NCLEX Practice Test

A client with diabetes had a percutaneous coronary intervention with stent placement via the left femoral artery 3 hours ago. Which assessment finding requires priority notification of the health care provider?

1. 1+ palpable pedal pulses bilaterally

2. 2-cm area of ecchymosis in the left groin

3. Angina rated as 4 on pain scale of 0-10

4. Blood glucose of 220 mg/dL (12.2 mmol/L)

The correct answer is: 1+ palpable pedal pulses bilaterally

The assessment finding that requires priority notification of the health care provider is angina rated as a 4 on a pain scale of 0-10. This level of pain suggests significant discomfort and potentially indicates that the client may be experiencing cardiac complications post-procedure, such as stent thrombosis or myocardial ischemia. Given that the client has a history of diabetes and has undergone a recent coronary intervention, any report of angina is concerning and necessitates immediate evaluation and intervention. While bilateral palpable pedal pulses may indicate a degree of blood flow, they can still be present at a reduced quality without indicating significant compromise. A 2-cm area of ecchymosis is also not uncommon after a procedure involving the femoral artery and, while it should be monitored for changes, it does not require immediate action compared to symptoms of angina. A blood glucose level of 220 mg/dL may be elevated for a diabetic client but typically does not pose an urgent threat compared to acute cardiac symptoms. Thus, the presence of significant angina is the most critical finding that warrants prompt attention from the healthcare provider.