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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A rationale:

Methotrexate is a medication used for cancer and autoimmune diseases. It does not chelate iron and is not used to treat iron overload conditions like hemochromatosis.

Choice B rationale:

Deferoxamine is an iron chelating agent used to treat iron overload conditions like hemochromatosis. It binds to excess iron and promotes its excretion from the body, preventing complications such as organ damage.

Choice C rationale:

Ferrous gluconate is an iron supplement used to treat iron deficiency anemia. It would not be appropriate for a patient with hemochromatosis, a condition characterized by iron overload.

Choice D rationale:

Iron dextran complex is another form of intravenous iron used to treat iron deficiency anemia. It is not indicated for treating iron overload conditions like hemochromatosis.

A. Adequate platelet production. B. Deficiency in intrinsic clotting system factor. C. Impairment of the thrombin fibrinogen reaction. D. Variable factor VIII deficiencies and platelet dysfunction.

Correct Answer is D

Explanation

Choice A rationale:

Adequate platelet production does not explain the prolonged bleeding times in von Willebrand disease. These patients often have normal platelet counts, but their platelets do not function properly due to the absence or dysfunction of von Willebrand factor.

Choice B rationale:

Deficiency in intrinsic clotting system factor is not the primary cause of prolonged bleeding times in von Willebrand disease. The deficiency or dysfunction of von Willebrand factor, a protein that helps platelets adhere to the blood vessel walls and clot properly, is the key issue in this disorder.

Choice C rationale:

Impairment of the thrombin fibrinogen reaction does not directly relate to von Willebrand disease. This disorder primarily involves platelet dysfunction and variable factor VIII deficiencies, leading to prolonged bleeding times.

Choice D rationale:

Variable factor VIII deficiencies and platelet dysfunction are characteristic of von Willebrand disease. Factor VIII helps with blood clotting, and its deficiency, along with impaired platelet function, contributes to the prolonged bleeding times in patients with von Willebrand disease.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with thalassemia major who is receiving a blood transfusion shows signs of hemochromatosis.The nurse anticipates a prescription for which medication?

Correct Answer is B

Explanation

The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?

Correct Answer is D

Explanation

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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?