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The client with varicose veins asks why they need to wear compression stockings. What is the best response by the nurse?
- A. They prevent blood clots from forming.
- B. They help push blood back to the heart.
- C. They reduce pain in the legs.
- D. They keep your legs warm.
Correct Answer: B
Rationale: Compression stockings apply pressure to promote venous return, helping blood flow back to the heart.
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The client diagnosed with subclavian steal syndrome has undergone surgery. Which assessment data would warrant immediate intervention by the nurse?
- A. The client’s pedal pulse on the left leg is absent.
- B. The client complains of numbness in the right hand.
- C. The client’s brachial pulse is strong and bounding.
- D. The client’s capillary refill time (CRT) is less than three (3) seconds.
Correct Answer: B
Rationale: Numbness in the right hand (B) post-subclavian surgery suggests nerve or vascular compromise, requiring immediate action. Absent pedal pulse (A) is unrelated, strong brachial pulse (C) is normal, and CRT <3 sec (D) is normal.
Which diagnostic test should the nurse expect for a client with suspected endocarditis?
- A. Blood cultures
- B. Chest X-ray
- C. Urinalysis
- D. Liver function tests
Correct Answer: A
Rationale: Blood cultures identify the causative organism in endocarditis.
The nurse is caring for a male client diagnosed with essential hypertension. Which information regarding antihypertensive medication should the nurse teach?
- A. Teach the client to take his blood pressure four (4) times each day.
- B. Instruct the client to have regular blood levels of the medication checked.
- C. Explain the need to rise slowly from a lying or sitting position.
- D. Demonstrate how to use a blood glucose meter daily.
Correct Answer: C
Rationale: Antihypertensives cause orthostatic hypotension; rising slowly (C) prevents falls. Frequent BP checks (A) are excessive, drug levels (B) are rarely monitored, and glucose meters (D) are irrelevant.
The home health nurse is admitting a client diagnosed with a DVT. Which action by the client warrants immediate intervention by the nurse?
- A. The client takes a stool softener every day at dinnertime.
- B. The client is wearing a Medic Alert bracelet.
- C. The client takes vitamin E over-the-counter medication.
- D. The client has purchased a new recliner that will elevate the legs.
Correct Answer: C
Rationale: Vitamin E (C) increases bleeding risk with DVT anticoagulation, requiring intervention. Stool softeners (A), Medic Alert (B), and leg elevation (D) are appropriate.
The client is prescribed nitroglycerin for angina. Which instruction should the nurse include?
- A. Take it every day even if you feel well.
- B. Place the tablet under your tongue.
- C. Swallow the tablet with water.
- D. Apply it as a patch on your chest.
Correct Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid absorption to relieve angina.