Acute peripheral arterial insufficiency typically presents with sudden, severe pain at rest, which may be accompanied by other signs such as pallor, paresthesia, paralysis, pulselessness, and poikilothermia (the six P's). This condition indicates a critical reduction in blood flow to the affected extremity, requiring immediate medical attention. Reference: AACN Adult CCRN Certification Review Course, AACN CCRN Exam Handbook.