NRNP 6540 HEALTH HISTORY TAKING AND
PHYSICAL EXAMINATION ASSESSMENT
SCRIPT 2026
◉ 13. Devon visits the urgent care facility for sudden symptoms of
pain to his lower extremity. The
initial diagnosis is acute arterial ischemia. Aside from pain, which
other symptoms may arise from this diagnosis? Select all that apply.
1. Pulselessness
2. Paresthesia
3. Pallor
4. Purulence
5. Paralysis
Answer: 13. Answer: 1, 2, 3, 5
Page: 219
Feedback
1.
,Pulselessness is a symptom for acute arterial ischemia. Checking
pulses is notoriously unreliable. Arterial Doppler signals should be
checked in anyone with suspected acute limb ischemia.
2.
Paresthesia is present in over 50% of cases. Sensory nerves are
smaller than motor nerves and more sensitive to ischemia so tend to
be affected first.
3.
Pallor is especially useful in comparison to the opposite limb; it is
also useful to check venous filling. Acutely ischemic limbs are
classically white rather than blue. Chronic critically ischemic limbs
may appear pink due to compensatory vasodilation, the so-called
sunset foot.
4.
Purulence is not a symptom that may arise from acute arterial
ischemia diagnosis.
5.
Paralysis is a poor prognostic sign and indicates an element of
irreversible ischemia.
◉ 14. Treatment to slow the progression of PAD should include
which of the following? Select all that apply.
1. Immobilization
2. Pharmacological
,3. Surgical
4. Conservative
5. Heat
Answer: 14. Answer: 2, 3, 4
Page: 220
Feedback
1.
Immobilization does not slow the progression of PAD.
2.
Pharmacological treatment is provided with conservative treatment
and used to slow the progression of PAD.
3.
Surgical treatment of PAD involves revascularization of the affected
extremity and is used to slow the progression of PAD.
4.
Conservative treatment involves modification of risk factors,
including smoking. It also includes blood pressure and diet
implementations to slow the progression of PAD.
5.
Heat is not a treatment used to slow the progression of PAD.
, ◉ 15. Sharon is a 70-year-old patient with venous ulcers to her right
lower extremity. She has a
history of multiple pregnancies and surgeries, and has a sedentary
lifestyle. Which of the following may be possible contributing factors
to her diagnosis given her history? Select all that apply.
1. Obesity
2. Reduced mobility
3. History of breast cancer
4. Degenerative disease
5. Parkinsonism
Answer: 15. Answer: 1, 2
Page: 221
Feedback
1.
Obesity, or being overweight, can increase the risk of developing a
venous leg ulcer, as this increases the pressure in the leg veins.
2.
Decreased or reduced mobility in the ankle contributes to the
diagnosis of venous leg ulcer.
3.
PHYSICAL EXAMINATION ASSESSMENT
SCRIPT 2026
◉ 13. Devon visits the urgent care facility for sudden symptoms of
pain to his lower extremity. The
initial diagnosis is acute arterial ischemia. Aside from pain, which
other symptoms may arise from this diagnosis? Select all that apply.
1. Pulselessness
2. Paresthesia
3. Pallor
4. Purulence
5. Paralysis
Answer: 13. Answer: 1, 2, 3, 5
Page: 219
Feedback
1.
,Pulselessness is a symptom for acute arterial ischemia. Checking
pulses is notoriously unreliable. Arterial Doppler signals should be
checked in anyone with suspected acute limb ischemia.
2.
Paresthesia is present in over 50% of cases. Sensory nerves are
smaller than motor nerves and more sensitive to ischemia so tend to
be affected first.
3.
Pallor is especially useful in comparison to the opposite limb; it is
also useful to check venous filling. Acutely ischemic limbs are
classically white rather than blue. Chronic critically ischemic limbs
may appear pink due to compensatory vasodilation, the so-called
sunset foot.
4.
Purulence is not a symptom that may arise from acute arterial
ischemia diagnosis.
5.
Paralysis is a poor prognostic sign and indicates an element of
irreversible ischemia.
◉ 14. Treatment to slow the progression of PAD should include
which of the following? Select all that apply.
1. Immobilization
2. Pharmacological
,3. Surgical
4. Conservative
5. Heat
Answer: 14. Answer: 2, 3, 4
Page: 220
Feedback
1.
Immobilization does not slow the progression of PAD.
2.
Pharmacological treatment is provided with conservative treatment
and used to slow the progression of PAD.
3.
Surgical treatment of PAD involves revascularization of the affected
extremity and is used to slow the progression of PAD.
4.
Conservative treatment involves modification of risk factors,
including smoking. It also includes blood pressure and diet
implementations to slow the progression of PAD.
5.
Heat is not a treatment used to slow the progression of PAD.
, ◉ 15. Sharon is a 70-year-old patient with venous ulcers to her right
lower extremity. She has a
history of multiple pregnancies and surgeries, and has a sedentary
lifestyle. Which of the following may be possible contributing factors
to her diagnosis given her history? Select all that apply.
1. Obesity
2. Reduced mobility
3. History of breast cancer
4. Degenerative disease
5. Parkinsonism
Answer: 15. Answer: 1, 2
Page: 221
Feedback
1.
Obesity, or being overweight, can increase the risk of developing a
venous leg ulcer, as this increases the pressure in the leg veins.
2.
Decreased or reduced mobility in the ankle contributes to the
diagnosis of venous leg ulcer.
3.
