Chapter 38: Nursing Management: Vascular Disorders Test Bank

Chapter 38: Nursing Management: Vascular Disorders
Test Bank
MULTIPLE CHOICE
1. When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal
aortic aneurysm, the nurse will focus discharge teaching on which patient risk factor?
a. Male gender
b. Turner syndrome
c. Abdominal trauma history
d. Uncontrolled hypertension
ANS: D
All of the factors contribute to the patients hgrisk, but only hypertension can potentially be
modified to decrease the patients risk for further expansion of the aneurysm.
DIF: Cognitive Level: Apply (application) REF: 842

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-
ray. When obtaining an admission history from the patient, it will be most important for the
nurse to ask about
a. low back pain.
b. trouble swallowing.
c. abdominal tenderness.
d. changes in bowel habits.
ANS: B
Difficulty swallowing may occur with a thoracic aneurysm because of pressure on the
esophagus. The other symptoms will be important to assess for in patients with abdominal
aortic aneurysms.

TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. Several hours after an open surgical repair of an abdominal aortic aneurysm, the UAP reports
to the nurse that urinary output for the past 2 hours has been 40 mL. The nurse notifies the
health care provider and anticipates an order for a(n)
a. hemoglobin count.
b. additional antibiotic.
c. decrease in IV infusion rate.
d. blood urea nitrogen (BUN) level.
ANS: D
The decreased urine output suggests decreased renal perfusion, and monitoring of renal
function is needed. There is no indication that infection is a concern, so antibiotic therapy and
a WBC count are not needed. The IV rate may be increased because hypovolemia may be
contributing to the patients decreased urinary output.

TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
4. A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD).
Which group of medications will the nurse plan to include when providing patient teaching
about PAD management?
a. Statins
b. Antibiotics
c. Thrombolytics
d. Anticoagulants
ANS: A
Current research indicates that statin use by patients with PAD improves multiple outcomes.
There is no research that supports the use of the other medication categories in PAD.

5. A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain,
pulselessness, pallor, and coolness in the right leg. The nurse should notify the health care
provider and immediately
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position.
ANS: D
The patients history and clinical manifestations are consistent with acute arterial occlusion,
and resting the leg will decrease the oxygen demand of the tissues and minimize ischemic
damage until circulation can be restored. Elevating the leg or applying an elastic wrap will
further compromise blood flow to the leg. Exercise will increase oxygen demand for the
tissues of the leg.
DIF: Cognitive Level: Apply (application) REF: 839-840

6. A patient at the clinic says, I have always taken a walk after dinner, but lately my leg cramps
and hurts after just a few minutes of starting. The pain goes away after I stop walking,
though. The nurse should
a. check for the presence of tortuous veins bilaterally on the legs.
b. ask about any skin color changes that occur in response to cold.
c. assess for unilateral swelling, redness, and tenderness of either leg.
d. assess for the presence of the dorsalis pedis and posterior tibial pulses.
ANS: D
The nurse should assess for other clinical manifestations of peripheral arterial disease in a
patient who describes intermittent claudication. Changes in skin color that occur in response
to cold are consistent with Raynauds phenomenon. Tortuous veins on the legs suggest venous
insufficiency. Unilateral leg swelling, redness, and tenderness indicate venous
thromboembolism (VTE).

7. The nurse performing an assessment with a patient who has chronic peripheral artery disease
(PAD) of the legs and an ulcer on the right second toe would expect to find
a. dilated superficial veins.
b. swollen, dry, scaly ankles.
c. prolonged capillary refill in all the toes.
d. a serosanguineous drainage from the ulcer.
ANS: C
Capillary refill is prolonged in PAD because of the slower and decreased blood flow to the
periphery. The other listed clinical manifestations are consistent with chronic venous disease.

8. When evaluating the discharge teaching for a patient with chronic peripheral artery disease
(PAD), the nurse determines a need for further instruction when the patient says, I will
a. have to buy some loose clothes that do not bind across my legs or waist.
b. use a heating pad on my feet at night to increase the circulation and warmth
in my feet.
c. change my position every hour and avoid long periods of sitting with my legs
crossed.
d. walk to the point of pain, rest, and walk again until the pain returns for at least 30
minutes 3 times a week.
ANS: B
Because the patient has impaired circulation and sensation to the feet, the use of a heating pad
could lead to burns. The other patient statements are correct and indicate that teaching has
been successful.

TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
9. After teaching a patient with newly diagnosed Raynauds phenomenon about how to manage
the condition, which action by the patient demonstrates that the teaching has been effective?
a. The patient exercises indoors during the winter months.
b. The patient places the hands in hot water when they turn pale.
c. The patient takes pseudoephedrine (Sudafed) for cold symptoms.
d. The patient avoids taking nonsteroidal antiinflammatory drugs (NSAIDs).
ANS: A
Patients should avoid temperature extremes by exercising indoors when it is cold. To avoid
burn injuries, the patient should use warm, rather than hot, water to warm the hands.
Pseudoephedrine is a vasoconstrictor, and should be avoided. There is no reason to avoid
taking NSAIDs with Raynauds phenomenon.

10. 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 patients
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.
ANS: D
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.

11. The health care provider prescribes an infusion of heparin (Hep-Lock) 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 any IM medications to prevent localized bleeding.
c. monitor posterior tibial and dorsalis pedis pulses with the Doppler.
d. have vitamin K available in case reversal of the heparin is needed.
ANS: B
IM injections are avoided in patients receiving anticoagulation. A PTT of 65 seconds is within
the therapeutic range. Vitamin K is used to reverse warfarin. Pulse quality is not affected by
VTE.

12. 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 appropriate?
a. Taking two blood thinners reduces the risk for another clot to form.
b. Lovenox will start to dissolve the clot, and Coumadin will prevent any more clots
from forming.
c. Lovenox will work right away, but Coumadin takes several days to have an
effect on preventing clots.
d. Because of the risk for a blood clot in the lungs, it is important for you to take
more than one blood thinner.
ANS: C
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. Furthermore, anticoagulants should not be
described as blood thinners.

13. The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin)
following 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 Coumadin.
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 Coumadin.
d. I will check with my health care provider before I begin any new medications.
ANS: B
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. The other patient statements are accurate.

14. A 46-year-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 around venous valves.
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 the patient who had just had
sclerotherapy.

15. Which topic should the nurse include in patient teaching for a patient with a venous stasis
ulcer on the left lower leg?
a. Need to increase carbohydrate intake
b. Methods of keeping the wound area dry
c. Purpose of prophylactic antibiotic therapy
d. Application of elastic compression stockings
ANS: D
Compression of the leg is essential to healing of venous stasis ulcers. High dietary intake of
protein, rather than carbohydrates, is needed. Prophylactic antibiotics are not routinely used
for venous ulcers. Moist dressings are used to hasten wound healing.

16. A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency.
Which patient statement is most supportive of the diagnosis?
a. I cant get my shoes on at the end of the day.
b. I cant seem to ever get my feet warm enough.
c. I have burning leg pains after I walk two blocks.
d. I wake up during the night because my legs hurt.
ANS: A
Because the edema associated with venous insufficiency increases when the patient has been
standing, shoes will feel tighter at the end of the day. The other patient statements are
characteristic of peripheral artery disease (PAD).

17. Which nursing action should be included in the plan of care after endovascular repair of an
abdominal aortic aneurysm?
a. Record hourly chest tube drainage.
b. Monitor fluid intake and urine output.
c. Check the abdominal incision for any redness.
d. Teach the reason for a prolonged recovery period.
ANS: B
Because renal artery occlusion can occur after endovascular repair, the nurse should monitor
parameters of renal function such as intake and output. Chest tubes will not be needed for
endovascular surgery, the recovery period will be short, and there will not be an abdominal
wound.

18. Which action by a nurse who is giving fondaparinux (Arixtra) to a patient with a lower leg
venous thromboembolism (VTE) indicates that more education about the drug is needed?
a. The nurse avoids rubbing the injection site after giving the drug.
b. The nurse injects the drug into the abdominal subcutaneous tissue.
c. The nurse ejects the air bubble in the syringe before giving the drug.
d. The nurse fails to assess the partial thromboplastin time (PTT) before giving the
drug.
ANS: C
The air bubble is not ejected before giving fondaparinux to avoid loss of medication. The
other actions by the nurse are appropriate.

TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment
19. A 23-year-old patient tells the health care provider about experiencing cold, numb fingers
when running during the winter and Raynauds phenomenon is suspected. The nurse will
anticipate teaching the patient about tests for
a. hyperglycemia.
b. hyperlipidemia.
c. autoimmune disorders.
d. coronary artery disease.
ANS: C
Secondary Raynauds phenomenon may occur in conjunction with autoimmune diseases such
as rheumatoid arthritis. Patients should be screened for autoimmune disorders. Raynauds
phenomenon is not associated with hyperlipidemia, hyperglycemia, or coronary artery disease.

