Practice Question
A patient with peripheral arterial disease (PAD) is sitting in a chair and has cool feet that are reddish-purple in color. What action should the nurse take?
Answer Choices:
Correct Answer:
Evaluate the distal pulses.
Rationale:
🟤 Peripheral arterial disease (PAD) reduces blood flow to the extremities, and signs like cool, reddish-purple feet indicate poor perfusion or possible dependent rubor, a classic sign of arterial insufficiency.
🟤 The first priority is to assess distal pulses (e.g., dorsalis pedis, posterior tibial) to evaluate the degree of circulation impairment.
🟤 This assessment helps determine if the patient is experiencing critical limb ischemia, which may require urgent intervention.
🟤 If pulses are weak or absent, the nurse should notify the provider promptly for further vascular evaluation or imaging.
🟤 Other actions (e.g., applying warmth or elevating legs with pillows) may worsen arterial flow and are not priority actions before assessment.
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This question is from RN ATI Concept of Nursing Final Exam which contains 106 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN Concept-Based Assessment Level Exam(s)
- Answer Choices: 4