99. A client has been admitted to the coronary care unit.
The nurse observes third-degree heart
block at a rate of 35 bpm on the client’s cardiac monitor. The client has a blood pressure of 90/60. The
nurse should take which of the following actions first?
■ 1. Prepare for transcutaneous pacing.
■ 2. Prepare to defibrillate the client at 200 joules.
■ 3. Administer an I.V. lidocaine infusion.
■ 4. Schedule the operating room for insertion of a permanent pacemaker.
Answer A
Solution.
Transcutaneous pacemaker therapy provides an adequate heart rate to a client in an emergency
situation. Defibrillation and a lidocaine infusion are not indicated for the treatment of third-degree heart
block. Transcutaneous pacing is used temporarily until a transvenous or permanent pace-maker can be
inserted.
100. A 74-year-old female is admitted to the telemetry unit for placement of a permanent pace-maker
because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent
pacemaker is to:
■ 1. Maintain skin integrity.
■ 2. Maintain cardiac conduction stability.
■ 3. Decrease cardiac output.
■ 4. Increase activity level.
Answer B
Solution.
Maintaining cardiac conduction stability to prevent arrhythmias is a priority immediately after artificial
pacemaker implantation. The client should have continuous electrocardiographic monitor-ing until
proper pacemaker functioning is verified. Skin integrity, while important, is not an immediate concern.
The pacemaker is used to increase heart rate and cardiac output, not decrease it. The client should limit
activity for the first 24 to 48 hours after pacemaker insertion. The client should also restrict movement
of the affected extremity for 24 hours.
101. The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the
hospital. The client understands the discharge plan when the client:
■ 1. Selects a low-cholesterol diet to control coro-nary artery disease.
■ 2. States a need for bed rest for 1 week after discharge.
■ 3. Verbalizes safety precautions needed to pre-vent pacemaker malfunction.
■ 4. Explains signs and symptoms of myocardial infarction (MI).
Answer C
Solution.
Education is a major component of the dis-charge plan for a client with an artificial pacemaker. The
client with a permanent pacemaker needs to be able to state specific information about safety pre-
cautions, such as to refrain from lifting more than 3 lb or stretching and bending and to count the pulse
once per week, that are necessary to maintain proper pacemaker function. The client will not necessar-
ily be placed on a low cholesterol diet. The client should resume activities as he is able, and does not
need to remain on bed rest. The client should know signs and symptoms of MI, but is not at risk because
of the pacemaker.
102. Upon assessment of third degree heart block on the monitor, the nurse should first:
■ 1. Call a code.
■ 2. Begin cardiopulmonary resuscitation.
■ 3. Have transcutaneous pacing ready at the bed-side.
■ 4. Prepare for defibrillation.
Answer C
Solution.
Transcutaneous pads should be placed on the client with third degree heart block. For a client who is
symptomatic, transcutaneous pacing is the treatment of choice. The hemodynamic stability and pulse
should be assessed prior to calling a code or initiating CPR. Defibrillation is performed for ven-tricular
fibrillation or ventricular tachycardia with no pulse.
103. Ventricular tachycardia is displayed on the cardiac monitor of a client admitted to the telemetry
unit. Which should the nurse do first?
■ 1. Prepare for immediate cardioversion.
■ 2. Begin cardiopulmonary resuscitation (CPR).
■ 3. Check for a pulse.
■ 4. Prepare for immediate defibrillation.
Answer C
Solution.
The presence of a pulse determines the treatment for ventricular tachycardia. It is also important to
assess the client’s heart rate and level of consciousness. Cardioversion may be used to treat
hemodynamically unstable tachycardias. Assess-ment of instability is required before cardioversion. It is
not appropriate to begin CPR unless the pulse is absent. Defibrillation is used to treat ventricular
fibrillation or pulseless ventricular tachycardia.
105. A client who has been given cardiopulmonary resuscitation (CPR) is transported by ambulance to
the hospital’s emergency department, where the admitting nurse quickly assesses the client’s condi-
tion. The most effective way to determine the effec-tiveness of CPR is noting whether the:
■ 1. Pulse rate is normal.
■ 2. Pupils are reacting to light.
■ 3. Mucous membranes are pink.
■ 4. Systolic blood pressure is at least 80 mm Hg.
Answer B
Solution.
