Review Deep Vein Thrombosis

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Deep Vein Thrombosis

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Question 1:

A nurse is providing education to a client about the risk factors for deep vein thrombosis (DVT). Which statement made by the client indicates a need for further teaching?

A. "I should avoid sitting for long periods during long flights." B. "I will stop taking my prescribed anticoagulant medication." C. "I will wear compression stockings as directed by my healthcare provider." D. "I need to stay hydrated and drink plenty of water."

Answer and Explanation

Choice A:

This choice is correct. Avoiding sitting for long periods during long flights is a recommended preventive measure for individuals at risk of DVT. Prolonged immobility can increase the risk of blood clot formation in the legs during travel.

Choice B:

This choice is incorrect. Stopping prescribed anticoagulant medication increases the risk of blood clot formation and should never be done without the guidance of a healthcare provider. Anticoagulants are often prescribed to prevent or treat DVT and reduce the risk of clot progression or recurrence.

Choice C:

This choice is correct. Wearing compression stockings, as directed by a healthcare provider, can help prevent DVT by improving blood flow in the legs and reducing the risk of clot formation.

Choice D:

This choice is correct. Staying hydrated and drinking plenty of water can help prevent DVT by maintaining adequate blood volume and circulation. Dehydration can increase the risk of blood clot formation.

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Question 2:

A client presents with swelling, redness, and warmth in one leg. The nurse suspects deep vein thrombosis (DVT). What initial assessment should the nurse perform to confirm the presence of DVT?

A. Auscultating the lungs for crackles. B. Checking for a positive Homans' sign. C. Measuring blood pressure in both arms. D. Performing a capillary refill test.

Answer and Explanation

Choice A:

This choice is incorrect because auscultating the lungs for crackles is not directly related to confirming the presence of deep vein thrombosis (DVT). Lung auscultation may be performed to assess for potential complications of DVT, such as pulmonary embolism.

Choice B:

This choice is correct. Homans' sign is a clinical test used to assess for the presence of DVT. The nurse flexes the client's knee and gently dorsiflexes the foot. A positive Homans' sign is indicated by calf pain or discomfort during dorsiflexion and may suggest the presence of a blood clot in the deep veins of the leg.

Choice C:

This choice is incorrect because measuring blood pressure in both arms is not a specific assessment for deep vein thrombosis (DVT). It may be done as part of a routine assessment but does not confirm the presence of DVT.

Choice D:

This choice is incorrect because performing a capillary refill test is not specific to DVT assessment. Capillary refill is a measure of peripheral perfusion and may be useful in assessing overall circulatory status, but it does not directly confirm the presence of DVT.

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Question 3:

A nurse is caring for a client with deep vein thrombosis (DVT). What is the primary goal of treatment for this client?

A. Relieving leg pain and swelling. B. Preventing the clot from dislodging. C. Eliminating the risk factors for DVT. D. Administering anticoagulant therapy.

Answer and Explanation

Choice A:

This choice is incorrect because while relieving leg pain and swelling is an important aspect of DVT treatment, the primary goal is to prevent the clot from dislodging and causing a pulmonary embolism or other complications.

Choice B:

This choice is correct. The primary goal of DVT treatment is to prevent the clot from dislodging and traveling to the lungs, where it can cause a potentially life-threatening pulmonary embolism. Anticoagulant therapy and other interventions are used to stabilize the clot and prevent its migration.

Choice C:

This choice is incorrect because eliminating the risk factors for DVT is not the primary goal of treatment for a client who already has DVT. Preventing clot progression and complications take precedence over addressing risk factors at this stage.

Choice D:

This choice is incorrect because while administering anticoagulant therapy is a common treatment for DVT, it is a specific intervention rather than the primary goal. Anticoagulants help prevent the clot from growing and reduce the risk of embolism.

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Question 4:

A client is at high risk for deep vein thrombosis (DVT) due to immobility. What should the nurse implement as a preventive measure for this client?

A. Encouraging active range of motion exercises. B. Administering low-dose aspirin daily. C. Applying a heating pad to the affected leg. D. Providing a soft mattress for the client's bed.

Answer and Explanation

Choice A:

This choice is correct. Encouraging active range of motion exercises helps prevent deep vein thrombosis (DVT) by promoting blood flow and reducing stasis in the veins. Moving the legs and ankles regularly helps prevent clot formation in immobilized clients.

