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. A pharmacist would not provide a definitive answer regarding how long it takes for heparin to dissolve clots. The nurse should provide correct information about heparin's function.

B. Heparin reaches a therapeutic blood level relatively quickly (within hours), but it does not dissolve clots; it just prevents further clot formation.

C. Heparin is an anticoagulant, not a thrombolytic. It prevents the formation of new clots and reduces the risk of existing clots becoming larger, but it does not break down the clots. Thrombolytics (e.g., tissue plasminogen activator) are required for dissolving clots.

D. Oral medications like warfarin (Coumadin) are also anticoagulants but are not used for dissolving clots.

A. Temperature B. Oxygen saturation C. Blood pressure D. Apical pulse rate

Correct Answer is C

Explanation

A. Temperature is not directly related to the effects of nitroglycerin or the client’s need for additional doses.

B. While oxygen saturation is important, it does not directly influence the decision to administer nitroglycerin, which primarily works to relieve chest pain by dilating coronary arteries and reducing myocardial oxygen demand.

C. Nitroglycerin is a vasodilator that can lower blood pressure. It is crucial to check the client’s blood pressure before administering another dose of nitroglycerin because excessive drops in blood pressure can lead to dizziness, fainting, or other complications. If the blood pressure is already low, further administration may be contraindicated.

D. Apical pulse rate is important to monitor but is not the most critical cue in this scenario. Nitroglycerin primarily affects blood pressure and coronary circulation rather than directly influencing heart rate.

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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

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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