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A patient has been diagnosed with venous stasis. Which of these findings would the nurse most likely observe?

Pallor of the toes and cyanosis of the nail beds

Thin, shiny, atrophic skin

Brownish discoloration to the skin of the lower leg

Unilateral cool foot

Answer and Explanation

The Correct Answer is C

A. Pallor and cyanosis: Indicative of arterial insufficiency, not venous disease.

B. Thin, shiny skin: Seen in peripheral arterial disease (PAD).

C. Brownish discoloration: Caused by hemosiderin deposits from chronic venous congestion.

D. Unilateral cool foot: Suggests acute arterial obstruction.

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Correct Answer is B

Explanation

A. 1 minute: This is not the correct duration for assessing bowel sounds.

B. 2 minutes each quadrant: Bowel sounds should be auscultated for at least 2 minutes per quadrant before determining that they are absent.

C. 5 minutes: Listening for 5 minutes is excessive and typically unnecessary unless there is concern about a complete absence of bowel sounds.

D. 10 minutes: 10 minutes is also too long for auscultation unless specifically indicated by clinical findings, like suspected paralytic ileus.

A. Decrease in tear production B. Unequal pupillary constriction in response to light C. Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles D. Presence of arcus senilis observed around the cornea

Correct Answer is B

Explanation

A. Decrease in tear production: This is a common age-related change and is not considered abnormal.

B. Unequal pupillary constriction: Correct. Unequal pupillary constriction (anisocoria) is not normal and may indicate neurological issues.

C. Loss of outer eyebrow hair: This is a normal age-related change due to decreased hair follicles.

D. Arcus senilis: This is a common finding in older adults and is typically benign, caused by lipid deposits around the cornea.

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A patient has been diagnosed with venous stasis. Which of these findings would the nurse most likely observe?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is B

Explanation

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