ATI MED SURG Lewis Chapter 41; Vascular Disorders
Competency Certification Study Guide Exam Questions with
Certified for Accuracy Answers 2025/2026
The health care provider has prescribed bed rest with the feet elevated for a patient
admitted to the hospital with venous thromboembolism. Which action by the nurse to
elevate the patient's feet is best?
a. The patient is placed in the Trendelenburg position.
b. Two pillows are positioned under the affected leg.
c. The bed is elevated at the knee and pillows are placed under the feet.
d. One pillow is placed under the thighs and two pillows are placed under the lower
legs.
d. One pillow is placed under the thighs and two pillows are placed under the lower
legs.
The purpose of elevating the feet is to enhance venous flow from the feet to the right
atrium, which is best accomplished by placing two pillows under the feet and one under
the thighs. Placing the patient in the Trendelenburg position will lower the head below
heart level, which is not indicated for this patient. Placing pillows under the calf or
elevating the bed at the knee may cause blood stasis at the calf level.
The health care provider prescribes an infusion of heparin and daily partial
thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE).
The nurse will plan to
a. decrease the infusion when the PTT value is 65 seconds.
b. avoid giving IM medications to prevent localized bleeding.
c. have vitamin K available in case reversal of the heparin is needed.
d. monitor posterior tibial and dorsalis pedis pulses with the Doppler.
b. avoid giving IM medications to prevent localized bleeding.
Intramuscular injections are avoided in patients receiving anticoagulation to prevent
hematoma formation and bleeding from the site. A PTT of 65 seconds is within the
therapeutic range. Vitamin K is used to reverse warfarin. Pulse quality is not affected by
VTE.
A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox)
and warfarin (Coumadin). The patient asks the nurse why two medications are
necessary. Which response by the nurse is most accurate?
a. "Taking two blood thinners greatly reduces the risk for another clot to form."
, b. "Enoxaparin will work right away, but warfarin takes several days to begin preventing
clots."
c. "Enoxaparin will start to dissolve the clot, and warfarin will prevent any more clots
from forming."
d.
b. "Enoxaparin will work right away, but warfarin takes several days to begin preventing
clots."
Low molecular weight heparin (LMWH) is used because of the immediate effect on
coagulation and discontinued once the international normalized ratio (INR) value
indicates that the warfarin has reached a therapeutic level. LMWH has no thrombolytic
properties. The use of two anticoagulants is not related to the risk for pulmonary
embolism, and two are not necessary to reduce the risk for another VTE. Anticoagulants
do not thin the blood.
A 46-yr-old service-counter worker undergoes sclerotherapy for treatment of superficial
varicose veins at an outpatient center. Which instructions should the nurse provide to
the patient before discharge?
a. Sitting at the work counter, rather than standing, is recommended.
b. Exercise, such as walking or jogging, can cause recurrence of varicosities.
c. Elastic compression stockings should be applied before getting out of bed.
d. Taking an aspirin daily will help prevent clots from forming arou
ANS C
Elastic compression stockings are applied with the legs elevated to reduce pressure in
the lower legs. Walking is recommended to prevent recurrent varicosities. Sitting and
standing are both risk factors for varicose veins and venous insufficiency. An aspirin a
day is not adequate to prevent venous thrombosis and would not be recommended for a
patient who had just had sclerotherapy.
The nurse has started discharge teaching for a patient who is to continue warfarin
(Coumadin) after hospitalization for venous thromboembolism (VTE). The nurse
determines that additional teaching is needed when the patient says which of the
following?
a. "I should get a Medic Alert device stating that I take warfarin."
b. "I should reduce the amount of green, leafy vegetables that I eat."
c. "I will need routine blood tests to monitor the effects of the warfarin."
d. "I will check with my health
b. "I should reduce the amount of green, leafy vegetables that I eat."
Patients taking warfarin are taught to follow a consistent diet with regard to foods
that are high in vitamin K, such as green, leafy vegetables. However, they should
avoid supplements with vitamin k in them, such as green tea and vitamins.
