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Practice Question

A nurse is assessing a client. Which of the following actions should the nurse take to assess the posterior tibial pulse? (Select all that apply.)

Answer Choices:

Correct Answer:

Palpate the area behind the ankle bone.

Rationale:

Palpate the area behind the ankle bone.

■ The posterior tibial pulse is located behind the medial malleolus, which is the bony prominence of the ankle.

■ This location must be palpated carefully, especially in patients with peripheral vascular disease.

■ Accurate placement ensures that a true pulse is being assessed.

Use the pads of the fingers to feel for the pulse.

■ The pads of the fingers offer the best tactile sensitivity for detecting a pulse.

■ Using fingertips avoids excessive pressure that might obliterate a weak pulse.

■ This technique is standard in clinical vascular assessments.

Compare the pulse strength with the other leg.

■ Comparing pulse strength bilaterally helps identify asymmetry, which may indicate vascular compromise.

■ This comparison is essential in detecting early signs of arterial insufficiency.

■ Consistent pulse checks are important in clients with circulatory risk factors.

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This question is from ATI RN Capstone Exam (II) which contains 50 questions.

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From Exam
ATI RN Capstone Exam (II)

50 Questions

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Question Details
  • Category: RN - Nursing Exam(s)
  • Subcategory: ATI Exams
  • Domain: ATI CAPSTONE
  • Answer Choices: 4
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