a low-molecular-weight heparin used to prevent the development of deep vein thromboses (DVTs) in the postoperative period. Pain and swelling in a lower extremity can indicate development of DVT and therefore may signal ineffective medication therapy. Hold the daily dose of warfarin. Question The nurse is reviewing the laboratory test results for a patient whose warfarin (Coumadin) therapy was stopped before surgery. On postoperative day 2, the international normalized ratio (INR) result is 2.7. Which action by the nurse is most appropriate? A. Hold the daily dose of warfarin. B. Administer the daily dose of warfarin. C. Teach the patient signs and symptoms of bleeding. D. Call the health care provider to request an increased dose of warfarin. Answer Correct Answer: Administer the daily dose of warfarin. Rationale: The therapeutic range for INR is 2.0 to 3.0 for many clinical diagnoses. To maintain therapeutic values, the nurse will administer the medication as ordered. Holding the medication would lower the INR, which would increase the risk of clot formation. Conversely, the higher the INR is, the more prolonged the clotting time. Calling the health care provider is not indicated. Although teaching is important, administering the medication is a higher priority at this time. Question A postoperative patient asks the nurse why the provider ordered daily administration of enoxaparin (Lovenox). Which reply by the nurse is accurate? A. “This medication will help prevent breathing problems after surgery, such as pneumonia.” B. “This medication will help lower your blood pressure to a safer level, which is very important after surgery.” C. “This medication will help prevent blood clots from forming in your legs until your level of activity, such as walking, returns to normal.” D. “This medication is a narcotic pain medication that will help take away any muscle aches caused by positioning on the operating room table.” Answer Correct Answer: “This medication will help prevent blood clots from forming in your legs until your level of activity, such as walking, returns to normal.” Rationale: Enoxaparin (Lovenox) is an anticoagulant that is used to prevent DVTs postoperatively. All other options do not describe the action or purpose of enoxaparin. Question The nurse is caring for a preoperative patient who has an order for vitamin K by subcutaneous injection. The nurse should verify that which laboratory study is abnormal before administering the dose? A. Hematocrit (Hct) B. Hemoglobin (Hgb) C. Prothrombin time (PT) D. Activated partial thromboplastin time (aPTT) Answer Correct Answer: Prothrombin time (PT) Rationale: Vitamin K counteracts hypoprothrombinemia and/or reverses the effects of warfarin (Coumadin) and thus decreases the risk of bleeding. High values for either the PT or the international normalized ratio demonstrate the need for this medication. Answer