Competency Certification Study Guide Exam Questions with
Certified for Accuracy Answers 2025/2026
The health care provider has prescribed bed rest with the feet elevated for a patient
admitted to the hospital with venous thromboembolism. Which action by the nurse to
elevate the patient's feet is best?
a. The patient is placed in the Trendelenburg position.
b. Two pillows are positioned under the affected leg.
c. The bed is elevated at the knee and pillows are placed under the feet.
d. One pillow is placed under the thighs and two pillows are placed under the lower
legs.
d. One pillow is placed under the thighs and two pillows are placed under the lower
legs.
The purpose of elevating the feet is to enhance venous flow from the feet to the right
atrium, which is best accomplished by placing two pillows under the feet and one under
the thighs. Placing the patient in the Trendelenburg position will lower the head below
heart level, which is not indicated for this patient. Placing pillows under the calf or
elevating the bed at the knee may cause blood stasis at the calf level.
The health care provider prescribes an infusion of heparin and daily partial
thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE).
The nurse will plan to
a. decrease the infusion when the PTT value is 65 seconds.
b. avoid giving IM medications to prevent localized bleeding.
c. have vitamin K available in case reversal of the heparin is needed.
d. monitor posterior tibial and dorsalis pedis pulses with the Doppler.
b. avoid giving IM medications to prevent localized bleeding.
Intramuscular injections are avoided in patients receiving anticoagulation to prevent
hematoma formation and bleeding from the site. A PTT of 65 seconds is within the
therapeutic range. Vitamin K is used to reverse warfarin. Pulse quality is not affected by
VTE.
A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox)
and warfarin (Coumadin). The patient asks the nurse why two medications are
necessary. Which response by the nurse is most accurate?
a. "Taking two blood thinners greatly reduces the risk for another clot to form."
, b. "Enoxaparin will work right away, but warfarin takes several days to begin preventing
clots."
c. "Enoxaparin will start to dissolve the clot, and warfarin will prevent any more clots
from forming."
d.
b. "Enoxaparin will work right away, but warfarin takes several days to begin preventing
clots."
Low molecular weight heparin (LMWH) is used because of the immediate effect on
coagulation and discontinued once the international normalized ratio (INR) value
indicates that the warfarin has reached a therapeutic level. LMWH has no thrombolytic
properties. The use of two anticoagulants is not related to the risk for pulmonary
embolism, and two are not necessary to reduce the risk for another VTE. Anticoagulants
do not thin the blood.
A 46-yr-old service-counter worker undergoes sclerotherapy for treatment of superficial
varicose veins at an outpatient center. Which instructions should the nurse provide to
the patient before discharge?
a. Sitting at the work counter, rather than standing, is recommended.
b. Exercise, such as walking or jogging, can cause recurrence of varicosities.
c. Elastic compression stockings should be applied before getting out of bed.
d. Taking an aspirin daily will help prevent clots from forming arou
ANS C
Elastic compression stockings are applied with the legs elevated to reduce pressure in
the lower legs. Walking is recommended to prevent recurrent varicosities. Sitting and
standing are both risk factors for varicose veins and venous insufficiency. An aspirin a
day is not adequate to prevent venous thrombosis and would not be recommended for a
patient who had just had sclerotherapy.
The nurse has started discharge teaching for a patient who is to continue warfarin
(Coumadin) after hospitalization for venous thromboembolism (VTE). The nurse
determines that additional teaching is needed when the patient says which of the
following?
a. "I should get a Medic Alert device stating that I take warfarin."
b. "I should reduce the amount of green, leafy vegetables that I eat."
c. "I will need routine blood tests to monitor the effects of the warfarin."
d. "I will check with my health
b. "I should reduce the amount of green, leafy vegetables that I eat."
Patients taking warfarin are taught to follow a consistent diet with regard to foods
that are high in vitamin K, such as green, leafy vegetables. However, they should
avoid supplements with vitamin k in them, such as green tea and vitamins.