Choice B:

This choice is incorrect because low-dose aspirin is not specifically indicated for preventing DVT. While aspirin may have some antiplatelet effects, it is not the primary preventive measure for DVT in high-risk clients.

Choice C:

This choice is incorrect because applying a heating pad to the affected leg is not a preventive measure for DVT. Heat application is not recommended for DVT prevention and could cause burns or injury.

Choice D:

This choice is incorrect because providing a soft mattress for the client's bed does not directly prevent DVT. The focus should be on encouraging movement and mobility to prevent DVT in clients at risk.

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Question 5:

A client with a history of deep vein thrombosis (DVT) is prescribed warfarin (Coumadin) as an anticoagulant. What should the nurse include in the client's education about warfarin therapy?

A. "Avoid foods high in vitamin K, such as leafy greens." B. "Discontinue the medication if you experience bleeding." C. "Take the medication with grapefruit juice for better absorption." D. "Do not take over-the-counter pain medications while on warfarin."

Answer and Explanation

Choice A:

This choice is correct. Warfarin is an anticoagulant that works by inhibiting the synthesis of vitamin K-dependent clotting factors. Clients on warfarin should be advised to avoid significant fluctuations in vitamin K intake, as found in foods like leafy greens and other green vegetables, to maintain consistent anticoagulation levels.

Choice B:

This choice is incorrect because discontinuing warfarin suddenly can increase the risk of blood clot formation and other complications. Clients should follow their healthcare provider's instructions for warfarin dosing and management.

Choice C:

This choice is incorrect because taking warfarin with grapefruit juice is not recommended and may not improve medication absorption. Grapefruit juice can interfere with the metabolism of some medications, but it is not a recommended method for enhancing warfarin absorption.

Choice D:

This choice is incorrect because clients on warfarin should be cautious about taking over-the-counter pain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs), which can increase the risk of bleeding. Clients should consult their healthcare provider before taking any new medications while on warfarin.Questions

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Question 6:

A nurse is providing education to a client about the risk factors for deep vein thrombosis (DVT). Which client statement indicates an understanding of modifiable risk factors?

A. "My age and family history put me at risk for DVT." B. "I will stop taking my prescribed anticoagulant medication." C. "I will quit smoking to reduce my risk of DVT." D. "I cannot control my sedentary lifestyle."

Answer and Explanation

Choice A:

This choice is incorrect because age and family history are non-modifiable risk factors for DVT. While they may increase the risk, they cannot be changed or controlled by the client.

Choice B:

This choice is incorrect because stopping prescribed anticoagulant medication is not recommended and may increase the risk of DVT. Anticoagulants are often prescribed to prevent or treat DVT and should not be discontinued without healthcare provider guidance.

Choice C:

This choice is correct. Smoking is a modifiable risk factor for DVT, and quitting smoking can reduce the risk of blood clot formation and other cardiovascular complications.

Choice D:

This choice is incorrect because while the client may have difficulty controlling a sedentary lifestyle, it is still considered a modifiable risk factor for DVT. Engaging in regular physical activity can help reduce the risk of blood clot formation.

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Question 7:

A client is admitted to the hospital with a suspected deep vein thrombosis (DVT). Which question should the nurse ask during the health history to identify potential risk factors for DVT?

A. "Do you have a family history of high cholesterol?" B. "Have you ever been diagnosed with asthma?" C. "Have you recently traveled on a long flight?" D. "Do you take any medications for diabetes?"

Answer and Explanation

Choice A:

This choice is incorrect because a family history of high cholesterol is not directly related to DVT risk. While high cholesterol may contribute to other cardiovascular conditions, it is not a primary risk factor for DVT.

Choice B:

This choice is incorrect because a history of asthma is not a direct risk factor for DVT. Asthma is a respiratory condition and is not significantly associated with blood clot formation.

Choice C:

This choice is correct. Prolonged immobility during long flights, especially in cramped spaces, is a known risk factor for DVT. This condition is often referred to as "economy class syndrome" due to its association with long-haul flights in tight seating.

Choice D:

This choice is incorrect because the use of medications for diabetes does not directly relate to DVT risk. While some medications may influence blood clotting, diabetes itself is not a primary risk factor for DVT.

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Question 8:

A client is admitted to the emergency department with symptoms suggestive of deep vein thrombosis (DVT). Which non-modifiable risk factor should the nurse identify based on the client's health history?

