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 A
Explanation
A. Having the child bend at the waist allows the nurse to observe the spine for any abnormal curvature indicative of scoliosis, such as uneven shoulders or a rib hump.
B. Measuring the distance between the knees and the ankles is not a technique used to screen for scoliosis; it is more related to assessing leg length discrepancies.
C. Measuring the length of each leg does not assess for scoliosis but is more relevant for evaluating leg length inequalities.
D. Asking the child to walk across the room is useful for assessing gait and balance but does not directly assess for scoliosis.
Correct Answer is D
Explanation
A. The tympanic temperature of 37.1° C (98.8° F) is within normal limits and does not require re-measurement.
B. The respiratory rate of 14/min is also within the normal range (12-20 breaths per minute).
C. The blood pressure of 98/77 mm Hg is not alarmingly low and does not require immediate re-measurement.
D. A pulse rate of 42/min indicates bradycardia (normal resting heart rate is typically between