Nokea
The client asks the nurse what can be done to alleviate the pain and discomfort associated with varicose veins. Which response by the nurse is best?
- A. “Dangle your legs off the side of the bed as often as possible to alleviate the pain.”
- B. “There isn’t much you can do about the pain except have surgery to remove the veins.”
- C. “You should wear long pants to hide bulging veins; this will help your self-confidence.”
- D. “Wear elastic stockings to promote venous return; these will also help reduce discomfort.”
Correct Answer: D
Rationale: The best response to alleviate pain and discomfort associated with varicose veins includes application of elastic stockings and elevating the lower extremities. These promote venous return. Dangling legs, surgery as the only option, or wearing long pants do not address the pain effectively.
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The nurse is caring for the client with varicose veins. Which action should indicate to the nurse that an expected outcome has been met?
- A. States will walk daily to promote venous return
- B. Reports decreased need for compression stockings
- C. States can finally stand for prolonged periods of time
- D. Chooses diet high in potassium and low in magnesium
Correct Answer: A
Rationale: Walking promotes venous return; verbalizing intent to increase activity indicates an expected outcome has been met for the client with varicose veins. Decreased stocking use, prolonged standing, and specific diets are not beneficial.
The client newly diagnosed with HF has an ejection fraction of 20%. Which criteria should the nurse use to evaluate the client’s readiness for discharge to home? Select all that apply.
- A. There is a scale in the client’s home
- B. The client started ambulating 24 hours ago
- C. The client is receiving furosemide IV 20 mg bid
- D. A smoking cessation consult is scheduled for 2 days after discharge
- E. A home-care nurse is scheduled to see the client 3 days after discharge
Correct Answer: A;B;E
Rationale: The nurse should evaluate: A) A scale to monitor fluid status; B) Ambulation to confirm functional capability; E) Home-care nurse visit within 3 days for support. IV furosemide (C) should be oral before discharge, and smoking cessation (D) should start before discharge.
The nurse assesses the client at a vascular clinic after being treated with pentoxifylline for 6 weeks. The nurse determines that pentoxifylline has been effective when noting that the client has which finding?
- A. A decrease in lower-extremity edema
- B. No symptoms of withdrawal after quitting smoking
- C. A venous ulcer on the ankle that has decreased in size
- D. The ability to walk a longer distance without claudication
Correct Answer: D
Rationale: Pentoxifylline (Trental) is thought to act by improving capillary blood flow and is prescribed to decrease intermittent claudication. Effects are usually seen in 2 to 4 weeks. Edema, smoking withdrawal, and venous ulcers are not treated by pentoxifylline.
The nurse is teaching the client newly diagnosed with chronic stable angina. Which instructions on measures to prevent future angina should the nurse incorporate? Select all that apply.
- A. Increase isometric arm exercises to build endurance.
- B. Wear a facemask when outdoors in cold weather.
- C. Take nitroglycerin before a stressful event even if pain free.
- D. Perform most exertional activities in the morning.
- E. Take a daily laxative to avoid straining with bowel movements.
- F. Discontinue use of all tobacco products if you use these.
Correct Answer: B;C;F
Rationale: The nurse should instruct: B) Wearing a facemask in cold weather to prevent vasoconstriction; C) Taking nitroglycerin prophylactically to improve coronary blood flow; F) Discontinuing tobacco to reduce vasoconstriction. Isometric exercises, morning exertion, and daily laxatives are not recommended as they may increase cardiac workload or cause other issues.
The nurse plans teaching for a 20-year-old newly diagnosed with hypertrophic cardiomyopathy. The client is on the college soccer team. Which information should be the nurse’s priority when teaching the client?
- A. Provide pamphlets on genetic testing to avoid passing on an inherited disease.
- B. Reinforce the need to continue exercise with soccer to strengthen the heart.
- C. Provide information about CPR to persons living with the client.
- D. Counsel on foods for consuming on a low-fat, low-cholesterol diet.
Correct Answer: C
Rationale: Because sudden cardiac death is a large risk factor for those under 30 years of age, the nurse should provide information about having others living with the client trained in CPR as a preventative measure. Genetic testing, continued strenuous exercise, and diet are less immediate priorities.