Pupillary reaction is the best indication of whether oxygenated blood has been reaching the client’s
brain. Pupils that remain widely dilated and do not react to light probably indicate that serious brain
damage has occurred. The pulse rate may be normal, mucous membranes may still be pink, and systolic
blood pressure may be 80 mm Hg or higher, and serious brain damage may still have occurred.
106. A client is given amiodarone (Cordarone) in the emergency department for a dysrhythmia. Which of
the following indicates the drug is having the desired effect?
■ 1. The ventricular rate is increasing.
■ 2. The absent pulse is now palpable.
■ 3. The number of premature ventricular contrac-tions is decreasing.
■ 4. The fine ventricular fibrillation changes to coarse ventricular fibrillation.
Answer C
Solution.
Amiodarone is used for the treatment of premature ventricular contractions, ventricular tachycardia
with a pulse, atrial fibrillation, and atrial flutter. Amiodarone is not used as initial therapy for a pulseless
dysrhythmia.
107. During cardiopulmonary resuscitation (CPR), the xiphoid process at the lower end of the sternum
should not be compressed when performing cardiac compressions. Which of the following organs would
be most likely at risk for laceration by forceful com-pressions over the xiphoid process?
■ 1. Lung.
■ 2. Liver.
■ 3. Stomach.
■ 4. Diaphragm.
Answer B
Solution.
Because of its location near the xiphoid process, the liver is the organ most easily damaged from
pressure exerted over the xiphoid process during CPR. The pressure on the victim’s chest wall should be
sufficient to compress the heart but not so great as to damage internal organs. Injury may result,
however, even when CPR is performed properly.
108. When performing external chest compres-sions on an adult during cardiopulmonary resuscita-tion
(CPR), the rescuer should depress the sternum:
■ 1. 0.5 to 1 inch.
■ 2. 1 to 1.5 inches.
■ 3. 1.5 to 2 inches.
■ 4. 2 to 2.5 inches.
Answer C
Solution.
An adult’s sternum must be depressed 1.5 to 2 inches with each compression to ensure ade-quate heart
compression.
109. If a client is receiving rescue breaths and the chest wall fails to rise during cardiopulmonary
resuscitation, the rescuer should first:
■ 1. Try using an ambu bag.
■ 2. Decrease the rate of compressions.
■ 3. Intubate the client.
■ 4. Reposition the airway.
Answer D
Solution.
If the chest wall is not rising with rescue breaths, the head should be repositioned first to ensure that
the airway is adequately opened. An ambu bag allows for delivery of 100% oxygen. Com-pressions
should be maintained at 100 per minute.
110. During rescue breathing in cardiopulmonary resuscitation (CPR), the victim will exhale by:
■ 1. Normal relaxation of the chest.
■ 2. Gentle pressure of the rescuer’s hand on the upper chest.
■ 3. The pressure of cardiac compressions.
4. Turning the head to the side.
Answer A
Solution.
The exhalation phase of ventilation is a passive activity that occurs during CPR as part of the normal
relaxation of the victim’s chest. No action by the rescuer is necessary.
111. The rapid response team has been called to manage an unwitnessed cardiac arrest. The esti-mated
maximum time a person can be without cardiopulmonary function and still not experience permanent
brain damage is:
■ 1. 1 to 2 minutes.
■ 2. 4 to 6 minutes.
■ 3. 8 to 10 minutes.
■ 4. 12 to 15 minutes.
Answer B
Solution.
After a person is without cardiopulmonary function for 4 to 6 minutes, permanent brain dam-age is
almost certain. To prevent permanent brain damage, it is important to begin CPR promptly after a
cardiopulmonary arrest.
112. A nurse is helping a suspected choking vic-tim. The nurse should perform the Heimlich maneu-ver
when the victim:
■ 1. Starts to become cyanotic.
■ 2. Cannot speak due to airway obstruction.
■ 3. Can make only minimal vocal noises.
■ 4. Is coughing vigorously.
Answer B
Solution.
The Heimlich maneuver should be admin-istered only to a victim who cannot make any sounds due to
airway obstruction. If the victim can whisper words or cough, some air exchange is occurring and the
emergency medical system should be called instead of attempting the Heimlich maneu-ver. Cyanosis
may accompany or follow choking; however, the Heimlich maneuver should only be initiated when the
victim cannot speak.
