The nurse refers an older adult client for further evaluation after the nurse assesses warm skin and brown pigmentation around the ankles. The nurse suspects which of the following?

Dependent edema

Stasis ulceration

Arterial occlusion

Venous insufficiency

Answer and Explanation

The Correct Answer is D

A. Dependent edema is characterized by swelling in the lower extremities due to gravity and may not always present with pigmentation changes.

B. Stasis ulceration involves ulcerative lesions typically occurring on the lower legs, often associated with venous insufficiency, but the pigmentation alone does not confirm ulceration.

C. Arterial occlusion typically presents with symptoms such as pain, pallor, and decreased pulses, not necessarily with warm skin and brown pigmentation.

D. Venous insufficiency is characterized by symptoms such as warm skin, brown pigmentation around the ankles (due to hemosiderin deposition from blood pooling), and swelling.

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Correct Answer is D

Explanation

A. Aortic murmurs: These are best assessed with the client in an upright or slightly leaning forward position, not specifically the left lateral position.

B. Atrial repolarization: This is not directly assessed by body position; it is part of the ECG assessment.

C. The first heart sound: The first heart sound (S1) is heard throughout the auscultation process and is not specifically enhanced by a left lateral position.

D. Mitral stenosis: The left lateral position allows better auscultation of the mitral area, where mitral stenosis murmurs are best heard.

A. Smoking B. Diabetes C. Elevated Cholesterol Levels D. Hypertension

Correct Answer is ["A","B","C","D"]

Explanation

A. Smoking: Smoking is a major risk factor for peripheral vascular disease as it contributes to vascular damage and atherosclerosis.

B. Diabetes: Diabetes increases the risk of peripheral vascular disease by contributing to endothelial dysfunction and atherosclerosis.

C. Elevated Cholesterol Levels: High cholesterol levels contribute to the formation of atherosclerotic plaques in peripheral vessels.

D. Hypertension: High blood pressure can lead to damage of blood vessels and increase the risk of peripheral vascular disease.

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The nurse refers an older adult client for further evaluation after the nurse assesses warm skin and brown pigmentation around the ankles. The nurse suspects which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While auscultating heart sounds, asking the client to turn onto a left lying position would help the nurse assess the presence of which of the following?

Correct Answer is D

Explanation

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Correct Answer is ["A","B","C","D"]

Explanation

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