A. Gender B. Obesity C. Smoking history D. Sedentary lifestyle

Answer and Explanation

Choice A:

This choice is correct. Gender is a non-modifiable risk factor for DVT, with women generally having a higher risk than men. Hormonal changes, such as those associated with pregnancy, oral contraceptives, and hormone replacement therapy, can contribute to the increased risk in women.

Choice B:

This choice is incorrect because obesity is a modifiable risk factor for DVT, not a non-modifiable one. Clients can work to achieve and maintain a healthy weight to reduce their risk.

Choice C:

This choice is incorrect because smoking history is a modifiable risk factor for DVT. Clients can quit smoking to decrease their risk of blood clot formation.

Choice D:

This choice is incorrect because a sedentary lifestyle is a modifiable risk factor for DVT. Clients can engage in regular physical activity to reduce their risk.

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Question 9:

A client with a history of deep vein thrombosis (DVT) asks the nurse about the causes of this condition. What is the nurse's best response?

A. "DVT is caused by a bacterial infection in the blood vessels." B. "The exact cause of DVT is unknown, but it can be triggered by injuries." C. "DVT is primarily caused by atherosclerosis in the arteries." D. "The formation of blood clots in the veins is the main cause of DVT."

Answer and Explanation

Choice A:

This choice is incorrect because DVT is not caused by a bacterial infection in the blood vessels. It is primarily related to the formation of blood clots within the veins due to various risk factors.

Choice B:

This choice is incorrect because while injuries may be associated with DVT in some cases, they are not the primary cause. The formation of blood clots in the veins remains the underlying cause.

Choice C:

This choice is incorrect because atherosclerosis in the arteries is not the main cause of DVT. Atherosclerosis is a condition that involves the buildup of plaque in the arteries, not the veins.

Choice D:

This choice is correct. Deep vein thrombosis (DVT) is primarily caused by the formation of blood clots within the veins, typically in the lower extremities. These clots can obstruct blood flow and may lead to serious complications if not treated promptly.

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Question 10:

A client is prescribed estrogen-based hormone replacement therapy. What risk factor for deep vein thrombosis (DVT) should the nurse identify in this client?

A. Advanced age B. Male gender C. Smoking history D. Hormonal therapy

Answer and Explanation

Choice A:

This choice is incorrect because advanced age is a non-modifiable risk factor for DVT. While age is associated with increased risk, it is not directly related to the client's use of hormonal therapy.

Choice B:

This choice is incorrect because male gender is not a risk factor for DVT. Women, particularly those on estrogen-based therapies like hormone replacement therapy or oral contraceptives, are at higher risk.

Choice C:

This choice is incorrect because smoking history is a modifiable risk factor for DVT, not directly related to hormonal therapy. Smoking increases the risk of clot formation and is not specific to the client's use of hormonal therapy.

Choice D:

This choice is correct. Estrogen-based hormone replacement therapy and oral contraceptives can increase the risk of DVT due to their effect on blood coagulation. Estrogen can increase the production of certain clotting factors, raising the risk of blood clot formation in the veins. It is essential for healthcare providers to weigh the benefits and risks when prescribing hormonal therapy to clients.Questions

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Question 11:

A nurse is assessing a client for possible deep vein thrombosis (DVT). Which clinical manifestation is most indicative of DVT?

A. Chest pain and shortness of breath. B. Warmth and redness over the affected area. C. Pedal edema and bilateral leg pain. D. Weak pedal pulses and cool extremities.

Answer and Explanation

Choice A:

This choice is incorrect because chest pain and shortness of breath are more indicative of a potential pulmonary embolism, a serious complication of DVT. While DVT can lead to a pulmonary embolism, the primary manifestation of DVT is related to the affected limb.

Choice B:

This choice is correct. Warmth and redness over the affected area, typically the calf or thigh, are common clinical manifestations of DVT. The warmth is due to the inflammatory response caused by the blood clot formation.

Choice C:

This choice is incorrect because pedal edema and bilateral leg pain are non-specific findings and can be caused by various conditions, not just DVT. They are not specific enough to diagnose DVT on their own.

Choice D:

This choice is incorrect because weak pedal pulses and cool extremities are not typically associated with DVT. These findings suggest potential arterial insufficiency rather than venous thrombosis.

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Question 12:

A nurse is assessing a client for deep vein thrombosis (DVT). Which assessment technique should the nurse prioritize to identify DVT-related clinical manifestations?

A. Palpating the pulses in the extremities. B. Measuring calf and thigh circumference. C. Auscultating the lungs for crackles. D. Performing a capillary refill test.

