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The nurse is planning care for a client diagnosed with arterial occlusive disease. Which exercise instructions would the nurse teach the client?
- A. Have the client perform isometric exercises 30 minutes each day.
- B. Tell the client to start exercising on a stair stepper for 15 minutes.
- C. Inform the client that warm-up exercises are not necessary.
- D. Teach the client to walk in well-fitting shoes on level ground.
Correct Answer: D
Rationale: Walking on level ground in well-fitting shoes (D) promotes circulation in PAD. Isometric exercises (A) increase BP, stair steppers (B) are too strenuous, and warm-ups (C) are necessary.
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Which signs/symptoms would the nurse expect to find in the female client diagnosed with Marfan’s syndrome?
- A. Xerostomia, dry eyes, and complaints of a dry vagina.
- B. A triad of arthritis, conjunctivitis, and urethritis.
- C. Very tall stature and long bones in the hands and feet.
- D. Spinal deformities of the vertebral column and malaise.
Correct Answer: C
Rationale: Marfan’s syndrome causes tall stature and long extremities (C) due to connective tissue defects. Dryness (A) is Sjögren’s, triad (B) is reactive arthritis, and spinal deformities (D) are partial but not primary.
The client with hypertension asks why they need to limit stress. What is the best response?
- A. Stress causes fluid retention.
- B. Stress increases your heart rate and blood pressure.
- C. Stress reduces oxygen to your heart.
- D. Stress weakens your immune system.
Correct Answer: B
Rationale: Stress activates the sympathetic nervous system, increasing heart rate and blood pressure.
The nurse is teaching a class on venous insufficiency. The nurse would identify which condition as the most serious complication of chronic venous insufficiency?
- A. Arterial thrombosis.
- B. Deep vein thrombosis.
- C. Venous ulcerations.
- D. Varicose veins.
Correct Answer: C
Rationale: Venous ulcerations (C) are the most serious complication of chronic venous insufficiency, causing infection risk and impaired healing. Arterial thrombosis (A) is unrelated, DVT (B) is a separate condition, and varicose veins (D) are less severe.
The nurse is assessing a client with heart failure. Which finding indicates worsening condition?
- A. Weight gain of 3 pounds in 2 days
- B. Blood pressure of 120/80 mmHg
- C. Heart rate of 70 beats per minute
- D. Clear lung sounds bilaterally
Correct Answer: A
Rationale: Rapid weight gain in heart failure indicates fluid retention, a sign of worsening condition.
Which of the following nursing interventions is most helpful in promoting venous circulation?
- A. Offer the client an analgesic for pain.
- B. Apply elastic compression stockings.
- C. Encourage complete bedrest for 48 hours.
- D. Teach the client to sit with legs dependent.
Correct Answer: B
Rationale: Elastic compression stockings promote venous return by applying graduated pressure, reducing edema and improving circulation.