A 65-year-old patient with a history of Peripheral Artery Disease (PAD) presents to the clinic with complaints of intermittent claudication in the right leg. Which of the following management strategies should the nurse prioritize to improve the patient’s condition?

Encourage the patient to engage in regular low-impact exercise.

Advise the patient to limit fluid intake to prevent edema.

Instruct the patient to wear tight-fitting shoes to improve circulation.

Recommend strict bed rest to minimize pain.

Answer and Explanation

The Correct Answer is A

Choice A reason: Low-impact exercise, like walking, enhances collateral circulation in PAD, increasing blood flow to ischemic muscles. It reduces claudication by stimulating angiogenesis and improving endothelial function, a cornerstone of evidence-based management to alleviate symptoms effectively.

Choice B reason: Limiting fluid intake addresses edema, not a primary PAD issue, which involves arterial insufficiency, not venous stasis. This strategy lacks scientific support for claudication relief, as hydration status doesn’t directly influence arterial perfusion.

Choice C reason: Tight shoes restrict circulation, worsening PAD by compressing arteries and exacerbating ischemia. Proper footwear is essential, but constriction contradicts vascular physiology, potentially increasing pain and tissue damage rather than improving blood flow.

Choice D reason: Bed rest reduces activity, promoting stasis and deconditioning in PAD, worsening claudication. Immobility decreases muscle pump action and collateral flow, conflicting with evidence that exercise improves symptoms, making this detrimental to recovery.

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Correct Answer is ["B","D"]

Explanation

Choice A reason: Pulmonary edema involves fluid in alveoli, often from heart failure, not directly linked to pancytopenia. Low blood cell counts don’t cause fluid overload; this complication arises from cardiac or renal dysfunction, making it less relevant to pancytopenia’s hematologic deficits.

Choice B reason: Bleeding risk increases with pancytopenia due to thrombocytopenia, reducing platelet counts below 150,000/µL. Impaired clotting leads to spontaneous hemorrhage, such as petechiae or mucosal bleeding, a direct and common consequence of bone marrow suppression in this condition.

Choice C reason: Neurogenic shock results from spinal injury or autonomic dysfunction, causing vasodilation and hypotension. Pancytopenia affects blood cells, not neural regulation, so this complication isn’t a primary risk unless unrelated trauma or systemic failure occurs.

Choice D reason: Infection risk rises with pancytopenia from leukopenia, lowering white blood cells below 4,000/µL. Neutropenia impairs immune defense, increasing susceptibility to bacterial, fungal, or viral infections, a frequent and severe complication requiring vigilant monitoring in these patients.

Choice E reason: Seizures stem from neurologic or metabolic disturbances, like hypoglycemia, not pancytopenia. Reduced blood cells don’t directly affect brain excitability or seizure threshold, making this an unlikely complication unless secondary to infection or bleeding.

A. Metabolic alkalosis with hypoxemia B. Respiratory alkalosis with hypoxemia C. Metabolic acidosis with hypoxemia D. Respiratory acidosis with hypoxemia

Correct Answer is B

Explanation

Choice A reason: Metabolic alkalosis shows pH >7.45 with HCO3- >26 mEq/L from base excess. Here, pH is 7.48, but HCO3- is normal at 24 mEq/L, ruling out metabolic cause. PaO2 of 55 mmHg indicates hypoxemia, but the primary issue isn’t metabolic.

Choice B reason: Respiratory alkalosis occurs with pH >7.45 and PaCO2 <35 mmHg from hyperventilation. Here, pH is 7.48, PaCO2 is 28 mmHg, and HCO3- is normal, confirming respiratory etiology. PaO2 of 55 mmHg shows hypoxemia, matching this acute ventilatory pattern.

Choice C reason: Metabolic acidosis has pH <7.35 and HCO3- <22 mEq/L from acid gain. Here, pH is 7.48 and HCO3- is 24 mEq/L, contradicting acidosis. PaO2 of 55 mmHg indicates hypoxemia, but the acid-base status is alkalotic, not acidic.

Choice D reason: Respiratory acidosis features pH <7.35 and PaCO2 >45 mmHg from CO2 retention. Here, pH is 7.48 and PaCO2 is 28 mmHg, showing CO2 loss, not retention. Hypoxemia (PaO2 55 mmHg) is present, but the pattern is alkalotic.

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A 65-year-old patient with a history of Peripheral Artery Disease (PAD) presents to the clinic with complaints of intermittent claudication in the right leg. Which of the following management strategies should the nurse prioritize to improve the patient’s condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which potential complication would the nurse identify as a high risk for a patient admitted to the hospital with pancytopenia? (Select all that apply)

Correct Answer is ["B","D"]

Explanation

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

Correct Answer is B

Explanation

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