113. When performing the Heimlich maneuver on a conscious adult victim, the rescuer delivers inward
and upward thrusts specifically:
■ 1. Above the umbilicus.
■ 2. At the level of the xiphoid process.
■ 3. Over the victim’s midabdominal area.
■ 4. Below the xiphoid process and above the umbilicus.
Answer D
Solution.
The thrusts should be delivered below the xiphoid process, but above the umbilicus, to mini-mize the
risk of internal injuries.
114. The monitor technician informs the nurse that the client has started having premature ven-tricular
contractions every other beat. Which is the priority nursing action?
■ 1. Activate the rapid response team.
■ 2. Assess the client’s orientation and vital signs.
■ 3. Call the physician.
■ 4. Administer a bolus of lidocaine.
Answer B
Solution.
The priority action is to assess the client and determine whether the rhythm is life-threaten-ing. More
information, including vital signs, should be obtained and the physician should be quickly notified. A
bolus of lidocaine may be ordered to treat this arrhythmia. This is not a code-type situation unless the
client has been determined to be in a life-threatening situation.
115. The nurse is caring for a client whose con-dition has been deteriorating. The client becomes
unresponsive, the blood pressure is 80/40, and SpO2 is 90% on 50% face mask. The nurse should:
■ 1. Begin chest compressions.
■ 2. Call the rapid response team.
■ 3. Remove the family from the room.
■ 4. Ventilate the client with an ambu bag.
Answer B
Solution.
The rapid response team should be called immediately to evaluate and treat the client. There is no
indication at this time for manual ventilations or chest compressions. If the family is not interfer-ing in
client care, it can be reassuring to the family to see that all possible care is being provided.
116. Which activity would be appropriate to del-egate to unlicensed personnel for a client diagnosed
with a myocardial infarction who is stable?
■ 1. Evaluate the lung sounds.
■ 2. Help the client identify risk factors for CAD.
■ 3. Provide teaching on a 2 g sodium diet.
■ 4. Record the intake and output.
Answer D
Solution.
Unlicensed personnel are able to measure and record intake and output. The nurse is respon-sible for
client teaching, physical assessments, and evaluating the information collected on the client.
118. The nurse is tracking data on a group of clients with heart failure who have been discharged from
the hospital and are being followed at a clinic. Which of the following data indicate that nursing
interventions of monitoring and teaching have been effective?
■ 1. 90 percent of clients have not gained weight.
■ 2. 75 percent of the clients viewed the educa-tional DVD.
■ 3. 80 percent of the clients reported that they are taking their medications.
■ 4. 5 percent of the clients required hospitaliza-tion in the last 90 days.
Answer D
Solution.
The goals of managing clients outside of the hospital are for the clients to maintain health and prevent
readmission, thus interventions, such as monitoring and teaching appear to have contrib-uted to the low
readmission rate in this group of clients. Although it is important that clients do not gain weight, view
educational material and continue to take their medication, the primary indicator of effectiveness of the
program is the lack of re-hospi-talization.
119. The nurse in the intensive care unit is giv-ing a report to the nurse in a cardiac step-down unit
about a client who had coronary artery bypass surgery. Which of the following is the most effective way
to assure essential information about the client is reported?
■ 1. Give the report face-to-face with both nurses in a quiet room.
■ 2. Audiotape the report for future reference and documentation.
■ 3. Use a printed checklist with information indi-vidualized for the client.
■ 4. Document essential transfer information in the client’s electronic health record.
Answer C
Solution.
Using an individualized, printed check-list assures that all key information is reported; the checklist can
then serve as a record to which nurses can refer later. Giving a verbal report leaves room for error in
memory; using an audiotape or an electronic health record requires nurses to spend unnecessary time
retrieving information.
1. The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit. The
client, who exercises regularly, reports having pain in the calf during exercise that dis-appears at rest.
Which of the following findings requires further evaluation?
■ 1. Heart rate 57 bpm.
■ 2. SpO2 of 94% on room air.
■ 3. Blood pressure 134/82.
■ 4. Ankle brachial index of 0.65.
Answer D
Solution.
An Ankle Brachial Index of 0.65 suggests moderate arterial vascular disease in a client who is
experiencing intermittent claudication. A Doppler ultrasound is indicated for further evaluation. The
bradycardic heart rate is acceptable in an athletic client with a normal blood pressure. The SpO2 is
acceptable; the client has a smoking history.
