A 35-year-old woman presents with intermittent color changes in her fingers over the past year. She reports that her fingers turn white, then blue, and finally red when exposed to cold or during emotional stress. Episodes are usually painful and last 15–20 minutes. She denies any history of digital ulcers, skin thickening, or joint pain. She has no significant past medical history. Physical exam: Normal skin between episodes No digital ulcers or pitting Peripheral pulses intact Nailfold capillaries appear normal Which of the following is the most appropriate initial approach to this patient’s condition?

Primary varicose veins result from incompetent perforators, which produce local varicosities, or form incompetence of the saphenous vein valves, which produce more generalized varicosities. Which of the following best describes the characteristic features of varicose veins?      

A 28-year-old previously healthy patient presents to your office with right calf pain. She is taking oral contraceptive birth control pills.   PE findings Temp 98.6 F, pulse 105 bpm, RR 22 breaths/minute, BP 110/60 mmHg O2 Sat 92% Right calf is red and swollen with pitting edema. Right calf measurement is 36 cm circumference, left calf measurement is 32 cm circumference. The right leg is tender to touch especially on foot dorsiflexion. Dorsalis  pedis pulses are strong and equal in both lower extremities.  What is the most likely diagnosis?

A 52-year-old woman presents with aching and heaviness in her lower legs, especially after long periods of standing. She also reports visible, bulging veins along the medial aspect of both calves. She denies skin changes, ulcers, or numbness. Physical exam reveals: Tortuous, dilated superficial veins along the medial calves No edema, no hyperpigmentation, no ulceration Pedal pulses are 2+ bilaterally She asks what test is needed to evaluate her veins. Which of the following is the most appropriate diagnostic test to order?

For each provider order, click to specify whether the action is indicated or not indicated at this time. 

A 55-year-old man with a 30-pack-year smoking history presents for counseling on smoking cessation. He has mild chronic bronchitis but no history of cardiovascular disease. You review the health benefits of quitting smoking. Which of the following is a likely benefit within the first year after quitting?

A 56-year-old man is diagnosed with a proximal deep vein thrombosis (DVT) of the left leg. He has normal renal function and no history of bleeding. Regarding anticoagulation therapy for DVT, which of the following statements about anticoagulation therapy for DVT is FALSE?

A 70-year-old woman presents with swelling and aching in her lower legs, which worsen after prolonged standing and improve when she elevates her legs. Which of the following signs and symptoms is least commonly associated with the clinical presentation for peripheral venous insufficiency?

The nurse is caring for a client with a recent myocardial infarction (MI). Hemodynamic monitoring shows a right atrial pressure (RAP/CVP) of 5 mm Hg and a pulmonary artery wedge pressure (PAWP) of 20 mm Hg. The client reports shortness of breath, has an oxygen saturation of 91% on room air, and has bilateral inspiratory crackles on auscultation. The client’s blood pressure is 190/110 mm Hg, and the heart rate is 124 beats/min. Based on these findings, which condition does the nurse suspect?

The patient has completed all three phases of the alteplase infusion. What clinical finding would indicate that the fibrinolytic therapy has been successful?