A patient has returned to the unit following a peripheral artery angiogram with a stent insertion.
Four hours post-procedure, the nurse can no longer palpate the dorsalis pedis pulse and the foot is cold and dusky. What should be the nurse’s immediate action?

Reposition the limb and reassess.

Apply a warm blanket.

Notify the healthcare provider.

Elevate the extremity on a pillow.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While repositioning the limb and reassessing might be a part of the overall evaluation, it should not be the immediate action. The symptoms described are indicative of a serious issue that requires immediate medical attention.

Choice B rationale

Applying a warm blanket will not address the underlying issue. The symptoms described suggest a problem with circulation that needs immediate medical attention.

Choice C rationale

Notifying the healthcare provider is the correct immediate action. The symptoms described suggest that the patient may be experiencing a complication such as occlusion of the stent. This is a medical emergency that requires immediate intervention.

Choice D rationale

Elevating the extremity on a pillow is not the immediate action to take. While elevation can help with conditions like edema, it does not address the serious symptoms the patient is experiencing.

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Correct Answer is C

Explanation

Choice A rationale

Changes to achieve low HDL and high LDL levels are not recommended. In fact, the opposite is desired. High levels of HDL (good cholesterol) and low levels of LDL (bad cholesterol) are beneficial for overall health and can help prevent cardiovascular complications associated with diabetes.

Choice B rationale

Self-monitoring of blood glucose is important for managing diabetes, but a fasting plasma glucose level of 118 mg/dL does not necessarily indicate the need for regular self-monitoring. This level is slightly elevated and may indicate prediabetes, but further testing would be needed for a definitive diagnosis.

Choice C rationale

Maintenance of a healthy weight is beneficial for everyone, but it’s particularly important for individuals with prediabetes or diabetes. Achieving and maintaining a healthy weight can help regulate blood glucose levels and prevent or delay the progression of prediabetes to diabetes.

Choice D rationale

Utilizing carbohydrate counting to match insulin intake is a strategy used in the management of diabetes. However, a fasting plasma glucose level of 118 mg/dL, while slightly elevated, does not necessarily indicate the need for insulin therapy or carbohydrate counting. Further testing would be needed to confirm a diagnosis of diabetes.

A. The recommended diabetic diet. B. Administration of insulin. C. Importance of exercise. D. Urine testing for ketones.

Correct Answer is B

Explanation

Choice A rationale

While understanding the recommended diabetic diet is important for managing type 1 diabetes, it is not the immediate priority for a client who has received no instruction on diabetes management. Without insulin, a person with type 1 diabetes can develop life- threatening diabetic ketoacidosis, regardless of their diet.

Choice B rationale

Administration of insulin is the immediate priority for a client newly diagnosed with type 1 diabetes. In type 1 diabetes, the body does not produce insulin, a hormone that regulates blood sugar levels. Without insulin, blood sugar levels can become dangerously high, leading to diabetic ketoacidosis, a serious condition that requires emergency medical treatment.

Choice C rationale

While exercise is an important part of managing diabetes, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management. Exercise can help regulate blood sugar levels, but without insulin, exercise alone is not sufficient to prevent diabetic ketoacidosis.

Choice D rationale

Urine testing for ketones is an important part of managing type 1 diabetes, especially during illness or stress, when ketone levels can rise quickly. However, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management.

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A patient has returned to the unit following a peripheral artery angiogram with a stent insertion. Four hours post-procedure, the nurse can no longer palpate the dorsalis pedis pulse and the foot is cold and dusky. What should be the nurse’s immediate action?

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client undergoing screening for diabetes has a fasting plasma glucose level of 118 mg/dL. What should the nurse plan to educate the client about?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The client newly diagnosed with Type 1 diabetes is to be discharged in the morning and has received no instruction on diabetes. What should be the nurse’s teaching priority?

Correct Answer is B

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is aware that a client taking an antibiotic that causes diarrhea should be taught about:

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A patient has returned to the unit following a peripheral artery angiogram with a stent insertion. Four hours post-procedure, the nurse can no longer palpate the dorsalis pedis pulse and the foot is cold and dusky. What should be the nurse’s immediate action?

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A patient has returned to the unit following a peripheral artery angiogram with a stent insertion.
Four hours post-procedure, the nurse can no longer palpate the dorsalis pedis pulse and the foot is cold and dusky. What should be the nurse’s immediate action?