The nurse is assessing a client diagnosed with peripheral arterial disease (PAD). The client reports leg pain and cramping after walking a few blocks, which is relieved when the client stops and rests. The nurse documents that the client is experiencing which clinical manifestation?
Intermittent claudication
Neuropathy
Deep vein thrombosis
Venous insufficiency
The Correct Answer is A
A) Intermittent claudication: This term describes the leg pain and cramping that occurs during physical activity, such as walking, and is relieved by rest. It is a classic symptom of peripheral arterial disease (PAD) and results from insufficient blood flow to the muscles due to narrowed or blocked arteries. The client's description aligns perfectly with this definition.
B) Neuropathy: While neuropathy can cause leg pain, it typically presents differently, often with sensations like tingling, numbness, or burning rather than cramping during activity. Neuropathy does not specifically correlate with the pattern of pain relief upon resting, which is characteristic of intermittent claudication.
C) Deep vein thrombosis (DVT): DVT generally presents with symptoms like swelling, warmth, and tenderness in the affected leg, rather than cramping pain that is related to activity. The pain associated with DVT is not typically relieved by rest, making this option inconsistent with the client’s symptoms.
D) Venous insufficiency: This condition is characterized by symptoms such as swelling, varicosities, and skin changes, primarily in the lower extremities. Pain related to venous insufficiency tends to occur after prolonged standing or sitting and is not typically relieved by rest in the same way as intermittent claudication. Therefore, this option does not accurately describe the client’s experience.
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Correct Answer is C
Explanation
A) Vitamin A: While vitamin A can affect various bodily functions, it is not known to have a direct interaction with warfarin. Therefore, it is not considered incompatible with warfarin therapy.
B) Alprazolam: This medication, a benzodiazepine, is primarily used to treat anxiety and does not have a significant interaction with warfarin. Thus, it is not incompatible with warfarin therapy.
C) Vitamin K: This vitamin is a critical consideration when a client is on warfarin therapy. Warfarin works by inhibiting vitamin K-dependent clotting factors, so an increased intake of vitamin K can counteract the effects of warfarin, making this the correct answer. Clients on warfarin should maintain a consistent intake of vitamin K to prevent fluctuations in their INR levels.
D) Furosemide: This loop diuretic is used to manage conditions such as heart failure and edema. While it may affect electrolyte levels, it does not have a direct interaction that would render it incompatible with warfarin. It can be safely used alongside warfarin with appropriate monitoring.
Correct Answer is C
Explanation
A) Intermittent claudication: This symptom is indicative of arterial insufficiency, not chronic venous insufficiency. Intermittent claudication is characterized by pain in the legs during activity due to insufficient blood flow, which is not typical in venous conditions.
B) Decreased pedal pulses: In chronic venous insufficiency, pedal pulses are usually normal. Decreased pedal pulses suggest arterial disease, where blood flow is compromised. Thus, this finding would not be expected in a client with venous insufficiency.
C) Bronze/brown discoloration of the skin: This is a hallmark finding in chronic venous insufficiency. The discoloration occurs due to the deposition of hemosiderin from the breakdown of red blood cells, which is a result of prolonged venous stasis and chronic edema, particularly around the lower extremities.
D) Cool skin temperature: Skin temperature in chronic venous insufficiency is typically warm due to increased blood flow and stasis in the veins. Cool skin temperature is more characteristic of arterial insufficiency, where blood supply is reduced and can lead to cooler extremities.
E) Full screen mode is in effect during your proctored testing: This statement is irrelevant to the clinical assessment of chronic venous insufficiency and serves no purpose in understanding the client’s condition. It does not contribute to the assessment findings.