A 67-year-old male with a venous ulcer posterior to the medial malleolus is treated in an acute care setting. Which finding is MOST likely based on venous insufficiency?

• A. Pale, white skin color
• B. Absent peripheral pulses
• C. Diminished pain with the legs elevated
• D. Thin, shiny skin with hair loss

Answer: (C)

The key idea is how venous insufficiency affects leg pain. When venous return is poor, standing or walking causes venous pooling and swelling, producing an aching, heavy sensation. Elevating the legs helps gravity return blood more efficiently, reducing venous pressure and edema, which typically relieves pain. So diminished pain when the legs are elevated is the most likely finding with venous insufficiency.

Pale skin with absent pulses and thin, shiny skin with hair loss point more toward arterial disease, not venous.