A patient presents to therapy with moderate pain in the bilateral distal lower extremities. He reports that the pain is better when his feet are elevated. During evaluation, the therapist notes that the skin has brown discoloration and is flaky and dry. Pedal pulses are normal and +2 pitting edema is present bilaterally. The most likely cause of the patient's leg pain is:

The NPTE for PTAs is a standardized exam produced by the Federation of State Boards of Physical Therapy. The NPTE for PTA exam covers these topics: musculoskeletal, neuromuscular, cardiovascular, pulmonary, integumentary, metabolic, endocrine, gastrointestinal, gentitourinary, lymphatic, system interactions, equipment, therapeutic modalities, safety, professional responsibilities and evidenced based practice.