The nurse is assessing a client who was admitted yesterday with peripheral artery disease (PAD) and an ulcer on the lateral malleolus. Which finding is most important for the nurse to report to the healthcare provider?
Pain in lower legs when walking.
Black eschar over ankle ulcer.
Absent pedal pulses by Doppler.
Dependent rubor of lower extremities.
The Correct Answer is C
Choice A reason: Pain in the lower legs when walking, also known as intermittent claudication, is a common symptom of PAD but does not indicate an immediate threat to limb viability.
Choice B reason: Black eschar over the ankle ulcer indicates necrotic tissue, which is concerning but not as immediately critical as absent pulses. It does need to be monitored and treated to prevent infection and further complications.
Choice C reason: Absent pedal pulses by Doppler indicate a significant reduction in blood flow to the lower extremities, which can lead to critical limb ischemia and requires immediate intervention to restore perfusion and prevent tissue loss.
Choice D reason: Dependent rubor (redness when the leg is in a dependent position) is a sign of poor arterial circulation but does not require as urgent intervention as absent pedal pulses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Haemoglobin A1C of 6.2% is the best indication of long-term adherence to the prescribed diabetic regimen. The A1C test measures the average blood glucose levels over the past two to three months. A result of 6.2% indicates that the client has been maintaining good blood glucose control over this period, which reflects adherence to the regimen.
Choice B reason: Fasting plasma glucose of 189 mg/dL (10.49 mmol/L) is higher than the normal range. This result indicates poor short-term blood glucose control and suggests that the client may not be adhering to the prescribed regimen effectively.
Choice C reason: Postprandial plasma glucose of 225 mg/dL (12.49 mmol/L) is also higher than the recommended level for post-meal glucose. This result points to poor post-meal glucose control and suggests that the client may not be following their dietary or medication plan properly.
Choice D reason: High-density lipoprotein (HDL) of 40 mg/dL (1.03 mmol/L) is slightly below the recommended level for HDL cholesterol. While HDL is important for cardiovascular health, it is not a direct measure of blood glucose control or adherence to a diabetic regimen.
Correct Answer is D
Explanation
Choice A reason: While high serum insulin levels can be indicative of insulin resistance and metabolic syndrome, they are not as directly related to cardiac risk as large waist circumference.
Choice B reason: Hyperpigmentation on neck skin folds, also known as acanthosis nigricans, can indicate insulin resistance and metabolic syndrome but is not as strong a predictor of cardiac disease as central obesity.
Choice C reason: Poor muscle tone is not a direct indicator of cardiac disease risk. It can be associated with overall health and fitness but is not as specific a risk factor for cardiac disease.
Choice D reason: Large waist circumference with central fat, also known as abdominal obesity, is a well-known risk factor for cardiovascular disease. Central fat is associated with increased risk of heart disease, hypertension, and diabetes, making it a significant indicator to monitor.
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