A patient reports leg pain that awakens the patient at night.
The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled.
Which condition would the nurse suspect?
Peripheral arterial disease.
Lymphatic obstruction.
Chronic venous insufficiency.
Musculoskeletal abnormalities.
The Correct Answer is A
Choice A rationale:
The patient's symptoms of leg pain that worsens at night and occurs when the legs are elevated but improves when they are dangled are indicative of peripheral arterial disease (PAD) PAD is a condition caused by the narrowing of arteries in the legs due to atherosclerosis. This narrowing restricts blood flow to the muscles, causing pain, especially during activities or positions that demand increased blood flow like walking or elevating the legs.
Choice B rationale:
Lymphatic obstruction typically does not cause pain in the same manner described by the patient. Lymphatic obstruction may cause swelling and discomfort, but it usually does not lead to pain that worsens with elevation and improves with dangling.
Choice C rationale:
Chronic venous insufficiency can cause leg pain and swelling, especially when standing for extended periods. However, the characteristic of pain worsening at night and with leg elevation points more towards arterial issues like PAD rather than venous insufficiency.
Choice D rationale:
Musculoskeletal abnormalities could cause localized pain, but the pattern described by the patient (worsening at night, relief with dangling) is not typical of musculoskeletal issues. PAD, on the other hand, often presents with these specific symptoms due to compromised blood flow to the muscles in the legs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Spasm of a major coronary artery, also known as variant (Prinzmetal's) angina, typically occurs at rest and is not necessarily provoked by exertion. The patient's chest pain is exacerbated by exertion, making this choice less likely.
Choice B rationale:
Exposure of the thrombogenic surface to plaque refers to acute coronary syndromes like unstable angina or myocardial infarction. While plaque rupture and thrombosis can cause myocardial ischemia, the characteristic feature of these conditions is chest pain that may not be relieved by rest, unlike the patient described here.
Choice D rationale:
Myocardial ischemia secondary to microvascular disease, also known as cardiac syndrome X, is a condition where chest pain occurs without significant coronary artery stenosis. However, this condition usually affects women, and the pain is often unrelated to exertion. In the given case, the pain is provoked by exertion, making this choice less likely.
Correct Answer is D
Explanation
Choice A rationale:
Stenosis of the heart valves typically leads to murmurs and changes in heart sounds but does not directly impact blood pressure regulation.
Choice B rationale:
Decreased adrenergic sensitivity might lead to lower heart rate and blood pressure, not an increase in systolic blood pressure as seen in this case.
Choice C rationale:
Increased parasympathetic activity would lead to decreased heart rate, not an increase in systolic blood pressure as observed in the patient.
Choice D rationale:
Loss of elasticity in arterial vessels is the correct answer. With aging, arterial walls become less flexible and more rigid due to the accumulation of calcium and collagen. This loss of elasticity results in increased systolic blood pressure, which is the top number in a blood pressure reading. The diastolic pressure, represented by the bottom number, does not usually increase significantly with age. This change is a result of arteriosclerosis, which commonly occurs in elderly individuals.
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