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The nurse has conducted teaching, with a client who experienced pulmonary embolism, about methods to prevent recurrence after discharge. Which client statement demonstrates understanding of the teaching?
- A. I will limit the intake of fluids.
- B. I will sit down whenever possible.
- C. I am planning to continue to wear supportive hose.
- D. I will cross my legs only at the ankle and not at the knees.
Correct Answer: C
Rationale: Wearing supportive hose enhances venous return, reducing the risk of thrombus formation and pulmonary embolism recurrence. Limiting fluid intake can lead to hemoconcentration, increasing clot risk. Prolonged sitting or crossing legs (even at the ankles) can impede venous return and should be avoided.
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The nurse has given the client with a nonplaster (fiberglass) leg cast instructions regarding cast care at home. The nurse determines that the client needs further teaching if the client makes which statement?
- A. I should avoid walking on wet, slippery floors.
- B. I'm not supposed to scratch the skin underneath the cast.
- C. It's all right to wipe dirt off of the top of the cast with a damp cloth.
- D. If the cast gets wet, I can dry it with a hair dryer turned to the hot setting.
Correct Answer: D
Rationale: Using a hair dryer on a hot setting to dry a wet fiberglass cast can cause burns or damage the cast. Avoiding slippery floors, not scratching under the cast, and wiping the cast with a damp cloth are correct care instructions.
A client who is taking tranylcypromine sulfate requests information about foods that are acceptable to eat while taking the medication. Which foods are safe to consume while taking this medication?
- A. Yogurt
- B. Raisins
- C. Oranges
- D. Smoked fish
Correct Answer: C
Rationale: Tranylcypromine sulfate is classified as a monoamine oxidase inhibitor (MAOI); as such, tyramine-containing food should be avoided. Oranges are permissible. Types of food to be avoided include—but are not limited to—yogurt, raisins, and smoked fish. Additionally, beer, wine, caffeinated beverages, pickled meats, yeast preparations, avocados, bananas, and plums are to be avoided.
The home care nurse is evaluating a client's understanding of the self-management of trigeminal neuralgia. Which client statement indicates that there is a need for further teaching?
- A. I should chew on my good side.
- B. An analgesic will relieve my pain.
- C. I should use warm mouthwash for oral hygiene.
- D. Taking my carbamazepine will help control my pain.
Correct Answer: B
Rationale: Chronic irritation of cranial nerve V results in trigeminal neuralgia, and it is characterized by intermittent episodes of intense pain of sudden onset on the affected side of the face. The pain is rarely relieved by analgesics. It is recommended that clients chew on the unaffected side and use warm mouthwash for oral hygiene. Medications such as carbamazepine help control the pain of trigeminal neuralgia.
The nurse is working at an osteoporosis screening clinic and is interviewing and performing health assessments on women. Which clients are at greatest risk for developing osteoporosis? Select all that apply.
- A. An Asian woman
- B. A large-boned, dark-skinned woman
- C. A client who started menopause early
- D. A client with a family history of the disease
- E. A client who has a physically active lifestyle
- F. A client with an inadequate intake of calcium and vitamin D
Correct Answer: A,C,D,F
Rationale: Risk factors for osteoporosis include being of Asian or Caucasian descent, early menopause, a family history of osteoporosis, and inadequate intake of calcium and vitamin D. Large-boned, dark-skinned women (e.g., those of African descent) have a lower risk due to higher bone density. A physically active lifestyle is protective against osteoporosis, reducing the risk.
A client diagnosed with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with an exacerbation. Which factor contributed most to the change in client status?
- A. Decreased fat intake
- B. Decreased fluid intake
- C. Sleeping soundly during the night
- D. Anxiety about the upcoming pulmonologist visit
Correct Answer: B
Rationale: The client with exacerbation of COPD has ineffective coughing and excess sputum in the airways. The nurse assesses the client for contributing factors such as dehydration and a lack of knowledge of proper coughing techniques. The reduction of these factors helps limit exacerbations of the disease. Decreased fat intake, sleeping soundly, and anxiety related to scheduled pulmonologist visit are not directly associated with this change in condition.