Author Question: A nurse assesses the lower extremities of an older adult and notes a small ulcer between the ... (Read 74 times)

tuffie · **on:** Jul 11, 2018

A nurse assesses the lower extremities of an older adult and notes a small ulcer between the per-son's great toe and second toe.

The ulcer has well-defined edges and there is no bleeding; however, there is a small amount of necrotic tissue present. This wound is most likely a(n):
a. venous ulcer.
b. arterial ulcer.
c. pressure ulcer
d. surgical wound.

Question 2

An older person has sudden onset of a severe headache, left-sided facial drooping, and left arm numbness. The person's daughter calls 911 and the person is transported to the emergency de-partment.

The first diagnostic test that will likely be performed is a(n):
a. electrocardiogram (ECG) to assess for atrial fibrillation
b. computed axial tomography (CAT) scan to differentiate hemorrhagic from ischemic stroke.
c. international normalized ratio to determine level of anticoagulation.
d. lumbar puncture to assess for infection.

bob · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

ANS: B
Arterial ulcers are often located between the toes. They usually present with well-defined edges, do not bleed, and have necrotic tissue. These features are not found in venous ulcers. Pressure ulcers develop from unrelieved pressure. There is no indication in the description that there is un-relieved pressure. There is no mention of surgery in the scenario above.

Answer to Question 2

ANS: B
The first diagnostic test that will be done is a CAT scan to differentiate hemorrhagic from is-chemic stroke. If it is an ischemic stroke, tissue plasminogen activator (tPA) can be administered to dissolve the clot but must be done within 3 hours. Depending on the patient's presentation, all of the other diagnostic tests may also be done following the CAT scan.