Nokea
A client with peripheral arterial disease has received instructions from the nurse about how to limit the progression of the disease. The nurse determines that the client needs further teaching if which statement was made by the client?
- A. I need to eat a balanced diet.
- B. A heating pad on my leg will help soothe the leg pain.
- C. I need to take special care of my feet to prevent injury.
- D. I should walk daily to increase the circulation to my legs.
Correct Answer: B
Rationale: The application of heat directly to the extremity is contraindicated. The limb may have decreased sensitivity and be more at risk for burns. Additionally, the direct application of heat raises the oxygen and nutritional requirements of the tissue even further. The long-term management of peripheral arterial disease consists of measures that increase peripheral circulation (exercise), promote vasodilation (warmth), relieve pain, and maintain tissue integrity (foot care and nutrition).
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The nurse provides discharge teaching to a client after a vasectomy. Which statement by the client indicates the need for further teaching?
- A. I can use a scrotal support if I need to.'
- B. I don't need to practice birth control any longer.'
- C. I can resume sexual intercourse whenever I want.'
- D. I can use an ice bag and take an analgesic for pain or swelling.'
Correct Answer: B
Rationale: After vasectomy, the client must continue to practice a method of birth control until the follow-up semen analysis shows azoospermia. Live sperm may be present in the vas deferens after this procedure. Using scrotal support, resuming sexual activity, and promoting pain relief with ice and taking an analgesic such as acetaminophen are appropriate client statements.
The nurse has been preparing a client diagnosed with chronic obstructive pulmonary disease for discharge. Which statement by the client indicates the need for further teaching about nutrition?
- A. I will rest a few minutes before I eat.
- B. I will not eat as much cabbage as I once did.
- C. I will certainly try to drink 3 L of fluid every day.
- D. It's best to eat three large meals a day, so that I will get all my nutrients.
Correct Answer: D
Rationale: Large meals distend the abdomen and elevate the diaphragm, which may interfere with breathing for the client diagnosed with chronic obstructive pulmonary disease. Resting before eating may decrease the fatigue that is often associated with chronic obstructive pulmonary disease. Gas-forming foods may cause bloating, which interferes with normal diaphragmatic breathing. Adequate fluid intake helps liquefy pulmonary secretions.
The home care nurse visits a client who was recently diagnosed with cirrhosis and provides home care management instructions to the client. Which statement by the client indicates the need for further teaching?
- A. I will obtain adequate rest.
- B. I should monitor my weight regularly.
- C. I will take Tylenol if I get a headache.
- D. I should include sufficient carbohydrates in my diet.
Correct Answer: C
Rationale: Cirrhosis is a chronic liver disease, and acetaminophen (Tylenol) should be avoided because it can cause fatal liver damage in clients with cirrhosis. Adequate rest, regular weight monitoring, and sufficient carbohydrate intake (2000 to 3000 calories daily) are appropriate for managing cirrhosis.
The nurse is teaching a client with acute kidney injury to include proteins in the diet that are considered high quality or complete proteins. The nurse determines that the client needs further teaching if he indicates that which food item is considered high quality?
- A. Fish
- B. Eggs
- C. Chicken
- D. Broccoli
Correct Answer: D
Rationale: High-quality or complete proteins, which contain essential amino acids, come from animal sources like fish, eggs, and chicken. Broccoli, a plant-based source, provides low-quality or incomplete proteins, indicating the client's misunderstanding.
The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of an arterial ischemic leg ulcer. The nurse determines that there is a need for further teaching if the client makes which statement?
- A. I should inspect my feet daily.
- B. I should wear shoes and socks.
- C. I should cut my toenails straight across.
- D. I should raise my legs above the level of my heart periodically.
Correct Answer: D
Rationale: Raising legs above heart level is inappropriate for arterial ischemic ulcers, as it reduces blood flow to the extremities, worsening ischemia. Daily foot inspection, wearing shoes and socks, and cutting toenails straight across are correct care measures.