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A client with peripheral artery disease (PAD) makes the following statements to the nurse. Which indicates the need for further teaching?
- A. I should avoid using heating pads on my legs
- B. I need to walk until I feel pain, then rest
- C. I should keep my legs elevated when resting
- D. It's going to be really hard but I will stop smoking
Correct Answer: A
Rationale: Clients with PAD should avoid heating pads due to decreased skin sensitivity, which can lead to burns. This statement shows understanding, so no further teaching is needed for it. The other statements align with proper PAD management.
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The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?
- A. A 4-ounce steak, French fries, iceberg lettuce
- B. Baked chicken breast, broccoli, tomatoes
- C. Fried catfish, cornbread, peas
- D. Spaghetti with meat sauce, garlic bread
Correct Answer: B
Rationale: The diet recommended for this client would be low in saturated fats and red meat, high in vegetables and whole grains (fiber), low in salt, and low in trans fat. The best choice is baked chicken with broccoli and tomatoes. The French fries have too much fat and the iceberg lettuce has little fiber. The catfish is fried. The spaghetti dinner has too much red meat and no vegetables.
A client is postoperative after surgery to repair a fractured hip and has a history of atrial fibrillation. What action by the nurse is most important to prevent wound infections?
- A. Performing hand hygiene before client contact
- B. Changing the surgical dressing daily
- C. Monitoring the client's daily white blood cell count
- D. Administering prophylactic antibiotics
Correct Answer: A
Rationale: Hand hygiene is the best way to prevent infections in hospitalized clients. Dressing changes should be done with sterile technique, but hand hygiene is the most critical step. Assessing vital signs and white blood cell count will not prevent infection.
A nurse is assessing an obese client in the clinic for follow-up after an episode of deep vein thrombosis. The client's weight has decreased significantly since the last visit. What action by the nurse is best?
- A. Ask if the weight loss was intentional
- B. Encourage a high-protein, high-fiber diet
- C. Measure for new compression stockings
- D. Review a 3-day food recall diary
Correct Answer: C
Rationale: Compression stockings must fit correctly to be effective. After significant weight loss, the client should be re-measured for new stockings. The other options are appropriate but less critical.
A nurse wants to provide community service that helps meet the goals of Healthy People 2020 related to cardiovascular disease and stroke. What activity would best meet this goal?
- A. Teach a class on heart-healthy diets
- B. Participate in blood pressure screenings at the mall
- C. Provide pamphlets on heart disease at the grocery store
- D. Set up an information booth at the pet store
Correct Answer: B
Rationale: An important goal of Healthy People 2020 is to increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether it was normal or high. Blood pressure screenings in a public place best meet this goal.
An older client with peripheral vascular disease (PVD) is explaining the daily foot care regimen to the family practice nurse. What statement by the client may indicate a barrier to proper foot care?
- A. I nearly always wear comfy sweatpants and house shoes
- B. I'm glad I get energy assistance so my house isn't so cold
- C. I check my feet every day for cuts or sores
- D. My hands shake when I try to do things requiring coordination
Correct Answer: D
Rationale: Clients with PVD need to pay special attention to their feet. Toenails need to be kept short and cut straight across. The client whose hands shake may cause injury when trimming toenails, indicating a barrier to proper foot care. The nurse should refer this client to a podiatrist.