A nurse is assessing a client who has chronic venous insufficiency. Which of the following findings should the nurse expect?

Thick, deformed toenails

Edema

Dependent rubor

Hair loss

Answer and Explanation

The Correct Answer is B

Edema is a common finding in clients who have chronic venous insufficiency, due to the impaired venous return and increased capillary pressure. The edema is usually worse at the end of the day and improves with elevation.

a. Thick, deformed toenails are more likely to be seen in clients who have fungal infections or peripheral arterial disease, not chronic venous insufficiency.

c. Dependent rubor is a sign of peripheral arterial disease, not chronic venous insufficiency. It is a reddish color of the lower extremities that occurs when they are lowered and disappears when they are elevated.

d. Hair loss is another sign of peripheral arterial disease, not chronic venous insufficiency. It is caused by the reduced blood supply to the hair follicles.

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Correct Answer is A

Explanation

a.This is appropriate as regular, moderate exercise can help improve cardiovascular health and functional capacity in clients with heart failure. It is essential to discuss appropriate types and levels of exercise based on the individual’s condition.

b.This is incorrect because clients should be instructed to notify the provider if they gain 1 kg (2.2 lbs) in one day or 2 kg (4.4 lbs) in one week. A weight gain of 0.5 kg is not typically a threshold for concern.

c. Take diuretics early in the morning and before bedtime is wrong because it may disrupt the client's sleep patern and cause nocturia. The nurse should advise the client to take diuretics early in the morning and avoid taking them in the evening or at night, unless prescribed otherwise.

d. Take naproxen for generalized discomfort is wrong because naproxen is a nonsteroidal anti-inﬂammatory drug (NSAID) that can worsen heart failure by causing sodium and water retention, increasing blood pressure, and reducing the eﬀectiveness of diuretics and other heart failure medications. The nurse should advise the client to avoid NSAIDs and use acetaminophen or other alternatives for pain relief, as prescribed by the provider.

A. "I'll skip my coﬀee the morning of my test." B. "I'll take my heart medications the morning of my test." C. "I'll get 8 hours of sleep the night before the test." D. "I will not smoke prior to my test."

Correct Answer is B

Explanation

An exercise stress test is a diagnostic procedure that measures the heart's response to physical activity. The client is instructed to walk on a treadmill or pedal a stationary bike while their heart rate, blood pressure, and electrocardiogram are monitored. The test can help detect coronary artery disease, arrhythmias, or other cardiac problems.

The client should follow certain guidelines before the test, such as:

Avoiding caﬀeine, nicotine, alcohol, and stimulants for at least 4 hours before the test, as they can aﬀect the heart rate and blood pressure.
Fasting for at least 2 hours before the test, as eating can aﬀect the blood ﬂow to the heart.
Getting adequate rest and sleep the night before the test, as fatigue can aﬀect the performance and results of the test.
Wearing comfortable clothing and shoes that are suitable for exercise.
Informing the provider of any medications they are taking, as some medications may need to be withheld or adjusted before the test, such as beta blockers, calcium channel blockers, nitrates, or antiarrhythmics. These medications can aﬀect the heart rate and blood pressure and interfere with the interpretation of the test results.

Therefore, the comment made by the client that indicates a need for further teaching is "I'll take my heart medications the morning of my test." The client should consult with their provider about whether they should take their heart medications or not before the test. The other comments made by the client are appropriate and indicate that they understand the pre-test instructions.

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A nurse is assessing a client who has chronic venous insufficiency. Which of the following findings should the nurse expect?

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Correct Answer is B

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