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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.
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The nurse is teaching a group of community members about measures to reduce the risk of bladder cancer. What should the nurse include when providing these instructions? Select all that apply.
- A. Empty the bladder every 2 hours
- B. Do not start smoking; if you smoke, stop
- C. Increase the intake of fluids and vegetables
- D. Avoid using hair dyes and pesticides in the home e. Limit the intake of coffee and other caffeinated beverages
Correct Answer: A
Rationale: A. Empty the bladder every 2 hours: Regularly emptying the bladder helps reduce the exposure of the bladder to potentially harmful substances that can increase the risk of developing bladder cancer.
A client with disseminated intravascular coagulation (DIC) has a nursing diagnosis of Impaired Gas Exchange. Which action is appropriate when providing care based on this nursing diagnosis?
- A. Place the client in low-Fowler position to improve gas exchange
- B. Monitor the client's oxygen saturation intermittently
- C. Encourage frequent amulation
- D. Use continuous endotracheal suctioning instead of coughing and deep breathing
Correct Answer: B
Rationale: Monitoring the client's oxygen saturation intermittently is the most appropriate action when providing care for a client with disseminated intravascular coagulation (DIC) who has a nursing diagnosis of Impaired Gas Exchange. DIC can lead to a variety of complications, including inadequate oxygenation of tissues due to abnormal clotting and bleeding. By monitoring the client's oxygen saturation levels, the healthcare team can assess the effectiveness of gas exchange and adjust interventions as needed to optimize oxygenation. This action helps in early detection of worsening gas exchange and guides appropriate interventions to address any respiratory issues promptly. Placing the client in a low-Fowler position may not be suitable for all patients with DIC, encouraging frequent ambulation could be risky due to the increased bleeding tendency, and using continuous endotracheal suctioning is not recommended as it can lead to aggravation of respiratory issues and increase the risk of further complications.
A client has a blood pressure of 142/92 mmHg. Which classification is appropriate for the nurse to use when documenting this data?
- A. Normal
- B. Hypertension stage I
- C. Prehypertension
- D. Hypertension stage II
Correct Answer: D
Rationale: A blood pressure reading of 142/92 mmHg falls into the category of Hypertension Stage II based on the guidelines from the American Heart Association. In this classification, systolic blood pressure is 140-159 mmHg and diastolic blood pressure is 90-99 mmHg. Stage II hypertension indicates that the individual has a significantly elevated blood pressure level that requires prompt management and monitoring. It is crucial for the nurse to document this accurately to ensure appropriate interventions are provided to the client.
A patient has heard of several friends being diagnosed with colon cancer and does not want to develop the same health problem. What should the nurse recommend to this patient? Select all that apply.
- A. Obtain regular exercise
- B. Maintain a healthy weight
- C. Ingest two servings of red wine every day
- D. Obtain recommended screening after age 50 e. Consume a diet high in fruit and vegetables and low in saturated fat and red meat
Correct Answer: A
Rationale: A. Regular exercise has been shown to reduce the risk of developing colon cancer. Exercise helps in maintaining a healthy weight, supporting the immune system, and promoting overall health.
The nurse is providing teaching to a client diagnosed with cardiomyopathy. What statement made by the client indicates the discharge teaching was effective?
- A. "I will exercise as much as possible, regardless of feeling weak and short of breath."
- B. "My pants getting tight around the waist means I'm eating too much and should cut back on food."
- C. "I will eat foods containing sodium only if drinking water with them."
- D. "I will see my cardiologist next week to discuss implanting a pacemaker."
Correct Answer: C
Rationale: The correct statement indicating effective discharge teaching for a client diagnosed with cardiomyopathy is "I will eat foods containing sodium only if drinking water with them." This statement shows the client understands the importance of reducing sodium intake to manage cardiomyopathy effectively. Excess sodium can contribute to fluid retention and worsen symptoms of heart failure, which often accompanies cardiomyopathy. By pairing sodium-containing foods with water, the client can help mitigate the potential negative effects of sodium on their condition. The other options are incorrect as they do not demonstrate an understanding of the condition or appropriate self-care measures.