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The nurse is reinforcing instructions to a client with coronary artery disease who is prescribed a low-cholesterol diet. The nurse should advise the client to choose which food item?
- A. Eggs and bacon
- B. Oatmeal with fresh fruit
- C. Cream of chicken soup
- D. Grilled cheese sandwich
Correct Answer: B
Rationale: Oatmeal with fresh fruit is a suitable choice for a client with coronary artery disease on a low-cholesterol diet as it is low in cholesterol and provides heart-healthy benefits. Eggs and bacon, cream of chicken soup, and grilled cheese sandwich are higher in cholesterol and may not be as heart-healthy for this client. Eggs and bacon are high in cholesterol, cream of chicken soup may contain saturated fats, and a grilled cheese sandwich typically contains high amounts of fat and cholesterol, making them less suitable choices for a client with coronary artery disease on a low-cholesterol diet.
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A client has a new prescription for propranolol. Which of the following instructions should be included?
- A. Take the medication with food.
- B. Monitor heart rate daily.
- C. Increase intake of potassium-rich foods.
- D. Avoid consuming dairy products.
Correct Answer: B
Rationale: The correct answer is to monitor heart rate daily. Propranolol is a beta-blocker that can lower heart rate and blood pressure, so it is essential to monitor heart rate regularly to detect any signs of bradycardia, a potential side effect of the medication. Choice A is incorrect because propranolol can be taken with or without food. Choice C is incorrect as increasing potassium-rich foods is not specifically required with propranolol. Choice D is also incorrect as there is no need to avoid consuming dairy products with propranolol.
The client is starting therapy with digoxin (Lanoxin). What instruction should the nurse reinforce about the medication?
- A. Take the medication with meals.
- B. Avoid dairy products.
- C. Monitor for yellow or blurred vision.
- D. Increase potassium-rich foods in the diet.
Correct Answer: C
Rationale: The correct answer is C: 'Monitor for yellow or blurred vision.' When a client is taking digoxin, it is crucial to monitor for signs of toxicity, such as yellow or blurred vision, as these can indicate an adverse reaction. Reporting these visual disturbances promptly to the healthcare provider is important for further evaluation and management to prevent potential complications. Choices A, B, and D are incorrect because taking digoxin with meals, avoiding dairy products, or increasing potassium-rich foods are not specific instructions related to monitoring for adverse effects of digoxin therapy.
A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should reinforce which dietary instruction?
- A. Avoid foods high in vitamin K.
- B. Increase intake of dairy products.
- C. Limit intake of foods high in fiber.
- D. Increase protein intake.
Correct Answer: A
Rationale: The correct answer is to avoid foods high in vitamin K. Clients taking warfarin (Coumadin) should maintain a consistent intake of vitamin K to keep the medication's effectiveness stable. Foods high in vitamin K, such as leafy greens, can interfere with the anticoagulant effects of warfarin. Therefore, it is crucial for clients to avoid these foods to ensure the therapeutic effects of warfarin. Choices B, C, and D are incorrect because increasing dairy products, limiting fiber intake, or increasing protein intake do not directly impact the effectiveness of warfarin therapy and are not necessary dietary modifications for clients on this medication.
The client with chronic stable angina is prescribed a beta blocker. The nurse is reinforcing instructions. What instruction should the nurse include?
- A. Take the medication with a meal.
- B. Report a pulse rate below 60 beats per minute.
- C. Discontinue the medication if dizziness occurs.
- D. Avoid drinking grapefruit juice.
Correct Answer: B
Rationale: The correct instruction for the nurse to include is to advise the client to report a pulse rate below 60 beats per minute. Beta blockers are known to lower heart rate, and a pulse rate below 60 beats per minute may indicate bradycardia, a condition that requires medical attention. Option A, 'Take the medication with a meal,' is incorrect because beta blockers don't necessarily need to be taken with food. Option C, 'Discontinue the medication if dizziness occurs,' is incorrect because abrupt cessation of beta blockers can lead to rebound hypertension and other adverse effects. Option D, 'Avoid drinking grapefruit juice,' is unrelated to beta blockers' mechanism of action or side effects.
The client with a history of angina pectoris is being discharged after coronary artery bypass graft (CABG) surgery. Which statement by the client indicates a need for further teaching?
- A. I will avoid lifting heavy objects for at least 6 weeks.
- B. I will call the doctor if I develop a fever or drainage from my incisions.
- C. I will take my pain medication before doing any activities that might cause discomfort.
- D. I can resume my normal activities, including driving, as soon as I feel like it.
Correct Answer: D
Rationale: The correct answer is D because after CABG surgery, patients need to follow specific guidelines for resuming activities, and driving is typically restricted for a certain period to ensure safety and proper recovery. Resuming normal activities too soon, including driving, can pose risks to the client's health and safety. It is essential to emphasize to the client the importance of following the healthcare provider's recommendations regarding activity restrictions post-surgery to prevent complications and promote optimal recovery. Choices A, B, and C are correct statements that align with post-CABG discharge instructions, emphasizing the importance of avoiding heavy lifting, monitoring for signs of infection, and managing pain effectively.