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The nurse is evaluating a hypertensive client's understanding of dietary modifications to control the disease process. The nurse determines that the client's understanding is satisfactory if the client made which meal selections?
- A. Corned beef, fresh carrots, boiled potato
- B. Hot dog on a bun, sauerkraut, baked beans
- C. Turkey, baked potato, salad with oil and vinegar
- D. Scallops, French fries, salad with bleu cheese dressing
Correct Answer: C
Rationale: Hypertensive clients should avoid high-sodium foods like corned beef, hot dogs, sauerkraut, scallops, French fries, and bleu cheese dressing. Turkey, baked potato, and salad with oil and vinegar are low in sodium, indicating correct dietary understanding.
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The nurse provides information to a client about performing a breast self-examination (BSE). The nurse determines that the client needs additional teaching if the client makes which statements? Select all that apply.
- A. The BSE must be done monthly.
- B. Lumps in my armpit area are normal.
- C. I can palpate my breasts with soapy water while showering.
- D. I should perform the examination on the day that I start my period.
- E. When I squeeze my nipples, I should expect to note some discharge.
- F. I should stand before a mirror and inspect each breast for anything unusual.
Correct Answer: B,D,E
Rationale: Any lumps in the armpit or nipple discharge are abnormal and require reporting to a healthcare provider. The BSE should be performed 2 to 3 days after menstruation ends, not on the first day, when breasts are tender. Monthly BSE, palpation with soapy water in the shower, and mirror inspection are correct techniques.
The clinic nurse provides instructions to a client who will begin taking oral contraceptives. Which statement by the client indicates the need for further teaching?
- A. I will take one pill daily at the same time every day.
- B. If I miss a pill, I must take it as soon as I remember.
- C. I will not need to use an additional birth control method after I start these pills.
- D. If I miss two pills, I will take them both as soon as I remember, and then two pills the next day.
Correct Answer: C
Rationale: The client must use a second birth control method during the first pill cycle of oral contraceptives to ensure protection against pregnancy. Taking the pill at the same time daily, taking a missed pill as soon as remembered, and taking two missed pills as soon as remembered with two the next day are correct actions.
The nurse is teaching dietary modifications to the client with hypertension. The nurse should instruct the client to eat which snack foods?
- A. Raw carrots
- B. Celery stalks
- C. Frozen pizza
- D. Cheese and crackers
- E. Canned tomato soup
Correct Answer: A,B
Rationale: Sodium should be avoided by the client with hypertension. Fresh fruits and vegetables such as carrots and celery are naturally lower in sodium. Hypertensive clients are also advised to keep fat intake to less than 30% of their total calories as part of prudent heart living. Each of the incorrect options contains high amounts of sodium, and frozen pizza and cheese and crackers are also likely to be higher in fat.
A client's wife tells the nurse, 'I can't believe my husband has high blood pressure. He feels fine. What caused this?' The nurse's response should include which of the following? Select all that apply.
- A. One-third of people with high blood pressure are not aware of it.
- B. Clients over 50 years of age are at the highest risk of hypertension.
- C. Hypertension is more common in Hispanics and Native Americans.
- D. Hypertension is more prevalent in the southeastern United States.
- E. Your husband works at a desk job all day, so he does not get as much physical activity as he should.
Correct Answer: A,B,D,E
Rationale: Many are unaware of hypertension, age over 50 and sedentary lifestyle increase risk, and it's more prevalent in the Southeast. Hypertension is more common in African Americans, not Hispanics or Native Americans.
The nurse is reviewing the medication history for a 24-year-old client in the fertility clinic. Which medication does the nurse understand to be a Category X medication in pregnancy?
- A. metformin
- B. amoxicillin
- C. gabapentin
- D. simvastatin
Correct Answer: D
Rationale: Simvastatin is Category X, contraindicated in pregnancy due to fetal harm. Others are safer (Categories B or C).