Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which sign would be least likely to support the diagnosis of DVT?

1. Positive Homan's sign

2. Swelling

3. Recent prolonged travel time

4. Extreme pallor of affected area

The correct answer is: Extreme pallor of affected area

The correct focus here is on the factors that would indicate the likelihood of a deep vein thrombosis (DVT). Extreme pallor of the affected area is least likely to support the diagnosis of DVT because it suggests a lack of blood flow, which can occur in conditions unrelated to thrombosis, such as arterial occlusions or very severe venous obstruction. In contrast, a positive Homan's sign, while not definitive, can indicate the presence of DVT if the calf is tender upon dorsiflexion of the foot. Swelling is a classic sign of DVT, often resulting from increased venous pressure and fluid accumulation due to the presence of the clot. Recent prolonged travel time is another recognized risk factor for DVT, as immobility can lead to stasis of blood flow in the legs, further supporting a DVT diagnosis. Thus, the other signs directly correlate with the clinical presentation of DVT, while extreme pallor indicates a different underlying problem that would not typically be associated with the diagnosis of DVT.