2. A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft.
The blood pressure has decreased from 124/80 to 94/62. What should the nurse assess first?
■ 1. IV fluid solution.
■ 2. Pedal pulses.
■ 3. Nasal cannula flow rate.
■ 4. Capillary refill.
Answer B
Solution.
With each set of vital signs, the nurse should assess the dorsalis pedis and posterior tibial pulses. The
nurse needs to ensure adequate perfu-sion to the lower extremity with the drop in blood pressure. I.V.
fluids, nasal cannula setting, and capil-lary refill are important to assess, however, priority is to
determine the cause of drop in blood pressure and that adequate perfusion through the new graft is
maintained.
4. Peripheral blood flow is dependent on which of the following variables?
■ 1. Blood viscosity and diameter of vessels.
■ 2. Diameter and resistance of vessels.
■ 3. Force of contraction of the heart and resis-tance of vessels.
■ 4. Pressure differences in the arterial and venous systems and resistance.
Answer D
Solution.
Blood flows in a unidirectional man-ner, and the blood flow involves the differences in pressure between
the arterial and venous systems. The two variables influencing blood flow within this closed system are
the pressure differences and the resistance to blood flow throughout the system. The greater the
resistance, the greater the driving force needed, which results in an increase in the force of the
contraction of the heart. Blood viscos-ity is important, and diameter influences resistance, but flow is
dependent on pressure differences and resistance. The force of the contraction of the heart and
resistance of vessels influence flow, but it is the pressure differences that control blood flow.
5. Blood pressure in the systemic circulation is highest in the:
■ 1. Arterioles.
■ 2. Capillaries.
■ 3. Aorta.
■ 4. Venules.
Answer C
Solution.
Blood pressure is the highest in the aorta as the blood is being ejected out of the left ventricle into the
aorta. The pressure declines as the blood flows through the arteries, capillaries, arterioles, veins,
capillaries, and venules. The force of the con-traction of the heart and resistance of vessels influ-ence
flow; however, it is the pressure differences that control blood flow.
6. A common abnormal laboratory result associ-ated with the development of peripheral vascular
disease (PVD) is:
■ 1. High serum calcium level.
■ 2. High serum lipid levels.
■ 3. Low serum potassium level.
■ 4. Low serum lipid levels.
Answer B
Solution.
High serum lipid levels are associated with an increased incidence of PVD. High serum calcium level, low
serum potassium level, and low serum lipid levels have no relation to PVD.
7. The nurse is planning care for a client with a history of peripheral vascular disease who has
symptoms of claudication. Nursing care should be directed to avoiding which of the following situations?
■ 1. Oxygen demand by the muscle exceeds the supply.
■ 2. Oxygen demand and supply of the working muscle are in balance.
■ 3. Oxygen supply exceeds the demand of the working muscle.
■ 4. Oxygen is absent.
Answer A
Solution.
Claudication is the term used to describe the discomfort a person experiences when oxygen demand in
the leg muscles is greater than the sup-ply. The pain is a result of tissue hypoxia in the working muscle.
Symptoms include aching, cramp-ing, and weakness.
8. Which of the following explains the influence of aging on the development of peripheral vascular
disease?
■ 1. Decreased resistance.
■ 2. Increased resistance.
■ 3. Decreased viscosity.
■ 4. Increased viscosity.
Answer B
Solution.
As people age, the accumulation of col-lagen in the intima of the blood vessels results in the vessels’
becoming stiff and less flexible. Conse-quently, there is an increased resistance within the aging adult’s
circulatory system.
9. The client admitted with peripheral vascu-lar disease (PVD) asks the nurse why her legs hurt
when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:
■ 1. Decreased blood flow.
■ 2. Increased blood flow.
■ 3. Slow blood flow.
■ 4. Thrombus formation.
Answer A
Solution.
Decreased blood flow is a common charac-teristic of all PVD. When the demand for oxygen to the
working muscles becomes greater than the sup-ply, pain is the outcome. Slow blood flow through-out
the circulatory system may suggest pump failure. Thrombus formation can result from stasis or damage
to the intima of the vessels.
10. The nurse is planning care for a client who is diagnosed with peripheral vascular disease (PVD)
and has a history of heart failure. The nurse should develop a plan of care that is based on the fact that
the client may have a low tolerance for exercise related to:
■ 1. Decreased blood flow.
