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A client with a history of coronary artery disease (CAD) is being discharged after angioplasty. Which instruction should the LPN/LVN reinforce to the client?
- A. You should report any chest pain or discomfort to your health care provider.
- B. Avoid all physical activity for the next 2 weeks.
- C. Return to work immediately after discharge.
- D. Take aspirin only if you experience chest pain.
Correct Answer: A
Rationale: The correct instruction to reinforce is to 'Report any chest pain or discomfort to your health care provider.' This is crucial because chest pain post-angioplasty can indicate complications that need immediate attention. Choice A is incorrect because returning to work immediately may not be advisable after angioplasty, as the client needs time to recover. Choice B is incorrect because avoiding all physical activity for 2 weeks may not be necessary; instead, gradual resumption of activities is usually recommended. Choice D is incorrect because aspirin should be taken as prescribed by the healthcare provider, not just when chest pain occurs.
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A client with a history of hypertension is being discharged on a low-sodium diet. Which statement by the client indicates a need for further teaching?
- A. I will use fresh herbs and spices instead of salt.
- B. I will avoid canned soups and processed foods.
- C. I can eat as much bacon and sausage as I want because they taste good.
- D. I will read food labels to check for sodium content.
Correct Answer: C
Rationale: Choice C is the correct answer because bacon and sausage are high in sodium, which contradicts the low-sodium diet requirement. Consuming them freely would contribute to increased sodium intake, which is not suitable for managing hypertension. Choices A, B, and D demonstrate appropriate understanding and actions for a low-sodium diet, such as using alternatives to salt, avoiding processed foods, and checking food labels for sodium content.
The client is reinforcing teaching for peripheral artery disease (PAD). Which statement by the client indicates correct understanding?
- A. I will keep my legs elevated on pillows while resting.
- B. I will avoid crossing my legs when sitting.
- C. I will wear tight compression stockings to improve circulation.
- D. I will apply heat to my legs to relieve pain and improve circulation.
Correct Answer: B
Rationale: The correct answer is B. Crossing the legs can further impede blood flow in clients with PAD, worsening symptoms. Avoiding leg crossing helps maintain adequate blood flow and reduces the risk of complications associated with peripheral artery disease. Choices A, C, and D are incorrect because elevating the legs, wearing tight compression stockings, and applying heat can exacerbate symptoms in PAD by restricting blood flow or causing potential harm.
A client with chronic obstructive pulmonary disease (COPD) is prescribed a metered-dose inhaler (MDI) with a spacer. Which instruction should the nurse reinforce to ensure correct use?
- A. Inhale deeply and slowly after activating the MDI.
- B. Hold the breath for 5 seconds after inhaling the medication.
- C. Rinse the mouth immediately after using the MDI.
- D. Exhale fully before placing the mouthpiece in the mouth.
Correct Answer: A
Rationale: Inhaling deeply and slowly after activating the MDI is the correct instruction to ensure effective delivery of the medication to the lungs. This technique helps the medication reach the lower airways where it can be most beneficial in managing COPD symptoms. Inhaling too quickly or not deeply enough may result in improper drug delivery and reduce the effectiveness of the treatment. Holding the breath for 5 seconds after inhaling the medication (Choice B) may not be necessary and could cause discomfort without additional benefits. Rinsing the mouth immediately after using the MDI (Choice C) is not necessary unless specified by the healthcare provider. Exhaling fully before placing the mouthpiece in the mouth (Choice D) is not ideal as it may result in inadequate medication delivery to the lungs.
The nurse is assisting with the care of a client diagnosed with heart failure. Which finding should the nurse report to the healthcare provider immediately?
- A. Weight gain of 2 pounds in 2 days
- B. Increased urination at night
- C. Mild shortness of breath on exertion
- D. Decreased appetite and fatigue
Correct Answer: A
Rationale: A weight gain of 2 pounds in 2 days is concerning in a client with heart failure as it can indicate fluid retention and worsening of the condition. This finding requires immediate medical attention to prevent further complications. Increased urination at night (choice B) may be due to various reasons like diuretic use and is not an immediate concern. Mild shortness of breath on exertion (choice C) is expected in clients with heart failure and may not require immediate reporting. Decreased appetite and fatigue (choice D) are common symptoms in heart failure but are not as urgent as sudden weight gain.
What preoperative instruction should the LPN/LVN reinforce to a client scheduled for a carotid endarterectomy?
- A. You will need to be NPO after midnight before the surgery.
- B. You should avoid deep breathing and coughing after the surgery.
- C. You will be able to eat and drink normally after the procedure.
- D. You can take all of your prescribed medications the morning of surgery.
Correct Answer: A
Rationale: The correct preoperative instruction that the LPN/LVN should reinforce to a client scheduled for a carotid endarterectomy is being NPO after midnight before the surgery. This instruction is essential to prevent aspiration and ensure a safe procedure. Avoiding oral intake helps reduce the risk of complications during anesthesia induction and the surgical process. Choices B, C, and D are incorrect because avoiding deep breathing and coughing, resuming normal eating and drinking, and taking all prescribed medications the morning of surgery are not recommended preoperative instructions for a carotid endarterectomy.