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A client with peripheral vascular disease (PVD) has symptoms of intermittent claudication. Which should the nurse include when teaching the client about intermittent claudication?
- A. It causes pain that occurs during periods of inactivity.
- B. It causes pain that increases when the legs are elevated and decreases when the legs are dependent.
- C. It causes cramping or aching pain in the lower extremities and the buttocks that occurs with a predictable level of activity.
- D. It is often described as a burning sensation in the lower legs.
Correct Answer: C
Rationale: Intermittent claudication is a symptom of peripheral vascular disease (PVD) characterized by cramping or aching pain in the lower extremities and buttocks that occurs with a predictable level of activity, such as walking a certain distance. This pain typically resolves with rest. The pain is due to inadequate blood flow to the muscles during activity, causing a buildup of lactic acid, which leads to muscle pain. This symptom is an important indicator of decreased arterial blood flow and is a common presentation in individuals with PVD. Therefore, when teaching the client about intermittent claudication, the nurse should emphasize the predictable nature of the pain related to activity and the relief experienced with rest.
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During the physical examination of a client who took a fall that fractured his hip, the nurse notices an impairment of the client's hearing, but that the client's visual acuity and motor function do not seem to be impaired. The client answers questions very precisely and readily grasps the meaning of everything the nurse says when the client can face the nurse. When teaching this client, the nurse should make it a priority to
- A. make verbal instructions face to face with the client.
- B. provide only written instructions.
- C. use only visual media.
- D. use only physical demonstrations with written instructions.
Correct Answer: A
Rationale: The client in this scenario has an impairment of hearing, so it is essential to ensure effective communication by facing the client when providing verbal instructions. By facing the client, the nurse can help the client by making it easier to lip-read and pick up verbal cues, improving the client's ability to understand the instructions clearly. This approach demonstrates sensitivity to the client's needs and promotes better communication during teaching sessions. Providing written instructions alone (option B), using only visual media (option C), or relying solely on physical demonstrations with written instructions (option D) may not be as effective for this particular client with impaired hearing.
During an assessment, the nurse determines that a patient with knee pain is at risk for osteoarthritis. What did the nurse assess in this patient?
- A. Having a history of falls
- B. Eating a diet high in calcium
- C. Walking 30 minutes each day
- D. Being overweight by 30 pounds
Correct Answer: D
Rationale: Osteoarthritis is a condition where the protective cartilage that cushions the ends of bones wears down over time. Excess weight puts extra stress on the joints, particularly weight-bearing joints like the knees. Being overweight by 30 pounds increases the risk of developing osteoarthritis in the knees because the added weight can accelerate the breakdown of cartilage. Therefore, the nurse identified the patient as at risk for osteoarthritis due to being overweight by 30 pounds.
A patient is scheduled for an electromyogram. What should the nurse instruct the patient to do in preparation for this diagnostic test? Select all that apply.
- A. Do not smoke for 3 hours before the test
- B. Avoid taking muscle relaxants before the test
- C. Avoid taking oral hypoglycemic agents before the test
- D. Alert the healthcare provider about an allergy to shellfish e. Avoid fluids containing caffeine for 3 hours before the test
Correct Answer: B
Rationale: B. It is essential for the patient to avoid taking muscle relaxants before the electromyogram test because these medications can affect the results by altering muscle activity and electrical signals, which are critical for diagnosing muscle and nerve disorders.
The nurse is planning care for a client with deep venous thrombosis (DVT). Which problem would be a priority for this client?
- A. Infection
- B. Fluid volume
- C. Peripheral perfusion
- D. Sleep pattern
Correct Answer: C
Rationale: In a client with deep venous thrombosis (DVT), the priority problem would be peripheral perfusion. DVT is a condition where a blood clot forms in a vein deep within the body, usually in the lower extremities. This clot can impede blood flow in the affected vein, leading to compromised circulation to the surrounding tissues. Poor peripheral perfusion can result in tissue ischemia and potential tissue necrosis. Monitoring and ensuring adequate peripheral perfusion is crucial to prevent tissue damage and further complications such as pulmonary embolism. Therefore, addressing and improving peripheral perfusion would be the priority in caring for a client with DVT.
During what period of gestation do congenital heart defects usually develop?
- A. First 8 weeks of gestation
- B. Second trimester
- C. Third trimester
- D. Last 4 weeks of gestation
Correct Answer: A
Rationale: Congenital heart defects typically develop during the first 8 weeks of gestation when the baby's heart is forming. This is a critical period of organogenesis, where the heart undergoes complex development and any disruptions during this time can lead to structural abnormalities in the heart. Factors such as genetics, environmental influences, and certain maternal health conditions can contribute to the development of congenital heart defects during this early stage of pregnancy. It is crucial for mothers to receive proper prenatal care to help reduce the risk of congenital heart defects and other birth abnormalities.