Nokea
The clinic nurse is teaching the client at risk for developing arteriosclerosis. The nurse should teach the client that the dietary therapy to decrease homo-cysteine levels includes eating foods rich in which nutrient?
- A. Monosaturated fats
- B. B complex Vitamins
- C. Vitamin C
- D. Calcium
Correct Answer: B
Rationale: Homocysteine interferes with the elasticity of the endothelial layer in blood vessels. Foods rich in B-complex vitamins, especially folic acid, have been found to lower serum homocysteine levels. Monosaturated fats, Vitamin C, and Calcium do not have a direct effect on homocysteine levels.
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The client, returning from a coronary catheterization in which the femoral artery approach was used, sneezes. Which should be the nurse’s priority intervention?
- A. Palpate pedal pulses
- B. Measure vital signs
- C. Assess for urticaria
- D. Check the insertion site
Correct Answer: D
Rationale: Checking the insertion site is priority. Sneezing increases intra-abdominal pressure and increases the risk for clot disruption and bleeding from the femoral artery. Pedal pulses, vital signs, and urticaria are secondary concerns.
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 nurse is caring for the client who had a cardiac valve replacement. To decrease the risk of DVT and PE, which interventions should the nurse plan to include? Select all that apply.
- A. Apply a pneumatic compression device.
- B. Administer a heparin infusion intravenously.
- C. Encourage coughing and deep breathing hourly.
- D. Teach about performing isometric leg exercises.
- E. Avoid the use of graded compression elastic stockings.
Correct Answer: A;D
Rationale: The nurse should include: A) Pneumatic compression devices to mimic walking pressures; D) Isometric exercises to compress vessels and reduce DVT risk. Heparin is typically subcutaneous, coughing/deep breathing prevents pulmonary issues, and compression stockings are beneficial unless PAD is present.
At 0745 hours, the nurse is informed by the HCP that a cardiac catheterization is to be completed on the client at 1400 hours. Which intervention should be the nurse’s priority?
- A. Place the client on NPO (nothing per mouth) status.
- B. Teach the client about the cardiac catheterization.
- C. Start an intravenous (IV) infusion of 0.9% NaCl.
- D. Witness the client’s signature on the consent form.
Correct Answer: A
Rationale: A cardiac catheterization is an invasive procedure requiring the client to lie still in a supine position. The client is usually sedated with medication, such as midazolam, during the procedure. To avoid aspiration, the client should be NPO 6 to 12 hours prior to the procedure, making this the priority at 0745 for a 1400 procedure.
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.