A nurse is assessing a client's peripheral circulation. In which of the following locations should the nurse palpate to assess the posterior tibial pulse? (Selectable areas, or "Hot Spots," are outlined in the artwork below. Select only the outlined area that corresponds to your answer.)
Iliac
Femoral
Popliteal
Tibial
The Correct Answer is D
A. The iliac pulse is located near the pelvis and is not used for assessing circulation in the lower extremities.
B. The femoral pulse is located in the upper thigh, not near the posterior tibial area.
C. The popliteal pulse is found at the back of the knee and is higher than the posterior tibial location.
D. The posterior tibial pulse is correctly located behind the medial malleolus on the inner side of the ankle. This location is where the posterior tibial artery is accessible and is commonly used to assess blood flow to the lower extremities.
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Correct Answer is B
Explanation
A. Assessing the pedal pulses does not provide relevant information about the irregularity of the radial pulse.
B. Assessing the apical pulse for a full minute is appropriate in this situation, as it provides a more accurate measurement of the heart rate and rhythm, especially when the radial pulse is irregular.
C. Assessing the popliteal pulses with a Doppler device is not necessary and does not directly address the irregular radial pulse.
D. While a pulse oximeter can provide information about oxygen saturation, it does not assess heart rate or rhythm.
Correct Answer is D
Explanation
A. Nodules, specifically rheumatoid nodules, can occur in RA, but they are not typically an early manifestation.
B. Fremitus is related to lung assessment and is not a manifestation of rheumatoid arthritis.
C. Tenderness in the soles of the feet is not a classic early manifestation of RA.
D. Joint swelling is one of the hallmark early signs of rheumatoid arthritis due to inflammation of the synovial membranes.