A nurse is assessing a client with peripheral artery disease (PAD). The client states that walking five blocks is possible without pain.
What query asked next by the nurse will give the best information?

"Could you walk further than that a few months ago?".

"Do you walk mostly uphill, downhill, or on flat surfaces?".

"Have you ever considered swimming instead of walking?".

"How much pain medication do you take each day?"

Answer and Explanation

The Correct Answer is A

Choice A rationale

This question directly assesses for intermittent claudication, a hallmark symptom of peripheral artery disease (PAD). A decrease in walking distance before the onset of pain (claudication) over time indicates a progressive worsening of the arterial stenosis. This is a critical piece of information for staging the disease and evaluating the effectiveness of treatment.

Choice B rationale

The type of terrain (uphill, downhill, flat) can influence the workload on the leg muscles and therefore affect the onset of pain. However, this is a secondary factor. The most important clinical indicator for the progression of PAD is a change in the pain-free walking distance over time, regardless of the terrain.

Choice C rationale

Suggesting swimming instead of walking is a recommendation for a different exercise modality, but it does not provide diagnostic information about the client's current condition. The purpose of the initial assessment is to gather objective data on the progression of the disease, not to provide alternative lifestyle recommendations at this stage.

Choice D rationale

Asking about pain medication usage is important for pain management, but it does not provide specific information about the severity or progression of the peripheral artery disease itself. The primary symptom of PAD is pain upon exertion, and the key assessment is to determine the distance a person can walk before experiencing this pain, as well as if that distance is changing. .

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Correct Answer is ["3.5"]

Explanation

Step 1 is to convert the child's weight from pounds to kilograms: 55 lb ÷ 2.2 lb/kg = 25 kg.

Step 2 is to calculate the total daily dosage in milligrams: 7 mg/kg × 25 kg = 175 mg/24h.

Step 3 is to calculate the dosage per dose: 175 mg ÷ 2 doses = 87.5 mg per dose.

Step 4 is to calculate the volume per dose in mL: 87.5 mg ÷ (125 mg/5 mL) = 87.5 mg ÷ 25 mg/mL = 3.5 mL per dose. The final calculated dosage for this child is 3.5 mL per dose.

A. Assess the client for bleeding. B. Monitor the daily activated partial thromboplastin time (aPTT) results. C. Stop the IV for aPTT above baseline. D. Use an IV pump for the infusion.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A rationale

Regular assessment for bleeding is critical because heparin inhibits the coagulation cascade by enhancing antithrombin III, which inactivates thrombin and factor Xa. This increases the risk of hemorrhage, so the nurse must monitor for signs like petechiae, ecchymosis, hematuria, or GI bleeding to prevent serious complications. Platelets should be maintained above 100,000.

Choice B rationale

The activated partial thromboplastin time (aPTT) measures the time it takes for a fibrin clot to form via the intrinsic and common pathways of the coagulation cascade. Heparin therapy is monitored by the aPTT, with a therapeutic range typically 1.5 to 2.5 times the client’s baseline or control value, usually 45-75 seconds.

Choice C rationale

Stopping an IV heparin infusion for an aPTT above baseline is not always the correct action, as the therapeutic range is purposefully elevated. The aPTT should be 1.5 to 2.5 times the control value. An aPTT above this therapeutic range warrants holding the dose or adjusting the rate according to established hospital protocols and provider orders.

Choice D rationale

Using an IV pump is essential for heparin infusion to ensure precise and consistent administration. Heparin is a high-alert medication with a narrow therapeutic index. An IV pump prevents boluses and ensures the client receives the exact prescribed dose over time, minimizing the risk of subtherapeutic levels or overdose.

Choice E rationale

Daily weighing is crucial for monitoring fluid balance and detecting fluid shifts, which can indicate internal bleeding, a significant risk with heparin. Using the same scale at the same time each day, with the client wearing similar clothing, ensures accurate and comparable measurements, providing a reliable trend of the client’s weight.

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A nurse is assessing a client with peripheral artery disease (PAD). The client states that walking five blocks is possible without pain. What query asked next by the nurse will give the best information?

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Naxlex Comprehensive Predictor Exams

The recommended dosage of phenytoin for a child is 7 mg/kg/24 h given qh. The child's weight is 55 lb. The medication is supplied in 125 mg/5 mL. Calculate the safe and therapeutic dosage for this child.

Correct Answer is ["3.5"]

Explanation

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Correct Answer is ["A","B","D","E"]

Explanation

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A nurse is assessing a client with peripheral artery disease (PAD). The client states that walking five blocks is possible without pain.
What query asked next by the nurse will give the best information?