■ 2. Increased blood flow.
■ 3. Decreased pain.
■ 4. Increased blood viscosity.
Answer A
Solution.
A client with PVD and heart failure will experience decreased blood flow. In this situation, low exercise
tolerance (oxygen demand becomes greater than the oxygen supply) may be related to less blood being
ejected from the left ventricle into the systemic circulation. Decreased blood supply to the tissues
results in pain. Increased blood viscosity may be a component, but it is of much less impor-tance than
the disease processes.
11. When assessing the lower extremities of a client with peripheral vascular disease (PVD), the
nurse notes bilateral ankle edema. The edema is related to:
■ 1. Competent venous valves.
■ 2. Decreased blood volume.
■ 3. Increase in muscular activity.
■ 4. Increased venous pressure.
Answer D
Solution.
In PVD, decreased blood flow can result in increased venous pressure. The increase in venous pressure
results in an increase in capillary hydro-static pressure, which causes a net filtration of fluid out of the
capillaries into the interstitial space, result-ing in edema. Valves often become incompetent with PVD.
Blood volume is not decreased in this condi-tion. Decreased muscular action would contribute to the
formation of edema in the lower extremities.
13. The nurse is teaching a client about risk factors associated with atherosclerosis and how to reduce
the risk. Which of the following is a risk fac-tor that the client is not able to modify?
■ 1. Diabetes.
■ 2. Age.
■ 3. Exercise level.
■ 4. Dietary preferences.
Answer B
Solution.
Age is a nonmodifiable risk factor for ath-erosclerosis. The nurse instructs the client to manage
modifiable risk factors such as comorbid diseases (e.g., diabetes), activity level, and diet. Controlling
serum blood glucose levels, engaging in regular aero-bic activity, and choosing a diet low in saturated
fats can reduce the risk of developing atherosclerosis.
14. The nurse is assessing the lower extremities of the client with peripheral vascular disease (PVD).
Dur-ing the assessment, the nurse should expect to find which of the following clinical manifestations of
PVD?
■ 1. Hairy legs.
■ 2. Mottled skin.
■ 3. Pink, cool skin.
■ 4. Warm, moist skin.
Answer B
Solution.
Reduction of blood flow to a specific area results in decreased oxygen and nutrients. As a result, the skin
may appear mottled. Loss of hair and cool, dry skin are other signs that the nurse may observe in a client
with PVD of the lower extremities.
15. The client has midcalf pain when walking a block or more. The client states that the discomfort
is relieved with rest. The pain is expected when arterial occlusion reaches which of the following
percentages?
■ 1. 20%.
■ 2. 40%.
■ 3. 50%.
■ 4. 100%.
Answer C
Solution.
Generally, a 50% to 75% occlusion in the arterial lumen causes symptoms associated with intermittent
claudication. When the demand for oxy-gen becomes greater than the supply in the working muscle, the
client experience pain (aching, cramping). When the individual sits down and rests, the demand and
supply of oxygen become balanced and the dis-comfort dissipates. Occlusion of 100% would result in
ischemia and necrosis of tissue distal to the artery and would require immediate surgical intervention.
16. The nurse is unable to palpate the client’s left pedal pulses. Which of the following actions
should the nurse take next?
■ 1. Auscultate the pulses with a stethoscope.
■ 2. Call the physician.
■ 3. Use a Doppler ultrasound device.
■ 4. Inspect the lower left extremity.
Answer C
Solution.
When pedal pulses are not palpable, the nurse should obtain a Doppler ultrasound device. Auscultation
is not likely to be helpful if the pulse isn’t palpable. Inspection of the lower extremity can be done
simultaneously when palpating, but the nurse should first try to locate a pulse by Doppler. Calling the
physician may be necessary if there is a change in the client’s condition.
17. When using a Doppler instrument to assess peripheral pulses, the correct placement of the
transducer is important because it is difficult to dif-ferentiate between:
■ 1. Arterial and capillary blood flow.
■ 2. Arterial and venous blood flow.
■ 3. Arterial and arteriole blood flow.
■ 4. Capillary and venous blood flow.
Answer B
Solution.
The sound produced by the Doppler instrument reflects all of the vascular structures in the path of the
sound beam; therefore, it may be hard to differentiate between arterial and venous blood flow.
Capillary and arteriole blood flow can-not be auscultated with a Doppler instrument.
