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During a blood pressure screening, an older adult client tells the nurse about chest fluttering while doing yard work. The client reports no other symptoms and the frequency is intermittent. Which action is correct by the nurse?
- A. Suggest the client stop exercising
- B. Reassure these are normal changes associated with aging
- C. Ensure the client is evaluated by his/her medical provider
- D. Check laboratory values for hypothyroidism
Correct Answer: C
Rationale: The correct action for the nurse in this situation would be to ensure the client is evaluated by his/her medical provider. Chest fluttering, also known as palpitations, can sometimes be related to cardiac arrhythmias, which can be a concern in older adults. Even though the client reports no other symptoms and the frequency is intermittent, it is essential for the medical provider to assess and determine the cause of the fluttering to rule out any serious underlying cardiac issues. Taking appropriate action promptly can help prevent any potential complications and ensure the client's well-being.
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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.
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.
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 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.
The nurse is caring for an adult client who has been diagnosed with high cholesterol. Which is important for the nurse to consider when teaching this adult client?
- A. Adults are more oriented to learning when the material is useful immediately.
- B. Adults are more likely to adhere to a regimen than are children.
- C. Adults usually can find information on their own.
- D. Adults do not need to be evaluated for understanding as children do.
Correct Answer: A
Rationale: When teaching an adult client with high cholesterol, it is important for the nurse to consider that adults are more oriented to learning when the material is useful immediately. This means that providing practical information and emphasizing how managing high cholesterol can benefit their health in the short term is likely to be more effective in engaging the client and encouraging adherence to recommendations. By focusing on the immediate relevance and benefits of the information, the nurse can enhance the client's motivation and understanding of the importance of managing their high cholesterol levels.