Nokea
The nurse has attended a staff education program about managing clients with peripheral arterial disease. Which of the following statements by the nurse would require follow-up?
- A. The client should engage in a daily exercise regimen.
- B. Smoking cessation is an essential treatment goal for clients who smoke.
- C. Resting in a recliner with the legs dependent should be recommended.
- D. Devices that elevate the legs above the heart should be provided at discharge.
Correct Answer: C
Rationale: Dependent leg positioning worsens peripheral arterial disease by reducing blood flow; elevation is contraindicated.
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The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.
The client reporting …………… and …………….would indicate improvement in their condition.
- A. Ambulation tolerance
- B. Edema after activity
- C. Weight loss
- D. Sleeping in bed
- E. High sodium intake
Correct Answer: A,D
Rationale: A: Improved ambulation tolerance indicates better functional capacity. D: Sleeping in bed (without orthopnea) suggests reduced pulmonary congestion. B, C, E: Edema, weight loss, and high sodium intake do not necessarily indicate improvement.
The nurse is caring for a client with a myocardial infarction experiencing tachycardia and coughing up frothy, pink-tinged sputum. Which finding would the nurse expect upon lung auscultation?
- A. Wheezing
- B. Crackles
- C. Rhonchi
- D. Diminished sounds
Correct Answer: B
Rationale: Frothy, pink-tinged sputum indicates pulmonary edema, often post-MI, causing crackles on lung auscultation due to fluid in alveoli.
Which of the following interventions should the nurse include when teaching clients strategies for preventing cardiovascular disease? Select all that apply.
- A. Encouraging regular physical exercise
- B. Promoting a diet high in saturated fats
- C. Advising smoking cessation
- D. Recommend no more than 5 alcoholic drinks a day
- E. Educating about the importance of regular blood pressure monitoring
- F. Instructing on the importance of regular cholesterol screenings
Correct Answer: A,C,E,F
Rationale: Regular exercise reduces cardiovascular risk. B: Incorrect - High saturated fat diets increase cardiovascular risk. C: Correct - Smoking cessation lowers cardiovascular disease risk. D: Incorrect - Alcohol should be limited to 1-2 drinks per day for men, 1 for women. E: Correct - Blood pressure monitoring detects hypertension early. F: Correct - Cholesterol screenings identify hyperlipidemia for early intervention.
Which of the following lifestyle modifications are recommended for managing essential hypertension? Select all that apply.
- A. Isometric exercises
- B. Decreasing sodium intake
- C. Smoking cessation
- D. Use of herbal supplements
- E. Weight loss
Correct Answer: B,C,E
Rationale: Isometric exercises can increase blood pressure and are not recommended. Reducing sodium intake helps lower blood pressure. C: Correct - Smoking cessation reduces cardiovascular risk. D: Incorrect - Herbal supplements are not universally recommended and may interact with medications. E: Correct - Weight loss reduces blood pressure and cardiovascular strain.
The nurse has collected a client's vital signs. The nurse notes that the client's apical pulse was 75 beats per minute, and the radial pulse was 69 beats per minute. The nurse should document this finding as
- A. a widened pulse pressure.
- B. a pulse deficit.
- C. pulsus paradoxus.
- D. an expected finding.
Correct Answer: B
Rationale: A difference between apical and radial pulses indicates a pulse deficit, often due to weak or missed beats.