Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which assessment item is most likely to indicate poor circulation in the lower extremities?

1. Substantial hair on tops of toes

2. Ankle brachial index of 1.0

3. Diminished dorsalis pedal pulses

4. Positive pinprick sensation at level of the ankle

The correct answer is: Diminished dorsalis pedal pulses

Diminished dorsalis pedal pulses serve as a key indicator of poor circulation in the lower extremities. These pulses are found on the top of the foot, and their diminished presence suggests that blood flow to that area may be impaired. This can be particularly concerning in patients with diabetes or other conditions that can affect vascular health, as adequate blood circulation is crucial for healing and overall lower extremity health. The presence of substantial hair on the tops of toes, an ankle-brachial index of 1.0, and a positive pinprick sensation at the level of the ankle do not directly indicate poor circulation. In fact, hair growth is often seen in good circulation, the ankle-brachial index of 1.0 generally reflects normal or adequate blood flow, and positive pinprick sensation indicates that there is intact sensation, which can be associated with adequate blood supply. These factors collectively highlight the critical role that pulse assessment plays in evaluating vascular health in the lower extremities.