Answer and Explanation

Choice A:

This choice is incorrect because palpating the pulses in the extremities primarily assesses arterial blood flow, not venous thrombosis. While pulse assessment is essential, it is not the priority for identifying DVT-related manifestations.

Choice B:

This choice is correct. Measuring calf and thigh circumference can help identify possible DVT by comparing the affected leg's size to the unaffected one. DVT can cause localized swelling in the affected limb.

Choice C:

This choice is incorrect because auscultating the lungs for crackles is not a specific assessment for DVT. Crackles may be present in pulmonary edema, which can be a complication of DVT, but they do not directly assess the presence of a blood clot in the veins.

Choice D:

This choice is incorrect because performing a capillary refill test is primarily used to assess peripheral perfusion and is not specific to DVT assessment.

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Question 13:

A client with deep vein thrombosis (DVT) is at risk of developing a pulmonary embolism. What assessment finding should the nurse prioritize to detect potential complications?

A. Swelling and redness in the affected leg. B. Elevated body temperature and chills. C. Pleuritic chest pain and hemoptysis. D. Abdominal pain and distension.

Answer and Explanation

Choice A:

This choice is incorrect because swelling and redness in the affected leg are common clinical manifestations of DVT but are not specific to detecting potential complications like a pulmonary embolism. The nurse should focus on respiratory and cardiovascular assessments for this purpose.

Choice B:

This choice is incorrect because elevated body temperature and chills may indicate an infection but are not specific to detecting potential complications of DVT, such as a pulmonary embolism.

Choice C:

This choice is correct. Pleuritic chest pain (sharp chest pain worsened by deep breathing or coughing) and hemoptysis (coughing up blood) are classic clinical manifestations of a pulmonary embolism, a potentially life-threatening complication of DVT.

Choice D:

This choice is incorrect because abdominal pain and distension are not typical signs of a pulmonary embolism. Abdominal pain may be related to other causes, such as gastrointestinal issues.

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Question 14:

A nurse is assessing a client with suspected deep vein thrombosis (DVT). Which diagnostic test should the nurse anticipate to confirm the presence of DVT?

A. Arterial blood gas (ABG) analysis. B. D-dimer blood test. C. Electrocardiogram (ECG). D. Chest X-ray.

Answer and Explanation

Choice A:

This choice is incorrect because arterial blood gas (ABG) analysis assesses oxygen and carbon dioxide levels in the blood, primarily used for respiratory and acid-base evaluations, not for confirming DVT.

Choice B:

This choice is correct. The D-dimer blood test is a screening test used to detect the presence of blood clot breakdown products in the blood. Elevated levels of D-dimer may suggest the presence of a blood clot, prompting further diagnostic testing for DVT.

Choice C:

This choice is incorrect because an electrocardiogram (ECG) primarily assesses the electrical activity of the heart and is not specific to confirming DVT. It may be useful to assess cardiac function in individuals with suspected pulmonary embolism.

Choice D:

This choice is incorrect because a chest X-ray is not used to confirm DVT. It is helpful in assessing the lungs and heart, particularly for detecting potential complications of DVT like a pulmonary embolism, but it does not directly diagnose DVT.

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Question 15:

A client with deep vein thrombosis (DVT) is prescribed anticoagulant therapy. What is the nurse's priority action in monitoring the client's response to the medication?

A. Assessing for changes in blood pressure. B. Monitoring the client's prothrombin time (PT) and international normalized ratio (INR). C. Checking the client's blood glucose levels. D. Evaluating the client's respiratory rate and pattern.

Answer and Explanation

Choice A:

This choice is incorrect because while monitoring blood pressure is essential, it is not the priority action for clients on anticoagulant therapy. The primary concern is assessing the client's response to the medication and their risk of bleeding.

Choice B:

This choice is correct. Monitoring the client's prothrombin time (PT) and international normalized ratio (INR) is crucial in assessing the effectiveness of anticoagulant therapy. The PT and INR measure how long it takes the blood to clot and help determine the appropriate dosage of anticoagulants to achieve the desired therapeutic effect.

Choice C:

This choice is incorrect because checking the client's blood glucose levels is not directly related to monitoring the response to anticoagulant therapy. Blood glucose monitoring is essential for clients with diabetes but not a priority in this context.

