When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?
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Solution
Middle lower abdomen to the left of the midline
Option C: The aorta lies directly left of the umbilicus; therefore, any other region is inappropriate for palpation.
Which of the following blood vessel layers may be damaged in a client with an aneurysm?
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Solution
Media
Option C: The factor common to all types of aneurysms is a damaged media. The media has more smooth muscle and less elastic fibers, so it’s more capable of vasoconstriction and vasodilation.
Options A, B, and D: The interna and externa are generally no damaged in an aneurysm.
Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?
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Solution
Aneurysm rupture
Option B: Rupture of an aneurysm is a life-threatening emergency and is of the greatest concern for the nurse caring for this type of client.
Option A: Hypertension should be avoided and controlled because it can cause the weakened vessel to rupture.
Option D: Diminished pedal pulses, a sign of poor circulation to the lower extremities, are associated with an aneurysm but isn’t life-threatening.
Option C: Cardiac arrhythmias aren’t directly linked to an aneurysm.
What is the definitive test used to diagnose an abdominal aortic aneurysm?
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Solution
Arteriogram
Option B: An arteriogram accurately and directly depicts the vasculature; therefore, it clearly delineates the vessels and any abnormalities.
Option A: An abdominal aneurysm would only be visible on an X-ray if it were calcified.
Options C and D: CT scan and ultrasound don’t give a direct view of the vessels and don’t yield as accurate a diagnosis as the arteriogram.
Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?
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Solution
Lower back pain
Option D: Lower back pain results from expansion of an aneurysm. The expansion applies pressure in the abdominal cavity, and the pain is referred to the lower back.
Option A: Abdominal pain is most common symptom resulting from impaired circulation.
Option B: Absent pedal pulses are a sign of no circulation and would occur after a ruptured aneurysm or in peripheral vascular disease.
Option C: Angina is associated with atherosclerosis of the coronary arteries.
What is the most common symptom in a client with abdominal aortic aneurysm?
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Solution
Abdominal pain
Option A: Abdominal pain in a client with an abdominal aortic aneurysm results from the disruption of normal circulation in the abdominal region.
Option D: Lower back pain, not upper, is a common symptom, usually signifying expansion and impending rupture of the aneurysm.
Options B and C: Headache and diaphoresis aren’t associated with abdominal aortic aneurysm.
A pulsating abdominal mass usually indicates which of the following conditions?
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Solution
Abdominal aortic aneurysm
Option A: The presence of a pulsating mass in the abdomen is an abnormal finding, usually indicating an outpouching in a weakened vessel, as in abdominal aortic aneurysm. The finding, however, can be normal on a thin person.
Options B, C, and D: Neither an enlarged spleen, gastritis, nor gastric distention cause pulsation.
In which of the following areas is an abdominal aortic aneurysm most commonly located?
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Solution
Distal to the renal arteries
Option B: The portion of the aorta distal to the renal arteries is more prone to an aneurysm because the vessel isn’t surrounded by stable structures, unlike the proximal portion of the aorta.
Option A: Distal to the iliac arteries, the vessel is again surrounded by stable vasculature, making this an uncommon site for an aneurysm.
Option C: There is no area adjacent to the aortic arch, which bends into the thoracic (descending) aorta.
What is the most common cause of abdominal aortic aneurysm?
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Solution
Atherosclerosis
Option A: Atherosclerosis accounts for 75% of all abdominal aortic aneurysms. Plaques build up on the wall of the vessel and weaken it, causing an aneurysm.
Options B, C, and D: Although the other conditions are related to the development of an aneurysm, none is a direct cause.
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
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Solution
Right-sided heart failure
Option D: Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure.
Option B: Cardiomyopathy is usually identified as a symptom of left-sided heart failure.
Option C: Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones.
Option A: Angina pectoris doesn’t cause weight gain, nausea, or a decrease in urine output.