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?
Notify the physician.
Evaluate the distal pulses.
Have the patient lie in bed with a pillow under the knees.
Cover the patient with a blanket.
The Correct Answer is B
Choice A reason: Notifying the physician is important, but it is not the immediate action to take. The nurse should first assess the patient's condition before contacting the physician.
Choice B reason: Evaluating the distal pulses is the correct action because it provides information on the blood flow to the extremities, which is crucial for patients with PAD.
Choice C reason: Having the patient lie in bed with a pillow under the knees is not recommended for PAD patients as it can decrease blood flow to the lower extremities.
Choice D reason: Covering the patient with a blanket may provide comfort, but it does not address the underlying issue of impaired blood flow in PAD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Echopraxia is the involuntary repetition of another person's movements or actions.
Choice B reason: Word salad refers to a confused or meaningless mixture of words and phrases, often seen in schizophrenia.
Choice C reason: Echolalia is the meaningless repetition of words just spoken by another person, occurring as a symptom of mental conditions.
Choice D reason: Illusion is a false idea or belief, or a deceptive appearance or impression.
Correct Answer is C
Explanation
Choice A reason: Using the incentive spirometer is important, but it is not specifically related to deep breathing and coughing exercises.
Choice B reason: Breathing deeply and coughing every 4 hours is part of postoperative care, but it does not indicate understanding of the technique to protect the incision.
Choice C reason: Splinting the incision with a pillow while coughing is a recommended technique to support the incision and reduce pain during coughing, indicating an understanding of the instructions.
Choice D reason: Lying flat is not recommended for deep breathing and coughing exercises as it can inhibit lung expansion and is not conducive to effective coughing.
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