Choice D:

This choice is incorrect because evaluating the client's respiratory rate and pattern is not the priority action for monitoring the response to anticoagulant therapy. Respiratory assessment is vital in detecting potential complications like a pulmonary embolism but does not directly assess the client's anticoagulation status.Questions

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Question 16:

A nurse is explaining the diagnostic tests for deep vein thrombosis (DVT) to a client. Which test is considered the gold standard for diagnosing DVT?

A. Venous Doppler ultrasound. B. D-dimer blood test. C. Magnetic resonance imaging (MRI). D. Contrast venography.

Answer and Explanation

Choice A:

This choice is incorrect because venous Doppler ultrasound is a non-invasive imaging test commonly used to diagnose DVT. However, it is not considered the gold standard due to potential limitations in visualizing small clots and deep veins.

Choice B:

This choice is incorrect because the D-dimer blood test is a screening test used to detect the presence of blood clot breakdown products. While it can help rule out DVT when negative, it is not the definitive diagnostic test.

Choice C:

This choice is incorrect because magnetic resonance imaging (MRI) is a sensitive imaging modality but is not considered the gold standard for diagnosing DVT. MRI may be used in specific cases, but contrast venography remains the gold standard.

Choice D:

This choice is correct. Contrast venography involves injecting contrast dye into the veins and taking X-ray images to visualize the blood flow and detect any clots. It is considered the gold standard for diagnosing DVT, as it provides direct visualization of the clot and the extent of its involvement.

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Question 17:

A nurse is reviewing the diagnostic workup for a client with suspected deep vein thrombosis (DVT). Which test should the nurse expect to be performed first to assess the client's risk for DVT?

A. D-dimer blood test. B. Magnetic resonance imaging (MRI). C. Complete blood count (CBC). D. Wells score assessment.

Answer and Explanation

Choice A:

This choice is incorrect because while the D-dimer blood test is used to rule out DVT in low-risk individuals, the Wells score assessment is typically performed first to assess the client's pretest probability of DVT.

Choice B:

This choice is incorrect because magnetic resonance imaging (MRI) is not typically used as an initial diagnostic test for DVT. It may be employed in specific cases but is not the first-line test.

Choice C:

This choice is incorrect because a complete blood count (CBC) is a general blood test that does not directly assess the risk of DVT. It may provide information about overall health but is not specific to DVT assessment.

Choice D:

This choice is correct. The Wells score assessment is a validated tool used to estimate the likelihood of DVT based on clinical criteria and risk factors. It is commonly used as the first step in the diagnostic workup to determine if further testing, such as venous Doppler ultrasound or D-dimer blood test, is necessary.

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Question 18:

A client is admitted to the hospital with symptoms suggestive of deep vein thrombosis (DVT). Which test can provide rapid results to rule out DVT and guide further diagnostic workup?

A. D-dimer blood test. B. Contrast venography. C. Magnetic resonance imaging (MRI). D. Wells score assessment.

Answer and Explanation

Choice A:

This choice is correct. The D-dimer blood test is a rapid and sensitive screening test that can help rule out DVT in low-risk individuals. A negative D-dimer result can be useful in excluding DVT, avoiding unnecessary imaging or invasive tests.

Choice B:

This choice is incorrect because contrast venography is not a rapid test and involves invasive procedures. It is not used as a first-line screening test due to its complexity and potential risks.

Choice C:

This choice is incorrect because magnetic resonance imaging (MRI) may provide valuable information, but it is not the first choice for rapid rule-out of DVT. MRI may be employed in specific cases when initial screening tests are inconclusive.

Choice D:

This choice is incorrect because the Wells score assessment is not a diagnostic test but a scoring system to estimate the likelihood of DVT. It does not provide rapid results to rule out DVT directly.

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Question 19:

A client is scheduled for a venous Doppler ultrasound to assess for deep vein thrombosis (DVT). What instructions should the nurse provide to the client before the procedure?

A. "You should avoid eating or drinking anything for 12 hours before the test." B. "Do not take any prescribed medications on the morning of the procedure." C. "Wear loose-fitting clothing that can be easily removed." D. "Expect to receive contrast dye intravenously during the test."

Answer and Explanation

Choice A:

This choice is incorrect because fasting is not necessary before a venous Doppler ultrasound. The client can eat and drink normally before the test.

Choice B:

This choice is incorrect because the client should continue to take prescribed medications as usual unless otherwise instructed by the healthcare provider. Medications that thin the blood, such as anticoagulants, may not be stopped before the test.

