INSTRUCTIONS What you need to know about venous thromboembolism
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What you need to know about venous thromboembolism
GENERAL PURPOSE To provide nurses with an overview of VTE. LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to: 1. Describe the pathophysiology of VTE. 2. Identify clinical manifestations of VTE. 3. List management strategies for patients with VTE.
1. Which blood vessel is occluded by a PE?
a. pulmonary artery
b. pulmonary vein
c. popliteal vein
d. femoral vein
2. When assessing for calf edema, measure the circumference of the patient's leg 4 inches
a. below the patella.
b. below the tibial tuberosity.
c. above the medial malleolus.
d. above the calcaneal tuberosity.
3. Signs of a lower extremity DVT include
c. unilateral leg edema.
4. Which d-dimer value is least likely to be associated with a DVT?
a. 450 ng/L
b. 550 ng/L
c. 750 ng/L
d. 900 ng/L
5. A duplex ultrasound is highly accurate for detecting proximal DVT in which veins?
a. popliteal and anterior tibial
b. femoral and posterior tibial
c. femoral and popliteal
d. peroneal and anterior tibial
6. Which test is considered the gold standard for detecting a DVT?
b. duplex ultrasound
c. V˙/Q˙ scan
d. contrast venography
7. Which diagnostic study is most useful in confirming a PE diagnosis?
a. chest X-ray
b. spiral computed tomography pulmonary angiography
8. Which is a normal V˙/Q˙ value?
9. For low-risk general surgery patients, the recommended VTE prophylaxis is
d. early and aggressive ambulation.
10. Which drug is a fibrinolytic?
d. protamine sulfate
11. Initial management for a hemodynamically stable patient with a PE and no bleeding risk will most likely include
a. pulmonary embolectomy.
b. IVC filter placement.
c. elastic compression sleeves.
d. fibrinolytic therapy.
12. The goal of warfarin therapy for DVT is an INR range of
a. 0.5 to 1.
b. 1.3 to 1.5.
c. 2 to 3.
d. 3.5 to 5.
13. The antidote for excessive heparin anticoagulation is
a. protein C.
b. vitamin K.
d. protamine sulfate.
14. Tell patients taking warfarin therapy to
a. avoid leafy green vegetables.
b. increase intake of leafy green vegetables.
c. eat a consistent, limited amount of foods high in vitamin K.
d. eat a consistent, limited amount of foods high in vitamin C.
15. Which substances may decrease warfarin's anticoagulation effect?
b. ginkgo biloba
d. St. John's wort
16. Air travelers at high risk for VTE should wear graduated compression stockings providing how much pressure at the ankles?
a. 5 to 10 mm Hg
b. 15 to 30 mm Hg
c. 35 to 45 mm Hg
d. 50 to 60 mm Hg
17. LMWH is indicated for patients at
a. low VTE risk without bleeding risk.
b. low-to-moderate VTE risk with bleeding risk.
c. moderate-to-high VTE risk with bleeding risk.
d. moderate-to-high VTE risk without bleeding risk.
18. Which scoring system specifically measures a patient's DVT risk?
a. Wells clinical prediction rule