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. "Have you recently taken any antihistamines?" B. "Did you take any acetaminophen (Tylenol) today?" C. "Have there been recent stressful events in your life? D. "Have you consistently taken your medications?"

Correct Answer is D

Explanation

A. Antihistamines can raise blood pressure, but this is less likely to be the primary cause compared to medication non-adherence.

B. Acetaminophen is generally safe for use in hypertensive patients and is unlikely to contribute to the high blood pressure in this scenario.

C. Stress can contribute to elevated blood pressure, but non-adherence to medications is a more likely cause of the severe BP elevation in this case.

D. Poor medication adherence is a common cause of elevated blood pressure despite treatment. If the client has not been consistently taking their antihypertensive medications, this could explain the elevated BP and symptoms (headache, blurred vision).

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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 D

Explanation

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