The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. The nurse should do which intervention to effectively accomplish this goal?
- A. Provide a quiet and low-stimulus environment.
- B. Encourage the family to come visit very frequently.
- C. Encourage the client to call friends and relatives each day.
- D. Recommend that the client watch TV as a constant diversion.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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After returning the client to bed following a cardiac catheterization procedure with the left femoral vessel as the access site, the nurse places a sign above the bed instructing the client to remain on bed rest and in which position?
- A. In semi-Fowler's position
- B. With the head of the bed elevated 45 degrees
- C. With the head of the bed elevated no more than 15 degrees
- D. With the foot of the bed elevated as much as tolerated by the client
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client is being ambulated due to activity intolerance caused by bacterial endocarditis. How can the nurse determine that the client is best tolerating ambulation?
- A. Mild dyspnea after walking 10 feet
- B. Minimal chest pain rated 1 on a 1-to-10 pain scale
- C. Pulse rate that increases from 68 to 94 beats per minute
- D. Blood pressure that increases from 114/82 to 118/86 mm Hg
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The client with Raynaud's phenomenon is being taught by the nurse about preventing episodes. Which instruction should the nurse reinforce?
- A. Wear gloves in cold weather.
- B. Avoid caffeine and chocolate.
- C. Increase intake of vitamin C.
- D. Use a heating pad for warmth.
Correct Answer: A
Rationale: Wearing gloves in cold weather is essential for preventing vasoconstriction and subsequent episodes of Raynaud's phenomenon. Cold temperatures can trigger vasospasms in individuals with Raynaud's, and wearing gloves helps maintain warmth and prevent the constriction of blood vessels in the extremities, reducing the likelihood of an episode.
A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed?
- A. Strict bed rest for 24 hours
- B. Bathroom privileges and self-care activities
- C. Unrestricted activities because the client is monitored
- D. Unsupervised hallway ambulation with distances less than 200 feet
Correct Answer: B
Rationale: After being transferred from the CCU to the general medical unit with cardiac monitoring, the client with MI is typically prescribed bathroom privileges and self-care activities. This allows for gradual recovery and mobility while still being closely monitored, promoting the client's overall well-being and independence.
Which statement indicates that a client with coronary artery disease (CAD) understands disease management?
- A. I will walk for one-half hour daily.
- B. As long as I exercise, I can eat anything I wish.
- C. My weight plays no role in this disease.
- D. My father's high cholesterol is irrelevant.
Correct Answer: A
Rationale: Choice A is the correct answer because regular physical activity, like walking for half an hour daily, is beneficial for managing coronary artery disease (CAD) and promoting heart health. It helps improve circulation, reduce cholesterol levels, and maintain a healthy weight, which are all important factors in managing CAD. Choices B, C, and D are incorrect as they convey misconceptions about disease management for CAD.