Nokea
The nurse reinforcing a teaching plan for a patient with Buerger disease (thromboangiitis obliterans) will focus on the need for which change?
- A. reduction of alcohol intake.
- B. avoiding cold remedies.
- C. cessation of smoking.
- D. weight reduction.
Correct Answer: C
Rationale: The hazards of cigarette smoking and its relationship to Buerger disease are the primary focus of patient teaching. None of the palliative treatments are effective if the patient does not stop smoking. Nowhere are the cause and effect of smoking so dramatically seen as with Buerger disease.
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What is the third step in the impulse pattern of conduction through the heart?
- A. Atrial wall
- B. Atrial-ventricular (AV) node
- C. Purkinje fibers
- D. Sinoatrial (SA) node
- E. Bundle branches
- F. Bundle of His
Correct Answer: B
Rationale: The conduction begins with the impulse from the SA node that travels down the atrial wall to the AV node, to the Bundle of His, to the bundle branches, and finally to the Purkinje fibers.
Which patient teaching would help to prevent venous stasis?
- A. Dangle legs when sitting.
- B. Avoid crossing the legs at the knee.
- C. Elevate legs when lying in bed or sitting.
- D. Massage extremities to help maintain blood flow.
- E. Wear elastic stockings when ambulating.
Correct Answer: B,C,E
Rationale: Avoid prolonged sitting or standing. Avoid crossing the legs at the knee. Elevate legs when sitting. Wear elastic stockings when ambulatory. Do not massage extremities because of danger of embolization of clots (thrombus breaking off and becoming an embolus).
The patient has a total cholesterol of 190 with a high-density lipid (HDL) of 110 and a low-density lipid (LDL) of 80. The nurse reinforces which instruction?
- A. Good job! Continue with your low fat diet.
- B. These levels are borderline: you still aren't eating properly.
- C. The dietician will need to talk to you about lowering your cholesterol a lot more.
- D. Your cholesterol level needs to be lowered a great deal to improve your survival chances.
Correct Answer: A
Rationale: Total cholesterol of less than 200 is desirable. The higher the number of HDLs the better. A high number of LDLs puts the patient at risk for heart disease.
Which assessment would lead the nurse to examine the leg closely for evidence of a stasis ulcer?
- A. Cool dry lower limb
- B. Darker, thick and toughened skin on medial surface of the leg
- C. Lack of hair and shiny appearance of the lower leg
- D. Lack of a pedal pulse
Correct Answer: B
Rationale: Signs of a venous disorder include darker, thick and toughened skin. Venous disorders can lead to a stasis ulcer. Cool hairless limbs with absent or weak pedal pulses are indicative of arterial insufficiency.
The nurse identifies the 'lub' sound of the 'lub/dub' of the cardiac cycle as the sound of which event?
- A. AV valves closing.
- B. closure of the semilunar valves.
- C. contraction of the papillary muscles.
- D. contraction of the ventricles.
Correct Answer: A
Rationale: The lub is the first sound of a low pitch heard when the AV valves close.