Choice C:

This choice is correct. The client should wear loose-fitting clothing that can be easily removed to allow access to the affected area during the ultrasound. This facilitates the ultrasound technician's ability to perform the test accurately.

Choice D:

This choice is incorrect because contrast dye is not typically used in a venous Doppler ultrasound. Contrast venography may involve the use of contrast dye, but not Doppler ultrasound.Questions

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Question 20:

A nurse is educating a client about the importance of compliance with anticoagulant therapy for deep vein thrombosis (DVT). The client asks, "Why is it essential to take these medications?" What is the nurse's best response?

A. "Anticoagulants help dissolve existing blood clots in the veins." B. "These medications prevent the formation of new blood clots in your veins." C. "They reduce pain and inflammation associated with DVT." D. "Anticoagulants improve blood flow to the affected limb."

Answer and Explanation

Choice A:

This choice is incorrect because anticoagulants do not dissolve existing blood clots in the veins. They prevent further clot formation and allow the body's natural mechanisms to dissolve the clot over time.

Choice B:

This choice is correct. Anticoagulants work by inhibiting the clotting factors in the blood, which prevents the formation of new blood clots and reduces the risk of the existing clot enlarging or causing additional complications.

Choice C:

This choice is incorrect because while anticoagulants may indirectly reduce pain and inflammation by preventing further clot formation, their primary action is to prevent clotting, not directly reduce pain and inflammation associated with DVT.

Choice D:

This choice is incorrect because while anticoagulants can improve blood flow by preventing clot formation, they do not directly "improve" blood flow to the affected limb.

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Question 21:

A client with deep vein thrombosis (DVT) is prescribed compression stockings. What is the nurse's best explanation for the purpose of using compression stockings?

A. "Compression stockings will dissolve the blood clot in your leg." B. "They prevent swelling in the affected leg." C. "Compression stockings improve blood circulation throughout your body." D. "These stockings will prevent new blood clots from forming in your veins."

Answer and Explanation

Choice A:

This choice is incorrect because compression stockings do not dissolve existing blood clots. Their primary purpose is to prevent new blood clots from forming by aiding blood flow and preventing stasis in the veins.

Choice B:

This choice is incorrect because while compression stockings may help reduce swelling in the affected leg by supporting venous return, their primary function is to prevent DVT and not specifically address swelling.

Choice C:

This choice is incorrect because compression stockings primarily target venous circulation in the legs and do not directly improve blood circulation throughout the entire body.

Choice D:

This choice is correct. Compression stockings exert pressure on the legs, assisting in venous return and preventing blood from pooling and clot formation. They are used as a preventive measure for individuals at risk of DVT or those diagnosed with DVT to reduce the risk of complications and recurrence.

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Question 22:

A nurse is caring for a client receiving intravenous (IV) heparin therapy for deep vein thrombosis (DVT). What is the nurse's priority action to ensure safe administration of the medication?

A. Monitoring the client's prothrombin time (PT) and international normalized ratio (INR). B. Assessing the client's liver function regularly. C. Administering heparin via a central venous catheter. D. Monitoring the client's activated partial thromboplastin time (aPTT).

Answer and Explanation

Choice A:

This choice is incorrect because monitoring prothrombin time (PT) and international normalized ratio (INR) is more relevant to monitoring oral anticoagulant therapy (e.g., warfarin) and not intravenous heparin therapy.

Choice B:

This choice is incorrect because while liver function tests may be important for some medications, they are not the priority for clients on intravenous heparin therapy. Heparin is primarily eliminated by the kidneys.

Choice C:

This choice is incorrect because while administering heparin via a central venous catheter is possible, it is not the priority action for safe administration. Monitoring the client's response to heparin therapy is more important.

Choice D:

This choice is correct. Monitoring the client's activated partial thromboplastin time (aPTT) is the priority action when administering intravenous heparin. The aPTT reflects the client's response to heparin and helps adjust the dosage to achieve the desired therapeutic effect while minimizing the risk of bleeding.

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Question 23:

A client is prescribed warfarin for the treatment of deep vein thrombosis (DVT). What is the nurse's priority teaching point regarding warfarin therapy?

A. "You should avoid foods high in vitamin K while on warfarin." B. "Warfarin will dissolve the blood clot in your leg." C. "Be sure to take your warfarin dose at the same time each day." D. "You can discontinue warfarin once the symptoms of DVT disappear."

Answer and Explanation

Choice A:

This choice is correct. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. Consistent vitamin K intake can impact the effectiveness of warfarin, so it is important for clients to maintain a stable vitamin K intake and avoid sudden changes in their diet.

