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.

Answer and Explanation

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.

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

Explanation

Choice A reason: A bounding pulse can indicate fluid volume excess, as the heart works harder to pump the increased volume.

Choice B reason: Elevated temperature is not specifically indicative of fluid volume excess and can be related to various conditions.

Choice C reason: Warmth at the IV site may indicate an infection or inflammation, not necessarily fluid volume excess.

Choice D reason: Profuse sweating is not typically a sign of fluid volume excess; instead, it may indicate dehydration or other conditions.

Choice E reason: Crackles in the lungs can indicate fluid overload, especially in the context of excessive IV fluid administration.

A. Demonstrate nondestructive ways to meet his/her needs. B. Establish and maintain strong personal relationships. C. Express understanding of his or her behavior on other people. D. Find lucrative employment and become a model employee.

Correct Answer is A

Explanation

Choice A reason: Patients with Personality Disorders often struggle with maladaptive behaviors. A general goal is to help them find nondestructive ways to fulfill their needs, promoting healthier interactions and coping mechanisms.

Choice B reason: While establishing relationships is important, the priority is to ensure that the patient's methods of interacting are healthy and nondestructive.

Choice C reason: Understanding the impact of one's behavior on others is a goal, but it is secondary to the patient learning nondestructive self-management skills.

Choice D reason: Employment is a long-term goal and, while important, it is not as immediately relevant to the therapeutic process as developing nondestructive behaviors.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is receiving IV fluids at 100 mL per hour. Which assessment findings would indicate fluid volume excess? (Select all that apply.)

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

Explanation

A general goal for a patient with a Personality Disorder is:

Correct Answer is A

Explanation

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