Certified Wound Care Nurse (CWCN) Practice Exam

What does nocturnal pain indicate when the affected leg is elevated?

1. Improved circulation

2. Relieved symptoms

3. Worsening arterial occlusion

4. Stable condition

The correct answer is: Worsening arterial occlusion

Nocturnal pain that occurs in the affected leg, particularly when it is elevated, is often indicative of worsening arterial occlusion. This type of pain is associated with peripheral artery disease (PAD), where insufficient blood flow and oxygen reach the tissues, especially when they are at rest or in a position that may limit circulation, such as elevation. When the limb is elevated, gravity can further impede the already restricted arterial flow, leading to pain due to ischemia. Patients may experience increased discomfort or pain during the night due to reduced circulation when lying down, highlighting an exacerbation of the underlying vascular condition. In contrast, improved circulation, relieved symptoms, or a stable condition would not be consistent with the presence of nocturnal pain. Improvements in blood flow would likely reduce pain, while relieved symptoms would signify an improvement in the patient's condition, not a worsening one. A stable condition would imply that there are no new symptoms or changes in the level of pain, which contradicts the occurrence of nocturnal pain indicating an issue. Thus, pain during elevation is a critical sign pointing to the potential worsening of arterial health.