Nokea
A client with heart failure has a left ventricular ejection fraction of 38%. When educating the client about managing the condition, which of the following advice should the nurse include? Select all that apply.
- A. The client should take frequent rest periods.
- B. The client should avoid strenuous activities.
- C. The client should stop all exercises.
- D. The client should stop smoking.
- E. The client should limit alcohol intake to 2 to 3 drinks daily.
Correct Answer: A,B,D
Rationale: Rest periods (A), avoiding strenuous activities (B), and stopping smoking (D) manage heart failure. All exercise (C) is not stopped; moderate activity is encouraged. Alcohol should be minimal, not 2-3 drinks (E).
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The local health clinic recommends vaccination against influenza for all its employees. The influenza vaccine is given annually in:
- A. November
- B. December
- C. January
- D. February
Correct Answer: A
Rationale: Influenza vaccines are typically administered in November, before the peak flu season, to ensure immunity during winter months.
The nurse enters the client's room and smells cigarette smoke. When confronted, the client says, 'I only smoked one cigarette because I was having a bad craving.' Which action by the nurse is most appropriate?
- A. escort the client outside to smoke
- B. call the health care provider to obtain an order for a nicotine patch
- C. remind the client that oxygen is in use and smoking is banned in the facility
- D. tell the client that if he continues to smoke in the room, he will be discharged from the hospital
Correct Answer: C
Rationale: Reminding the client of the danger of smoking near oxygen and hospital policy addresses safety and compliance immediately.
Which of the following statements regarding proper use of a cane is correct?
- A. When standing, the cane should reach a height even with the natural waist.
- B. When walking downstairs, the cane should be placed down on the step first, followed by the injured leg, and then the good leg.
- C. The elbow should be straight when holding the cane.
- D. The cane should be held in the hand of the same side that needs support.
Correct Answer: B
Rationale: Downstairs, the cane and injured leg move first, followed by the good leg, ensuring stability. The cane is held opposite the injured side, with the elbow slightly bent, and reaches hip level.
A client in labor has been given epidural anesthesia with Marcaine (bupivacaine). To reverse the hypotension associated with epidural anesthesia, the nurse should have which medication available?
- A. Narcan (naloxone)
- B. Dobutrex (dobutamine)
- C. Romazicon (flumazenil)
- D. Adrenalin (epinephrine)
Correct Answer: D
Rationale: Epinephrine is used to treat hypotension from epidural anesthesia by increasing blood pressure through vasoconstriction and cardiac stimulation.
The nurse on a physical rehabilitation unit is assigned a 63-year-old male client post-amputation of his left lower limb above the knee two weeks prior. The client has a history of peripheral vascular disease due to diabetes mellitus. Which statement by the client indicates a need for further teaching?
- A. I had my leg removed because of diabetes.
- B. My exercises are going well.
- C. My left leg hurts after I wrap my stump.
- D. I use canes to walk to the bathroom.
Correct Answer: C
Rationale: Pain after wrapping the stump may indicate improper wrapping or complications, requiring further assessment and education.