The nurse is evaluating a client with multiple cardiovascular risk factors. Which of the following assessment findings would be most indicative of chronic venous insufficiency?

Bilateral lower extremity reddening when legs are dangled in a dependent position.

Shiny white skin with "hole-punch" ulcers.

Leathery brown skin with irregular ulcers over the ankles.

Red, swollen, tender area to one calf.

Answer and Explanation

The Correct Answer is C

A. Bilateral lower extremity reddening when legs are dangled could be seen in other conditions like deep vein thrombosis (DVT) but is not typical of CVI.

B. Shiny white skin with "hole-punch" ulcers is more characteristic of arterial insufficiency rather than venous insufficiency.

C. Chronic venous insufficiency (CVI) is characterized by impaired venous return, which leads to fluid buildup, skin changes, and ulcer formation. The skin becomes leathery and brown due to hemosiderin deposition from blood pooling in the lower extremities. Ulcers often occur around the ankles and have irregular borders.

D. Red, swollen, tender areas in one calf are more indicative of DVT, not chronic venous insufficiency.

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Correct Answer is C

Explanation

A. Hydralazine is a vasodilator, but it does not have the same mechanism of action as ACE inhibitors or ARBs and would not be an appropriate substitute.

B. An antiplatelet medication is not appropriate for addressing a cough and is typically used for cardiovascular conditions like preventing blood clots.

C. ARBs, such as losartan, are a class of medications that work similarly to ACE inhibitors by blocking the effects of angiotensin II, but they do not cause the common side effect of a dry, hacking cough, which is seen with ACE inhibitors. This makes ARBs a good alternative for patients who experience this side effect.

D. Nitroglycerin is a vasodilator used in acute conditions like chest pain, not for managing hypertension or a cough related to ACE inhibitors.

A. Troponin level B. Electrocardiogram (ECG) C. Insertion of a peripheral IV D. Chest X-ray

Correct Answer is B

Explanation

A. A troponin level will confirm myocardial injury but should be done after an ECG, as the ECG provides immediate information on the condition.

B. The first action in a chest pain situation is to obtain an ECG to assess for myocardial infarction or other cardiac abnormalities. The ECG provides immediate information about the heart's electrical activity and can help identify whether the chest pain is related to a cardiac event.

C. Insertion of a peripheral IV is important for administering medications and fluids, but it is not as urgent as obtaining an ECG to evaluate the patient's heart.

D. A chest X-ray is useful for other potential diagnoses (e.g., pulmonary embolism or pneumothorax) but is not the first step in diagnosing a myocardial event.

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The nurse is evaluating a client with multiple cardiovascular risk factors. Which of the following assessment findings would be most indicative of chronic venous insufficiency?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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