Which patient statement supports a history of intermittent claudication?

I get short of breath when I climb a lot of stairs.

My fingers hurt when I go outside in cold weather.

My legs cramp when I walk more than a block.

When I stand too long, my feet start to swell.

Answer and Explanation

The Correct Answer is C

Choice A reason: Shortness of breath on stairs suggests cardiopulmonary issues, not intermittent claudication. Claudication is leg pain from arterial insufficiency during activity, not dyspnea, which reflects lung or heart strain.

Choice B reason: Finger pain in cold weather points to Raynaud’s or vasospasm, not claudication. Intermittent claudication affects lower limbs from arterial occlusion, not upper extremities or temperature-related vasomotor changes.

Choice C reason: Leg cramping after walking a block is classic intermittent claudication, from reduced blood flow in peripheral artery disease. Pain with activity, relieved by rest, matches its ischemic pathophysiology perfectly.

Choice D reason: Foot swelling from standing suggests venous stasis or edema, not claudication. Claudication involves arterial insufficiency causing pain with exertion, not fluid accumulation from prolonged static posture.

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Correct Answer is B

Explanation

Choice A reason: Ambulation in sickle cell crisis risks worsening pain and ischemia from exertion. Rest preserves oxygen, as sickle hemoglobin clogs vessels; encouraging movement contradicts physiology, delaying recovery in acute vaso-occlusion.

Choice B reason: Opioids relieve severe pain in sickle cell crisis from vaso-occlusion. Evaluating their effect ensures adequate control, as pain signals ongoing tissue hypoxia, guiding dose adjustments for comfort and healing.

Choice C reason: High-protein, high-calorie diets support chronic sickle cell needs, not acute crisis. Teaching this now is secondary, as pain and hydration take priority over nutrition education during active vaso-occlusive events.

Choice D reason: Limiting fluids worsens sickle cell crisis by increasing blood viscosity, promoting sickling. Hydration (IV/oral) dilutes hemoglobin S, improving flow, so restriction contradicts evidence-based crisis management principles.

A. Teach the patient about administration of insulin. B. Give oral hypoglycemic medications before meals. C. Discuss the role of diet in blood glucose control. D. Evaluate the patient’s use of pancreatic enzymes.

Correct Answer is A

Explanation

Choice A reason: CF-related diabetes (CFRD) from pancreatic damage requires insulin, as glucose of 180-250 mg/dL indicates insulin deficiency. Teaching administration addresses this directly, aligning with standard CFRD management for glycemic control.

Choice B reason: Oral hypoglycemics aren’t effective in CFRD, which stems from insulin lack, not resistance. Glucose levels of 180-250 mg/dL need insulin, making this inappropriate for CF’s unique endocrine pathology.

Choice C reason: Diet impacts glucose, but CFRD requires insulin first, not just dietary control. Levels of 180-250 mg/dL exceed dietary management alone, so this is secondary to initiating insulin therapy in CF.

Choice D reason: Pancreatic enzymes aid digestion in CF, not glucose control directly. Evaluating use is routine, but hyperglycemia of 180-250 mg/dL points to CFRD, necessitating insulin over enzyme adjustment.

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Which patient statement supports a history of intermittent claudication?

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Naxlex Comprehensive Predictor Exams

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