During the assessment of the patient, the nurse finds nonpalpable pedal pulses in the affected leg. How will the nurse proceed with assessment?

Have the primary provider prescribe a CT

Apply a tourniquet for 3 to 5 minutes and then reassess

Elevate the extremity and attempt to palpate the pulses

Use the doppler ultrasound to detect pedal pulses

Answer and Explanation

The Correct Answer is D

A. Having the primary provider prescribe a CT:
Prescribing a CT scan is not the initial action for assessing nonpalpable pedal pulses. CT scans are typically used for imaging purposes and are not the primary diagnostic tool for assessing peripheral pulses.

B. Apply a tourniquet for 3 to 5 minutes and then reassess:
While applying a tourniquet may increase the visibility of pulses in some cases, it is not the recommended method for assessing pedal pulses, especially if they are nonpalpable. Tourniquet use carries risks, such as tissue damage or ischemia, and is not a standard practice for assessing pulses.

C. Elevate the extremity and attempt to palpate the pulses:
Elevating the extremity may improve blood flow and make pulses easier to palpate, but if the pulses are nonpalpable, simply elevating the extremity may not be sufficient for assessment. Additionally, palpation alone may not accurately detect pulses in some cases.

D. Use the doppler ultrasound to detect pedal pulses:
This is the most appropriate action. Doppler ultrasound is a non-invasive diagnostic tool commonly used to assess peripheral pulses, especially when they are nonpalpable. It uses sound waves to detect blood flow and can provide accurate information about the presence and strength of pedal pulses. Using a doppler ultrasound can help confirm the status of pedal pulses and guide further management.

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Correct Answer is B

Explanation

A. Avoid alcohol for the first 3 weeks: Avoiding alcohol may be advisable for patients with hepatitis A to prevent additional strain on the liver. However, it is not specifically related to preventing transmission of the infection to others. Therefore, it is not a transmission measure typically included in discharge instructions for the patient's family.

B. Avoid handling patient's leftover foods: Hepatitis A is primarily transmitted through the fecal-oral route, often via contaminated food or water. By avoiding handling the patient's leftover foods, the risk of transmitting the virus to family members through contaminated food is minimized. This measure helps prevent the spread of infection within the household.

C. Have family members get an injection of immunoglobulin: Immunoglobulin may be administered to individuals who have been exposed to hepatitis A to provide passive immunity and reduce the severity of the illness. However, this measure is typically recommended for individuals who have not been previously vaccinated against hepatitis A and have been in close contact with an infected person, rather than as a general preventive measure for all family members.

D. Follow a low-protein, low carbohydrate diet: While maintaining a healthy diet is important for overall health, there is no specific dietary recommendation related to protein or carbohydrate intake for patients with hepatitis A. Therefore, this measure is not directly related to preventing transmission of the infection to others and would not typically be included in discharge instructions for the patient's family.

A. Human Immunodeficiency virus encephalopathy B. Beta-cell lymphoma C. Kaposi sarcoma D. Wasting syndrome

Correct Answer is A

Explanation

A. Human Immunodeficiency virus encephalopathy:
Human Immunodeficiency Virus (HIV) encephalopathy, also known as HIV-associated neurocognitive disorder (HAND), is a common neurological complication of HIV/AIDS. It occurs due to the direct effects of HIV on the central nervous system (CNS), leading to cognitive impairment, behavioral changes, and motor dysfunction. The progressive decline in cognitive, behavioral, and motor functions described in the patient is characteristic of HIV encephalopathy. Therefore, this choice is the most likely explanation for the patient's symptoms.

B. Beta-cell lymphoma:
Beta-cell lymphoma, also known as primary central nervous system lymphoma (PCNSL), is a rare but serious complication of HIV/AIDS. It involves the development of malignant lymphomas within the CNS. While PCNSL can cause neurological symptoms, such as cognitive decline and motor dysfunction, it typically presents with focal neurological deficits and signs of increased intracranial pressure, which are not mentioned in the scenario. Therefore, beta-cell lymphoma is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

C. Kaposi sarcoma:
Kaposi sarcoma is a type of cancer caused by human herpesvirus 8 (HHV-8) infection, which commonly affects individuals with HIV/AIDS. While Kaposi sarcoma can involve the CNS and potentially lead to neurological symptoms, such as headaches and focal neurological deficits, the progressive decline in cognitive, behavioral, and motor functions described in the scenario is not typically associated with Kaposi sarcoma. Therefore, this choice is less likely to explain the patient's symptoms compared to HIV encephalopathy.

D. Wasting syndrome:
Wasting syndrome, also known as cachexia, is a syndrome characterized by unintentional weight loss, weakness, and muscle atrophy. While wasting syndrome is a common complication of advanced HIV/AIDS, it primarily affects body composition and nutritional status rather than causing progressive decline in cognitive, behavioral, and motor functions. Therefore, wasting syndrome is less likely to be the cause of the patient's symptoms compared to HIV encephalopathy.

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During the assessment of the patient, the nurse finds nonpalpable pedal pulses in the affected leg. How will the nurse proceed with assessment?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is A

Explanation

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