What should a nursing student assess to ensure circulation in a patient with a fractured tibia?

• A. Capillary refill
• B. Distal pulse
• C. Color of toes
• D. Movement of foot

Answer: (B)

Assessing circulation in a fractured tibia centers on confirming that arterial blood is reaching the distal foot. The most direct and important check is the distal pulse—palpating the pulse at sites such as the dorsalis pedis and posterior tibial—and noting its presence and quality compared with the other leg. A strong, intact distal pulse indicates good arterial perfusion to the foot; a weak or absent pulse flags possible compromised circulation and urgent concern for ischemia that may require further evaluation or intervention.

Capillary refill, while useful for quick screening of peripheral perfusion, can be unreliable in adults and is influenced by temperature, lighting, and other factors, so it does not supplant the distal pulse as the primary measure. Color of the toes reflects perfusion but can be affected by many variables and may not change early. Movement of the foot assesses neuromuscular function rather than perfusion directly; it can be affected by pain or nerve injury and does not reliably indicate circulation status.