Which data, if assessed on a client, would be the most indicative of peripheral arterial disease? Select all that apply.
1. absence of hair on the big toe bilaterally
2. bilateral brown pigmentation around the ankles
3. pain that decreased with elevation of lower extremities
4. weak dorsalis pe...
NUR 215 Exam 2 Study Questions and
Answers with Verified Solutions Graded
A 2024
Which data, if assessed on a client, would be the most indicative of peripheral
arterial disease? Select all that apply.
1. absence of hair on the big toe bilaterally
2. bilateral brown pigmentation around the ankles
3. pain that decreased with elevation of lower extremities
4. weak dorsalis pedal pulses bilaterally
5. lower extremities cool bilaterally
1, 4, & 5
Which, data is assessed on a client, would be the most indicative of peripheral
venous disease? Select all that apply.
1. absence of hair on the big toe bilaterally
2. bilateral brown pigmentation around the ankles
3. pain that decreased with elevation of lower extremities
4. weak dorsalis pedal pulses bilaterally
5. lower extremities cool bilaterally
2&3
Which anatomical position would be most accurate for the nurse to use when
assessing the dorsalis pedis pulse?
1. behind the knee
2. over the lateral malleolus
3. in the groove behind the medial malleolus
4. lateral to the extensor tendon of the great toe
4
A client reports the new onset of pain in the left calf after climbing approximately
10 stairs that is relieved after sitting for 2 minutes. What is the best term for the RN
to document his finding as?
1. intermittent claudication
2. DVT
NUR 215 exam 2
, NUR 215 exam 2
3. Raynaud's pnenomenon
4. Lymphedema
1
Which principle(s) are most important to incorporate when completing a peripheral
vascular assessment of the upper and lower extremities? Select all that apply.
1. look for symmetry bilaterally
2. palpate and grade pulses
3. omit palpation of the lymph nodes
4. utilize Homan's sign to rule out DVT
5. Assess for sensory and motor function
1, 2, & 5
Where are bronchial sounds heard when auscultating the lungs?
neck
The nurse is assessing a 69-year-old client's risks for lung disease. The client
states, "It shouldn't be a problem for me. My spouse smokes quite heavily but I've
been a lifelong nonsmoker." the nurse should recognize the need to teach the client
about what topic?
health risks of second hand smoke
The nurse is preparing to perform a focused respiratory assessment on a client. The
nurse should be cognizant of what anatomical characteristic of the lungs?
right lung has 3 lobes
left lung has 2 lobes
Which action by a nurse demonstrates the proper sequence for auscultation of the
lungs?
listen at each site for at least one complete respiratory cycle
What characteristic nail color should the nurse recognize as an indication of
hypoxia?
cyanotic
What are the signs of hypoxia? Select all that apply.
1. Respiratory rate > 30
NUR 215 exam 2
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