18. Which of the following lipid abnormalities is a risk factor for the development of atherosclerosis
and peripheral vascular disease?
■ 1. Low concentration of triglycerides.
■ 2. High levels of high-density lipid (HDL) cholesterol.
■ 3. High levels of low-density lipid (LDL) cholesterol.
■ 4. Low levels of LDL cholesterol.
Answer C
Solution.
An increased LDL cholesterol concentra-tion has been documented as a risk factor for the development
of atherosclerosis. LDL cholesterol is not broken down in the liver but is deposited into the intima of the
blood vessels. Low triglyceride levels are desirable. High HDL and low LDL levels are beneficial and are
known to be protective for the cardiovascular system.
19. When assessing an individual with periph-eral vascular disease, which clinical manifestation
would indicate complete arterial obstruction in the lower left leg?
■ 1. Aching pain in the left calf.
■ 2. Burning pain in the left calf.
■ 3. Numbness and tingling in the left leg.
■ 4. Coldness of the left foot and ankle.
Answer D
Solution.
Coldness in the left foot and ankle is consistent with complete arterial obstruction. Other expected
findings would include paralysis and pallor. Aching pain, a burning sensation, or numb-ness and tingling
are earlier signs of tissue hypoxia and ischemia and are commonly associated within incomplete
obstruction.
20. One goal of care for a client with PVD is to decrease anxiety, so as to decrease or prevent vaso-
constriction of the:
■ 1. Arteries.
■ 2. Capillaries.
■ 3. Lymphatics.
■ 4. Veins.
Answer A
Solution.
Anxiety stimulates the sympathetic nervous system, which results in the secretion of epinephrine,
angiotensin, and serum proteins that cause vasoconstriction in the arteries of the periph-eral circulatory
system. As a result, peripheral vas-cular resistance is increased. This vasoconstriction may increase pain
in the areas where PVD is the greatest. The lymphatic system does not affect the blood supply of tissues.
21. A 70-year-old male with the diagnosis of claudication has been hospitalized for an evaluation of
his increasingly impaired mobility and com-plaints of pain. The client tells the nurse that he can no
longer walk a block without having severe pain in his left calf and foot. Based on these data, which
nursing diagnosis would be most appropriate for this client?
■ 1. Activity intolerance related to decreased blood supply and pain.
■ 2. Self-care deficit related to increased leg pain.
■ 3. Ineffective coping related to chronic pain.
■ 4. Impaired skin integrity related to poor circu-lation.
Answer A
Solution.
Activity intolerance related to decreased blood supply and pain is a common problem with clients
experiencing claudication. The goal should be to educate the client to maintain his level of activity and
incorporate frequent rest periods to pre-vent episodes of decreased blood supply. The data do not
suggest that the client cannot perform self-care activities, is not coping with his chronic pain, or that his
skin integrity is impaired. It should be appropriate to incorporate the nursing diagnosis of Risk for
impaired skin integrity into the client’s plan of care.
23. A client with a history of heart failure has bilateral +4 edema of her right ankle that extends up to
midcalf. She is sitting out of bed and has her legs in a dependent position. Which of the following goals is
the priority?
■ 1. Decrease venous congestion.
■ 2. Maintain normal respirations.
■ 3. Maintain body temperature.
■ 4. Prevent injury to lower extremities.
Answer A
Solution.
Decreasing venous congestion in the extremities is a desired outcome for clients with heart failure. The
nurse should elevate the client’s legs above the level of the heart to achieve this goal. The client is not
demonstrating difficulty breath-ing or being cold. The nurse should prevent injury to the swollen
extremity; however, this is not the priority.
24. The nurse is assessing an older Caucasian male who has a history of peripheral vascular dis-ease. The
nurse observes that the man’s left great toe is black. The discoloration is probably a result of:
■ 1. Atrophy.
■ 2. Contraction.
■ 3. Gangrene.
■ 4. Rubor.
Answer C
Solution.
The term gangrene refers to blackened, decomposing tissue that is devoid of circulation. Chronic
ischemia and death of the tissue can lead to gangrene in the affected extremity. Injury, edema, and
decreased circulation lead to infection, gangrene, and tissue death. Atrophy is the shrinking of tissue,
and contraction is joint stiffening secondary to disuse. The term rubor denotes a reddish color of the
skin.