Choice B:

This choice is incorrect because warfarin does not directly dissolve the blood clot in the leg. It prevents the formation of new clots and allows the body's natural mechanisms to dissolve the existing clot over time.

Choice C:

This choice is incorrect because while taking warfarin at the same time each day can help with adherence, the priority teaching point is about vitamin K intake and not the exact timing of the medication.

Choice D:

This choice is incorrect because discontinuing warfarin without medical guidance can be dangerous. Warfarin is typically prescribed for a specific duration, and its cessation should be guided by the healthcare provider based on the client's individual condition and risk factors.

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Question 24:

A client with deep vein thrombosis (DVT) is prescribed enoxaparin, a low molecular weight heparin (LMWH). What is the nurse's priority action before administering the medication?

A. Measuring the client's blood pressure. B. Assessing the client's platelet count. C. Ensuring the client has an indwelling urinary catheter. D. Obtaining the client's weight.

Answer and Explanation

Choice A:

This choice is incorrect because measuring the client's blood pressure is important but not the priority action before administering enoxaparin.

Choice B:

This choice is incorrect because assessing the client's platelet count is necessary before starting anticoagulant therapy, but it is not the priority action before administering enoxaparin.

Choice C:

This choice is incorrect because ensuring the client has an indwelling urinary catheter is not a priority action for administering enoxaparin. It is not directly related to the medication's administration or the client's safety.

Choice D:

This choice is correct. Enoxaparin is dosed based on the client's weight, so obtaining an accurate weight is the priority action before administering the medication. Proper dosing is essential to achieve the desired therapeutic effect while minimizing the risk of bleeding or clotting complications.Questions

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Question 25:

A client recently underwent surgery and is at risk of developing deep vein thrombosis (DVT). What preventive measure should the nurse recommend to the client?

A. Performing isometric exercises hourly. B. Wearing graduated compression stockings. C. Limiting fluid intake to reduce blood volume. D. Avoiding elevation of the legs while resting.

Answer and Explanation

Choice A:

This choice is incorrect because while isometric exercises can promote blood flow, the recommended preventive measure for DVT is wearing graduated compression stockings. Exercises alone may not be sufficient to prevent clot formation.

Choice B:

This choice is correct. Graduated compression stockings apply pressure to the lower extremities, improving blood flow and reducing the risk of stasis and clot formation. They are commonly used as a preventive measure for clients at risk of DVT, particularly after surgery or during prolonged immobility.

Choice C:

This choice is incorrect because limiting fluid intake is not a preventive measure for DVT and may not be safe or appropriate for all clients. Adequate hydration is essential to maintain blood volume and circulation.

Choice D:

This choice is incorrect because elevating the legs while resting is a recommended measure to improve blood flow and reduce edema, which can be beneficial. However, wearing graduated compression stockings is a more specific preventive measure for DVT.

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Question 26:

A nurse is providing education to a client at risk of deep vein thrombosis (DVT). What is the most crucial instruction the nurse should include in the client's teaching plan?

A. "Avoid sitting or standing in one position for extended periods." B. "Massage the legs regularly to improve blood circulation." C. "Increase your intake of leafy greens and foods rich in vitamin K." D. "Take over-the-counter pain medications for leg discomfort."

Answer and Explanation

Choice A:

This choice is correct. Prolonged sitting or standing in one position can lead to reduced blood flow and stasis, increasing the risk of DVT. Encouraging regular movement and changing positions can help prevent clot formation.

Choice B:

This choice is incorrect because massaging the legs may not be suitable for everyone and is not a primary preventive measure for DVT. While it can aid in improving blood circulation, it should be done cautiously and not as a standalone preventive action.

Choice C:

This choice is incorrect because increasing the intake of vitamin K-rich foods is not a preventive measure for DVT. Vitamin K is involved in the clotting process, but it does not directly impact the risk of DVT.

Choice D:

This choice is incorrect because taking over-the-counter pain medications for leg discomfort does not prevent DVT. While pain management may be necessary for symptomatic relief, it does not address the underlying risk factors for DVT.

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Question 27:

A client with a history of deep vein thrombosis (DVT) is scheduled for a long-haul flight. What should the nurse recommend to the client as a preventive measure during the flight?

A. Perform calf-stretching exercises in the aisle. B. Use a heating pad on the legs to promote circulation. C. Avoid wearing compression stockings during the flight. D. Take prescribed anticoagulant medication before boarding.

