Progressive Care Nursing Certification (PCCN) Practice Exam

Given a patient with decreased skin temperature and ankle pallor, what condition should the nurse suspect?

1. DVT

2. Chronic venous insufficiency

3. Acute arterial occlusion

4. PAD

The correct answer is: PAD

Decreased skin temperature and ankle pallor are clinical indicators that suggest compromised blood flow, which can be indicative of peripheral artery disease (PAD). In PAD, the arteries supplying blood to the limbs become narrowed or blocked, leading to insufficient blood flow. As a result, affected areas may exhibit signs such as reduced temperature due to less warm blood reaching those tissues, along with a pale appearance due to diminished perfusion. In contrast, deep vein thrombosis (DVT) typically presents with localized swelling, redness, and warmth rather than a decrease in temperature. Chronic venous insufficiency usually shows skin changes such as brown pigmentation and may present with edema but does not typically result in pallor or a cooler skin temperature. Acute arterial occlusion, while it does also cause pallor and decreased temperature due to sudden loss of blood flow, is often associated with more severe symptoms like severe pain and the characteristic "6 P's" (pain, pallor, pulselessness, paresthesia, paralysis, and poikilothermia). Therefore, the set of symptoms described aligns most closely with PAD.