Progressive Care Nursing Certification (PCCN) Practice Exam

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Which of the following describes a typical clinical presentation of arterial insufficiency?

  1. pitting edema

  2. thickened toenails and hair loss on legs

  3. warm, cyanotic legs

  4. open sores on the medial malleolus

The correct answer is: thickened toenails and hair loss on legs

Arterial insufficiency commonly presents with thickened toenails and hair loss on the legs due to reduced blood flow and oxygen delivery to the tissues. The lack of adequate circulation affects the health of the skin and nails. When blood supply diminishes, it compromises the nutrition and growth of various tissues, leading to changes such as hair loss and thickened, possibly discolored toenails. In contrast, pitting edema is more indicative of venous insufficiency rather than arterial issues, as impaired venous return causes fluid accumulation. Warm, cyanotic legs typically suggest venous congestion or other vascular issues rather than arterial insufficiency, where pale and cool extremities are more common. Open sores on the medial malleolus also indicate venous problems, as they are often associated with venous ulcerations. Therefore, the presence of thickened toenails and hair loss on the legs serves as a hallmark of arterial insufficiency.