Answer and Explanation

Choice A:

This choice is correct. Performing calf-stretching exercises in the aisle can help improve blood circulation in the legs during a long flight and reduce the risk of stasis and clot formation.

Choice B:

This choice is incorrect because using a heating pad on the legs during a flight may not be feasible or safe. It is not a recommended preventive measure for DVT.

Choice C:

This choice is incorrect because wearing compression stockings during the flight is a recommended preventive measure for DVT. Compression stockings help improve blood flow and reduce the risk of clot formation during prolonged immobility.

Choice D:

This choice is incorrect because taking prescribed anticoagulant medication before boarding a flight is not a recommended preventive measure for all clients. The decision to take anticoagulant medication before a flight should be based on the client's individual risk factors and medical history.

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Question 28:

A client with deep vein thrombosis (DVT) is being discharged from the hospital. What should the nurse include in the client's discharge teaching to promote ongoing preventive measures?

A. "Avoid engaging in regular physical activity." B. "Maintain a diet high in saturated fats and cholesterol." C. "Elevate your legs above the heart level while resting." D. "Continue taking prescribed anticoagulant medication as directed."

Answer and Explanation

Choice A:

This choice is incorrect because regular physical activity is an essential preventive measure for DVT. Encouraging the client to engage in physical activity is vital for maintaining good circulation and reducing the risk of clot formation.

Choice B:

This choice is incorrect because a diet high in saturated fats and cholesterol is not a recommended preventive measure for DVT. A healthy, balanced diet is important for overall health, but it does not specifically prevent DVT.

Choice C:

This choice is incorrect because elevating the legs above heart level while resting is beneficial for reducing edema and improving blood flow but is not the primary preventive measure for DVT.

Choice D:

This choice is correct. The client should continue taking prescribed anticoagulant medication as directed by their healthcare provider. Anticoagulant therapy is often prescribed for a specific duration to prevent clot formation and reduce the risk of complications in clients with DVT.

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Question 29:

A nurse is providing education to a client with deep vein thrombosis (DVT) about potential complications. Which symptom should the nurse instruct the client to report immediately?

A. Mild leg swelling after prolonged standing. B. Redness and warmth at the site of the affected leg. C. Occasional cramping in the unaffected leg. D. Mild fatigue and generalized body aches.

Answer and Explanation

Choice A:

This choice is incorrect because mild leg swelling after prolonged standing may be expected, especially in clients with a history of DVT. It is not a critical symptom to report immediately.

Choice B:

This choice is correct. Redness and warmth at the site of the affected leg could indicate an inflammatory response or progression of the clot. These signs may be indicative of a potential complication, such as an infection or extension of the clot, and should be reported immediately for further evaluation and intervention.

Choice C:

This choice is incorrect because occasional cramping in the unaffected leg may not be directly related to the DVT. While any changes in leg symptoms should be reported to the healthcare provider, this symptom is less urgent than redness and warmth in the affected leg.

Choice D:

This choice is incorrect because mild fatigue and generalized body aches are non-specific symptoms and may not be directly related to DVT. While it is essential to report any new or concerning symptoms, redness and warmth in the affected leg are more indicative of potential complications related to DVT.Questions

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Question 30:

A nurse is caring for a client with suspected deep vein thrombosis (DVT). Which diagnostic test is used to assess blood flow and detect clots in the deep veins of the legs non-invasively?

A. D-dimer blood test. B. Magnetic resonance imaging (MRI). C. Contrast venography. D. Venous Doppler ultrasound.

Answer and Explanation

Choice A:

This choice is incorrect because the D-dimer blood test is a screening test for DVT but does not directly assess blood flow or detect clots non-invasively.

Choice B:

This choice is incorrect because magnetic resonance imaging (MRI) is a sensitive imaging modality, but it may not be readily available or suitable for all clients. It is not the primary choice for non-invasive assessment of blood flow and clots in suspected DVT.

Choice C:

This choice is incorrect because contrast venography is an invasive procedure involving the injection of contrast dye and X-ray imaging. It is not non-invasive, and venous Doppler ultrasound is a preferred first-line test.

Choice D:

This choice is correct. Venous Doppler ultrasound is a non-invasive imaging test used to assess blood flow in the veins and detect clots in the deep veins of the legs. It is readily available, safe, and does not involve the use of contrast dye or radiation.

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Deep Vein Thrombosis

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