A nurse is assessing a client who has chronic venous insufficiency. Which of the following findings should the nurse expect?
Dependent rubor
Thick, deformed toenails
Hair loss
Edema
The Correct Answer is D
Choice A: Dependent rubor
Dependent rubor is a reddish discoloration of the skin that occurs when the leg is in a dependent position (hanging down). This condition is typically associated with arterial insufficiency rather than chronic venous insufficiency. Arterial insufficiency occurs when there is inadequate blood flow through the arteries, leading to symptoms such as pain, cramping, and changes in skin color. Dependent rubor is a sign of poor arterial circulation and is not commonly seen in venous insufficiency.
Choice B: Thick, deformed toenails
Thick, deformed toenails can be a sign of fungal infections or other conditions affecting the nails, but they are not specifically indicative of chronic venous insufficiency. While individuals with chronic venous insufficiency may have poor circulation that can contribute to nail problems, this symptom is not a primary or common finding associated with the condition. Instead, it is more often related to other underlying health issues.
Choice C: Hair loss
Hair loss on the legs can occur due to various reasons, including poor circulation. However, it is more commonly associated with arterial insufficiency rather than chronic venous insufficiency. In arterial insufficiency, the reduced blood flow can lead to hair loss, shiny skin, and other changes in the lower extremities. Chronic venous insufficiency primarily affects the veins and leads to symptoms such as swelling, varicose veins, and skin changes.
Choice D: Edema
Edema, or swelling, is a hallmark symptom of chronic venous insufficiency. This condition occurs when the veins in the legs are unable to effectively return blood to the heart, leading to blood pooling in the lower extremities. The increased pressure in the veins causes fluid to leak into the surrounding tissues, resulting in swelling. Edema is often more pronounced at the end of the day or after prolonged periods of standing or sitting. Managing edema is a key aspect of treating chronic venous insufficiency, and it often involves the use of compression stockings, elevation of the legs, and other measures to improve venous return.
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Correct Answer is B
Explanation
Choice A reason:
Intense pruritus: While itching (pruritus) can be a symptom of skin conditions, it is not a definitive sign of malignancy in nevi. Pruritus can be associated with benign conditions such as eczema or allergic reactions. However, if a mole starts to itch, it should be monitored closely, but it is not as strong an indicator of malignancy as irregular borders.
Choice B reason:
Irregular borders: This is a significant sign of potential malignancy in nevi. Melanomas often have uneven, notched, or scalloped borders, unlike benign moles, which typically have smooth, even borders. The irregularity in the border is due to the uncontrolled growth of melanocytes, which can spread unevenly.
Choice C reason:
Uniform pigmentation: Uniform pigmentation is generally a sign of a benign mole. Malignant moles often have multiple colors or an uneven distribution of color, which can include shades of brown, black, red, white, or blue. A mole with uniform color is less likely to be malignant.
Choice D reason:
Purulent drainage: While purulent drainage (pus) indicates an infection, it is not a typical sign of malignancy in nevi. Infections can occur in any skin lesion, but they do not specifically indicate cancer. Malignant moles are more likely to change in size, shape, or color rather than produce pus.
Correct Answer is B
Explanation
Choice A: Tamoxifen
Tamoxifen is a medication primarily used to treat breast cancer. It works as a selective estrogen receptor modulator (SERM), which means it blocks estrogen receptors in breast tissue. Estrogen can promote the growth of breast cancer cells, so blocking its effects can help to slow or stop the growth of these cells. However, tamoxifen is not typically used for prostate cancer because prostate cancer is driven by androgens (male hormones) rather than estrogens.
Choice B: Leuprolide
Leuprolide is a medication commonly used in the treatment of prostate cancer. It is a type of hormone therapy known as a luteinizing hormone-releasing hormone (LHRH) agonist. Leuprolide works by reducing the production of testosterone, a hormone that can stimulate the growth of prostate cancer cells. By lowering testosterone levels, leuprolide helps to slow the progression of prostate cancer and can be used in various stages of the disease.
Choice C: Finasteride
Finasteride is a medication used to treat benign prostatic hyperplasia (BPH) and male pattern baldness. It works by inhibiting the enzyme 5-alpha-reductase, which converts testosterone to dihydrotestosterone (DHT). While finasteride can reduce the size of the prostate and improve urinary symptoms in BPH, it is not typically used as a primary treatment for prostate cancer. Its role in prostate cancer is more preventive, as it can lower the risk of developing the disease.
Choice D: Cyclophosphamide
Cyclophosphamide is a chemotherapy drug used to treat various types of cancer, including lymphomas, leukemias, and some solid tumors. It works by interfering with the DNA of cancer cells, preventing them from dividing and growing. While cyclophosphamide can be used in certain cancer treatments, it is not a standard treatment for prostate cancer. Prostate cancer is more commonly treated with hormone therapy, targeted therapy, or other specific chemotherapy agents.