The nurse is caring for a patient who has a venous leg ulcer. The patient asks why these ulcers occur. What will the nurse explain as the cause for the development of venous ulcers?

"Your veins are not functioning properly. Lack of venous blood volume causes these ulcers"

"Your veins are weaker and blood is not moving up as it should. The congestion in your veins causes the ulcers to form.

"Because the veins are not working properly, there is not enough oxygen going to the skin of your legs."

"Your veins clogged so the body causes the arteries to swell and the excess oxygen in the blood causes the ulcers."

Answer and Explanation

The Correct Answer is B

A. "Your veins are not functioning properly. Lack of venous blood volume causes these ulcers": While venous insufficiency contributes to the development of venous ulcers, the primary issue is not necessarily a lack of venous blood volume but rather impaired venous return due to valve dysfunction.

B. "Your veins are weaker and blood is not moving up as it should. The congestion in your veins causes the ulcers to form.": This explanation accurately describes the pathophysiology of venous ulcers. Venous insufficiency leads to venous congestion, which causes increased pressure in the veins of the lower extremities. This pressure can result in the breakdown of skin and the formation of ulcers, typically around the ankles.

C. "Because the veins are not working properly, there is not enough oxygen going to the skin of your legs.": While venous insufficiency can affect tissue oxygenation to some extent, the primary mechanism leading to venous ulcers is venous congestion and increased pressure in the lower extremities, rather than insufficient oxygen delivery.

D. "Your veins clogged so the body causes the arteries to swell and the excess oxygen in the blood causes the ulcers.": This explanation does not accurately describe the pathophysiology of venous ulcers. Venous ulcers result from impaired venous return and venous congestion, not arterial swelling or excess oxygen in the blood.

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Correct Answer is D

Explanation

A. Dry skin:
Dry skin is not a commonly reported side effect of diltiazem, a calcium channel blocker used for blood pressure management. While dry skin can occur due to various reasons, it is less likely to be directly associated with diltiazem use. Therefore, it is not the side effect that the nurse should prioritize instructing the patient to report to the provider.

B. Burning sensation:
Although burning sensation is not a common side effect of diltiazem, it can occasionally occur as a skin reaction or hypersensitivity reaction to the medication. While this symptom may warrant attention, it is generally less concerning compared to other potential side effects of diltiazem. Therefore, while it is important for the patient to report any unusual sensations or discomfort, burning sensation alone may not be the most critical side effect to report.

C. Diarrhea:
Diarrhea is a potential side effect of diltiazem use. Calcium channel blockers like diltiazem can affect gastrointestinal motility and lead to gastrointestinal disturbances, including diarrhea. While diarrhea can be bothersome and may indicate intolerance to the medication, it is generally considered a common side effect rather than a severe adverse reaction. Therefore, while the nurse should educate the patient about the possibility of diarrhea and encourage reporting any persistent or severe cases, it may not be the most critical side effect to report to the provider.

D. Irregular heart rate:
Irregular heart rate, including bradycardia or tachycardia, is a significant and potentially serious side effect of diltiazem. As a calcium channel blocker, diltiazem can affect cardiac conduction, leading to alterations in heart rate and rhythm. Irregular heart rate can indicate a significant cardiovascular complication and may require prompt medical attention. Therefore, the nurse should prioritize instructing the patient to report any changes in heart rate, including palpitations, rapid heartbeat, or irregular pulse, to the provider immediately.

A. A Administer post-exposure prophylaxis medication. B. Determine the HIV status of the patient. C. Advise exposed health care providers to use precautions. D. Undergo early reevaluation after exposure.

Correct Answer is C

Explanation

A. Administer post-exposure prophylaxis medication: While post-exposure prophylaxis (PEP) medication may be necessary in certain cases of needlestick injuries involving potential exposure to HIV, it is not the first step to perform. The initial priority is to ensure the safety of the healthcare provider and prevent potential transmission of the virus.

B. Determine the HIV status of the patient: Determining the HIV status of the patient is essential for risk assessment and guiding subsequent management. However, this step may take some time, and immediate action to protect the healthcare provider should not be delayed while waiting for the patient's HIV status to be confirmed.

C. Advise exposed healthcare providers to use precautions: This is the first step to perform after a needlestick injury. Healthcare providers should be immediately advised to use standard precautions, including hand hygiene and the use of personal protective equipment, to minimize the risk of transmission of bloodborne pathogens.

D. Undergo early reevaluation after exposure: Early reevaluation after exposure is important to assess the risk of transmission and determine the need for further interventions, including PEP medication. However, advising exposed healthcare providers to use precautions should take precedence as an immediate response to the injury.

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The nurse is caring for a patient who has a venous leg ulcer. The patient asks why these ulcers occur. What will the nurse explain as the cause for the development of venous ulcers?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient taking diltiazem for blood pressure management. The nurse instructs the patient to report which side effect to the provider?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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