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    HESI Health Assessment WGU d344 Proctored Exam
    Select All That Apply

    An older male client reports to the nurse that his feet are cold. Before covering the client's feet, which assessment(s) should the nurse complete? Select all that apply.

    Explanation & Rationale

    A. Palpating the dorsal surface of the feet for warmth helps assess peripheral circulation and whether the cold sensation is due to poor blood flow. B. Observing the color of the feet and toes is crucial as changes in color can indicate circulation issues, such as cyanosis or pallor, which can be related to the sensation of coldness. C. Assessing the volume of the pedal pulses helps determine the adequacy of blood flow to the feet. Weak or absent pulses could indicate peripheral vascular problems contributing to the cold sensation. D. The Babinski reflex is not relevant for assessing cold feet. It is typically assessed in infants or individuals with neurological concerns rather than for peripheral circulation issues. E. Measuring skin elasticity around the ankles is useful for assessing hydration status and potential edema but is not directly related to assessing the cause of cold feet.

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