Nokea
The nurse is teaching a group of clients about varicose veins and home care management. Which of the following should the nurse include in the teaching session?
- A. When you are sitting, keep your legs lower than your heart
- B. Wear compression stockings during the day
- C. Participate in activities that have you stand for long periods
- D. Take a low-dose aspirin to prevent the development of new varicose veins
Correct Answer: B
Rationale: Compression stockings reduce venous pooling and improve circulation, a key management strategy for varicose veins.
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The nurse is caring for a client with the below tracing on the electrocardiogram (ECG). The nurse should anticipate which prescription from the primary healthcare provider (PHCP)?
- A. captopril
- B. atropine
- C. adenosine
- D. diltiazem
Correct Answer: B
Rationale: Atropine is used to treat bradycardia, which may be indicated by certain ECG tracings showing slow heart rates. Captopril is an ACE inhibitor for hypertension or heart failure, adenosine is used for supraventricular tachycardia, and diltiazem is a calcium channel blocker for rate control in atrial arrhythmias.
History of Present Illness (HPI)
The client was found disoriented upon arrival and in acute respiratory distress.
The client's caregiver noted that the prescribed medications had not been
taken for several days. Medical history includes hypertension, diabetes mellitus,
congestive heart failure, and arthritis. Client Assessment Bounding peripheral pulses,
normotensive, crackles in the lung fields, tachypnea, jugular venous distention, and
abdominal distention.
Diagnosis
1. Pulmonary edema
2. Acute decompensated heart failure
Based on the clinical data, which prescription would the nurse request from the primary healthcare provider for a client with pulmonary edema and acute decompensated heart failure? Select all that apply.
- A. Albuterol
- B. Hydrocortisone
- C. Diltiazem
- D. Nitroglycerin
- E. Furosemide
Correct Answer: D,E
Rationale: Albuterol is for bronchospasm, not pulmonary edema. B: Incorrect - Hydrocortisone is not indicated for heart failure. C: Incorrect - Diltiazem is for rate control, not fluid overload. D: Correct - Nitroglycerin reduces preload, alleviating pulmonary edema. E: Correct - Furosemide is a diuretic to reduce fluid overload.
Which of the following findings would support a diagnosis of acute myocardial infarction (AMI)? Select all that apply.
- A. Dizziness
- B. Hypotension
- C. Orthopnea
- D. Nausea
- E. Polyuria
- F. Pulsus paradoxus
Correct Answer: A,B,D
Rationale: Dizziness can result from reduced cardiac output in AMI. Hypotension may occur due to impaired cardiac function. C: Incorrect - Orthopnea is more typical of heart failure. D: Correct - Nausea is a common symptom of AMI. E: Incorrect - Polyuria is not associated with AMI. F: Incorrect - Pulsus paradoxus is linked to pericardial conditions like tamponade.
The home health nurse is caring for a client who experienced a myocardial infarction two weeks ago. Which of the following client statement requires immediate follow-up?
- A. I am having difficulty coping with the stress at work.
- B. I am unsure if I want to continue with cardiac rehabilitation.
- C. I have not been taking my prescribed clopidogrel because I cannot afford it.
- D. I started using nicotine patches to help me quit smoking.
Correct Answer: C
Rationale: Clopidogrel is critical for preventing stent thrombosis post-MI. Non-adherence requires urgent follow-up.
The nurse has instructed a client who is scheduled to have a carotid ultrasound. Which of the following statements by the client would require follow up?
- A. I plan to eat a light meal before the ultrasound.
- B. I will remove any jewelry or metal objects from my neck before the procedure.
- C. I understand that the ultrasound will use sound waves to create images of my carotid arteries.
- D. I should fast for at least 8 hours before the ultrasound.
Correct Answer: D
Rationale: Carotid ultrasound does not require fasting, so this statement requires correction.