The nurse is providing care for a client recently diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis?

Visible clubbing of the fingers and toes

Unequal peripheral pulses between extremities

Reddened extremities with muscle atrophy

Loss of hair on the distal extremities

Answer and Explanation

The Correct Answer is D

A. Visible clubbing of the fingers and toes

Clubbing is a condition characterized by changes in the shape and appearance of the fingers and toes. It involves enlargement of the fingertips and the nails becoming curved and rounded. Clubbing is not typically associated with peripheral arterial occlusive disease (PAD). It is more commonly seen in conditions such as chronic respiratory or cardiovascular diseases.

B. Unequal peripheral pulses between extremities

Unequal peripheral pulses can be indicative of vascular abnormalities. However, in PAD, the characteristic finding is diminished or absent pulses rather than unequal pulses between extremities. Other conditions, such as arterial embolism or thrombosis, may present with unequal pulses.

C. Reddened extremities with muscle atrophy

Reddened extremities and muscle atrophy are not typical findings in PAD. These symptoms are more characteristic of conditions associated with chronic inflammation or compromised venous circulation, such as chronic venous insufficiency or venous stasis.

D. Loss of hair on the distal extremities

Loss of hair on the distal extremities, particularly on the lower legs and feet, is a common finding in PAD. It results from reduced blood flow and oxygen supply to the hair follicles in the affected areas.

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Correct Answer is D

Explanation

A. Intake and output:

Intake and output refer to monitoring the amount of fluids a person consumes (intake) and eliminates (output) through urine, feces, and other means. While tracking fluid intake and output is important, it may not provide a direct indication of excess fluid retention.

B. Pitting pedal edema:

Pitting pedal edema is swelling in the lower extremities, particularly the ankles and feet, that leaves an indentation (pit) when pressure is applied. This can be a sign of fluid retention but may not always be the earliest or most reliable indicator.

C. Crackles in the bases of the lungs:

Crackles or rales in the bases of the lungs can be indicative of pulmonary congestion, which may occur due to fluid accumulation. However, crackles alone may not always be specific to fluid overload and can be present in other respiratory conditions.

D. Daily weights:

Daily weights are a critical and sensitive measure for assessing fluid balance. Sudden weight gain, especially over a short period, can be a strong indicator of fluid retention. Monitoring weight on a daily basis helps to detect changes early, allowing for prompt intervention.

A. “I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet.” B. “The older I get the higher my risk for peripheral arterial disease gets.” C. “Since my family is from Italy, I have a higher risk of developing peripheral arterial disease.” D. “I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels.”

Correct Answer is A

Explanation

A. “I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet.”

Explanation: This statement reflects an understanding of the association between smoking and reduced blood flow, particularly due to nicotine's vasoconstrictive effects.

B. “The older I get the higher my risk for peripheral arterial disease gets.”

Explanation: While age is a non-modifiable risk factor for PAD, it is not a statement indicating a change in behavior to address risk factors. It is correct information but doesn't involve a proactive approach to risk reduction.

C. “Since my family is from Italy, I have a higher risk of developing peripheral arterial disease.”

Explanation: Family history is a non-modifiable risk factor, and the statement correctly identifies this risk factor. However, it doesn't address modifiable factors or actions to reduce risk.

D. “I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels.”

Explanation: This statement demonstrates an understanding of a dietary modification to lower cholesterol levels, which is a positive step toward reducing a modifiable risk factor for PAD.

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The nurse is providing care for a client recently diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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