20. While working in the outpatient clinic, the nurse notes that a patient has a history of
intermittent claudication. Which statement by the patient would support this information?
a. When I stand too long, my feet start to swell.
b. I get short of breath when I climb a lot of stairs.
c. My fingers hurt when I go outside in cold weather.
d. My legs cramp whenever I walk more than a block.
ANS: D
Cramping that is precipitated by a consistent level of exercise is descriptive of intermittent
claudication. Finger pain associated with cold weather is typical of Raynauds phenomenon.
Shortness of breath that occurs with exercise is not typical of intermittent claudication, which
is reproducible. Swelling associated with prolonged standing is typical of venous disease.

21. When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral
artery disease (PAD), which instructions should the nurse include?
a. Exercise only if you do not experience any pain.
b. It is very important that you stop smoking cigarettes.
c. Try to keep your legs elevated whenever you are sitting.
d. Put elastic compression stockings on early in the morning.
ANS: B
Smoking cessation is essential for slowing the progression of PAD to critical limb ischemia
and reducing the risk of myocardial infarction and death. Circulation to the legs will decrease
if the legs are elevated. Patients with PAD are taught to exercise to the point of feeling pain,
rest, and then resume walking. Support hose are not used for patients with PAD.

22. An 80-year-old patient with a history of an abdominal aortic aneurysm arrives at the
emergency department (ED) with severe back pain and absent pedal pulses. Which actions
should the nurse take first?
a. Obtain the blood pressure.
b. Obtain blood for laboratory testing.
c. Assess for the presence of an abdominal bruit.
d. Determine any family history of kidney disease.
ANS: A
Because the patient appears to be experiencing aortic dissection, the nurses first action should
be to determine the hemodynamic status by assessing blood pressure. The other actions also
may be done, but they will not provide information that will determine what interventions are
needed immediately for this patient.

OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
23. After receiving report, which patient admitted to the emergency department should the nurse
assess first?
a. 67-year-old who has a gangrenous left foot ulcer with a weak pedal pulse
b. 58-year-old who is taking anticoagulants for atrial fibrillation and has black stools
c. 50-year-old who is complaining of sudden sharp and worst ever upper
back pain
d. 39-year-old who has right calf tenderness, redness, and swelling after a long plane
ride
ANS: C
The patients presentation is consistent with dissecting thoracic aneurysm, which will require
rapid intervention. The other patients do not need urgent interventions.
DIF: Cognitive Level: Analyze (analysis) REF: 846

OBJ: Special Questions: Prioritization; Multiple Patients
24. The nurse is caring for a patient immediately after repair of an abdominal aortic aneurysm. On
assessment, the patient has absent popliteal, posterior tibial, and dorsalis pedis pulses. The
legs are cool and mottled. Which action should the nurse take first?
a. Notify the surgeon and anesthesiologist.
b. Wrap both the legs in a warming blanket.
c. Document the findings and recheck in 15 minutes.
d. Compare findings to the preoperative assessment of the pulses.
ANS: A
Lower extremity pulses may be absent for a short time after surgery because of vasospasm
and hypothermia. Decreased or absent pulses together with a cool and mottled extremity may
indicate embolization or graft occlusion. These findings should be reported to the physician
immediately because this is an emergency situation. Because pulses are marked prior to
surgery, the nurse would know whether pulses were present prior to surgery before notifying
the health care providers about the absent pulses. Because the patients symptoms may
indicate graft occlusion or multiple emboli and a possible need to return to surgery, it is not
appropriate to wait 15 minutes before taking action. A warming blanket will not improve the
circulation to the patients legs.

25. When caring for a patient on the first postoperative day after an abdominal aortic aneurysm
repair, which assessment finding is most important for the nurse to communicate to the health
care provider?
a. Presence of flatus
b. Loose, bloody stools
c. Hypoactive bowel sounds
d. Abdominal pain with palpation
ANS: B
Loose, bloody stools at this time may indicate intestinal ischemia or infarction, and should be
reported immediately because the patient may need an emergency bowel resection. The other
findings are normal on the first postoperative day after abdominal surgery.

OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
26. The nurse is caring for a patient with critical limb ischemia who has just arrived on the
nursing unit after having percutaneous transluminal balloon angioplasty. Which action should
the nurse perform first?
a. Begin oral intake.
b. Obtain vital signs.
c. Assess pedal pulses.
d. Start discharge teaching.
ANS: B
Bleeding is a possible complication after catheterization of the femoral artery, so the nurses
first action should be to assess for changes in vital signs that might indicate hemorrhage. The
other actions are also appropriate but can be done after determining that bleeding is not
occurring.

27. A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for
on the vascular unit. Which action by a licensed practical/vocational nurse (LPN/LVN) caring
for the patient requires the registered nurse (RN) to intervene?
a. The LPN/LVN has the patient sit in a chair for 90 minutes.
b. The LPN/LVN assists the patient to walk 40 feet in the hallway.
c. The LPN/LVN gives the ordered aspirin 160 mg after breakfast.
d. The LPN/LVN places the patient in a Fowlers position for meals.
ANS: A
The patient should avoid sitting for long periods because of the increased stress on the suture
line caused by leg edema and because of the risk for venous thromboembolism (VTE). The
other actions by the LPN/LVN are appropriate.

OBJ: Special Questions: Delegation TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment
28. A 46-year-old is diagnosed with thromboangiitis obliterans (Buergers disease). When the
nurse is developing a discharge teaching plan for the patient, which outcome has the highest
priority for this patient?
a. Cessation of all tobacco use
b. Control of serum lipid levels
c. Maintenance of appropriate weight
d. Demonstration of meticulous foot care
ANS: A
Absolute cessation of nicotine use is needed to reduce the risk for amputation in patients with
Buergers disease. Other therapies have limited success in treatment of this disease.

OBJ: Special Questions: Prioritization TOP: Nursing Process: Planning
29. Which assessment finding for a patient who has been admitted with a right calf venous
thromboembolism (VTE) requires immediate action by the nurse?
a. Erythema of right lower leg
b. Complaint of right calf pain
c. New onset shortness of breath
d. Temperature of 100.4 F (38 C)
ANS: C
New onset dyspnea suggests a pulmonary embolus, which will require rapid actions such as
oxygen administration and notification of the health care provider. The other findings are
typical of VTE.

OBJ: Special Questions: Prioritization TOP: Nursing Process: Planning
30. Which nursing intervention for a patient who had an open repair of an abdominal aortic
aneurysm 2 days previously is appropriate for the nurse to delegate to unlicensed assistive
personnel (UAP)?
a. Monitor the quality and presence of the pedal pulses.
b. Teach the patient the signs of possible wound infection.
c. Check the lower extremities for strength and movement.
d. Help the patient to use a pillow to splint while coughing.
ANS: D
Assisting a patient who has already been taught how to cough is part of routine postoperative
care and within the education and scope of practice for UAP. Patient teaching and assessment
of essential postoperative functions such as circulation and movement should be done by RNs.

OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
31. The nurse is caring for a patient with a descending aortic dissection. Which assessment
finding is most important to report to the health care provider?
a. Weak pedal pulses
b. Absent bowel sounds
c. Blood pressure 137/88 mm Hg
d. 25 mL urine output over last hour
ANS: C
The blood pressure is typically kept at less than 120 mm Hg systolic to minimize extension of
the dissection. The nurse will need to notify the health care provider so that -blockers or
other antihypertensive medications can be prescribed. The other findings are typical with
aortic dissection and should also be reported but do not require immediate action.

OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
32. A patient is being evaluated for post-thrombotic syndrome. Which assessment will the nurse
perform?
a. Ask about leg pain with exercise.
b. Determine the ankle-brachial index.
c. Assess capillary refill in the patients toes.
d. Check for presence of lipodermatosclerosis.
ANS: D
Clinical signs of post-thrombotic syndrome include lipodermatosclerosis. In this situation, the
skin on the lower leg becomes scarred, and the leg becomes tapered like an inverted bottle.
The other assessments would be done for patients with peripheral arterial disease.

33. Which actions could the nurse delegate to unlicensed assistive personnel (UAP) who are
providing care for a patient who is at risk for venous thromboembolism?
a. Monitor for any bleeding after anticoagulation therapy is started.
b. Apply sequential compression device whenever the patient is in bed.
c. Ask the patient about use of herbal medicines or dietary supplements.
d. Instruct the patient to call immediately if any shortness of breath occurs.
ANS: B
UAP training includes the use of equipment that requires minimal nursing judgment, such as
sequential compression devices. Patient assessment and teaching require more education and
critical thinking and should be done by the registered nurse (RN).

