A patient reports leg pain that awakens the patient at night.
The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled.
Which condition would the nurse suspect?

Peripheral arterial disease.

Lymphatic obstruction.

Chronic venous insufficiency.

Musculoskeletal abnormalities.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The patient's symptoms of leg pain that worsens at night and occurs when the legs are elevated but improves when they are dangled are indicative of peripheral arterial disease (PAD) PAD is a condition caused by the narrowing of arteries in the legs due to atherosclerosis. This narrowing restricts blood flow to the muscles, causing pain, especially during activities or positions that demand increased blood flow like walking or elevating the legs.

Choice B rationale:

Lymphatic obstruction typically does not cause pain in the same manner described by the patient. Lymphatic obstruction may cause swelling and discomfort, but it usually does not lead to pain that worsens with elevation and improves with dangling.

Choice C rationale:

Chronic venous insufficiency can cause leg pain and swelling, especially when standing for extended periods. However, the characteristic of pain worsening at night and with leg elevation points more towards arterial issues like PAD rather than venous insufficiency.

Choice D rationale:

Musculoskeletal abnormalities could cause localized pain, but the pattern described by the patient (worsening at night, relief with dangling) is not typical of musculoskeletal issues. PAD, on the other hand, often presents with these specific symptoms due to compromised blood flow to the muscles in the legs.

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Correct Answer is A

Explanation

Choice B rationale:

A decrease in plasma renin levels is not a known cause of primary hypertension. Primary hypertension often has no identifiable cause, and it is a diagnosis of exclusion.

Choice C rationale:

Too much plaque in the blood vessels describes atherosclerosis, which is a risk factor for hypertension but not the direct cause of primary hypertension. Plaque buildup narrows arteries and increases resistance, contributing to elevated blood pressure.

Choice D rationale:

Kidney disease can cause secondary hypertension but is not the most common cause of primary hypertension. Primary hypertension, also known as essential hypertension, is the most common form, and its exact cause remains unknown in many cases.

A. 0.459% saline. B. 0.9% NaCl. C. 5% dextrose in 0.45% saline. D. Dextran.

Correct Answer is B

Explanation

Choice A rationale:

0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.

Choice B rationale:

0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.

Choice C rationale:

5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.

Choice D rationale:

Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.

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A patient reports leg pain that awakens the patient at night.The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled.Which condition would the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is diagnosed with primary hypertension and asks the nurse what caused the condition.Which response would the nurse give?

Correct Answer is A

Explanation

Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?

Correct Answer is B

Explanation

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A patient reports leg pain that awakens the patient at night.
The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled.
Which condition would the nurse suspect?