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 A
Explanation
Choice A reason:
A sudden decrease in abdominal pain can indicate that the appendix has perforated. When the appendix bursts, the pressure is relieved, leading to a temporary reduction in pain. However, this is quickly followed by severe pain and signs of peritonitis, such as a rigid abdomen and high fever.
Choice B reason:
The absence of Rovsing’s sign is not a specific indicator of a perforated appendix. Rovsing’s sign is a clinical test used to diagnose appendicitis, where pain is elicited in the right lower quadrant when the left lower quadrant is palpated. Its absence does not necessarily indicate perforation.
Choice C reason:
A low-grade fever is a common symptom of appendicitis but does not specifically indicate perforation. A perforated appendix typically leads to a high fever due to the spread of infection within the abdomen.
Choice D reason:
A rigid abdomen is a sign of peritonitis, which can occur after the appendix has perforated. While this is an important symptom, the sudden decrease in pain followed by severe symptoms is more indicative of perforation.
Correct Answer is A
Explanation
Choice A: Unlike Chickenpox, the Vesicles of Smallpox Are More Abundant on the Face
This statement indicates an understanding of the teaching. Smallpox lesions are indeed more abundant on the face and extremities compared to chickenpox, which tends to have a more central distribution on the trunk. Smallpox lesions are also typically more uniform in their stage of development, whereas chickenpox lesions can appear in various stages of healing simultaneously.
Choice B: Smallpox Lesions Appear in Various Stages of Healing
This statement is incorrect. Unlike chickenpox, where lesions can be in different stages of healing at the same time, smallpox lesions generally progress through the same stages simultaneously. This uniformity in lesion development is a distinguishing feature of smallpox.
Choice C: Vaccination Against Smallpox Provides Lifelong Immunity
This statement is partially correct but needs clarification. The smallpox vaccine provides long-lasting immunity, but it may not be lifelong. Immunity can wane over time, and booster vaccinations may be necessary for continued protection.
Choice D: There Are Rare, Occasional Occurrences of Smallpox
This statement is incorrect. Smallpox was declared eradicated in 1980 by the World Health Organization (WHO). There have been no naturally occurring cases of smallpox since then. The only known stocks of the virus are kept in secure laboratories for research purposes.