OBJ: Special Questions: Delegation TOP: Nursing Process: Planning
34. The nurse who works in the vascular clinic has several patients with venous insufficiency
scheduled today. Which patient should the nurse assign to an experienced licensed
practical/vocational nurse (LPN/LVN)?
a. Patient who has been complaining of increased edema and skin changes in the legs
b. Patient who needs wound care for a chronic venous stasis ulcer on the right
lower leg
c. Patient who has a history of venous thromboembolism and is complaining of some
dyspnea
d. Patient who needs teaching about the use of elastic compression stockings for
venous insufficiency
ANS: B
LPN education and scope of practice includes wound care. The other patients, which require
more complex assessments or education, should be managed by the RN.

OBJ: Special Questions: Delegation; Multiple Patients TOP: Nursing Process: Planning
35. The nurse reviews the admission orders shown in the accompanying figure for a patient newly
diagnosed with peripheral artery disease. Which admission order should the nurse question?
a. Use of treadmill for exercise

b. Referral for dietary instruction
c. Exercising to the point of discomfort
d. Combined clopidogrel and omeprazole therapy
ANS: D
Because the antiplatelet effect of clopidogrel is reduced when it is used with omeprazole, the
nurse should clarify this prescription with the health care provider. The other interventions are
appropriate for a patient with peripheral artery disease.

COMPLETION
1. When assessing a patient with possible peripheral artery disease (PAD), the nurse obtains a
brachial BP of 147/82 and an ankle pressure of 112/74. The nurse calculates the patients
ankle-brachial index (ABI) as ________ (round up to the nearest hundredth).
ANS:
0.76
The ABI is calculated by dividing the ankle systolic BP by the brachial systolic BP.


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Chapter 38: Nursing Management: Vascular Disorders

DIF: Cognitive Level: Apply (application) REF: 842

DIF: Cognitive Level: Apply (application) REF: 842

DIF: Cognitive Level: Apply (application) REF: 845

DIF: Cognitive Level: Apply (application) REF: 836

DIF: Cognitive Level: Apply (application) REF: 839-840

DIF: Cognitive Level: Apply (application) REF: 834

DIF: Cognitive Level: Apply (application) REF: 835

DIF: Cognitive Level: Apply (application) REF: 837-839

DIF: Cognitive Level: Apply (application) REF: 841

DIF: Cognitive Level: Apply (application) REF: 854

DIF: Cognitive Level: Apply (application) REF: 854

DIF: Cognitive Level: Apply (application) REF: 850

DIF: Cognitive Level: Apply (application) REF: 850-851

14. A 46-year-old service-counter worker undergoes sclerotherapy for treatment of superficial

DIF: Cognitive Level: Apply (application) REF: 856-857

DIF: Cognitive Level: Apply (application) REF: 857

DIF: Cognitive Level: Apply (application) REF: 857-858

DIF: Cognitive Level: Apply (application) REF: 843

DIF: Cognitive Level: Apply (application) REF: 851

DIF: Cognitive Level: Apply (application) REF: 840

DIF: Cognitive Level: Apply (application) REF: 834

DIF: Cognitive Level: Apply (application) REF: 836

DIF: Cognitive Level: Apply (application) REF: 846

DIF: Cognitive Level: Analyze (analysis) REF: 846

DIF: Cognitive Level: Apply (application) REF: 845

DIF: Cognitive Level: Apply (application) REF: 844-845

DIF: Cognitive Level: Apply (application) REF: 838

DIF: Cognitive Level: Apply (application) REF: 838

DIF: Cognitive Level: Apply (application) REF: 840

DIF: Cognitive Level: Apply (application) REF: 855

DIF: Cognitive Level: Apply (application) REF: 855

DIF: Cognitive Level: Apply (application) REF: 846

DIF: Cognitive Level: Apply (application) REF: 849

DIF: Cognitive Level: Apply (application) REF: 855

DIF: Cognitive Level: Apply (application) REF: 855

a. Use of treadmill for exercise

DIF: Cognitive Level: Apply (application) REF: 835

DIF: Cognitive Level: Apply (application) REF: 836

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