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Which dietary recommendation should the nurse provide to a client with hypertension?
- A. Follow the DASH diet.
- B. Increase red meat consumption.
- C. Drink caffeinated beverages daily.
- D. Use table salt liberally.
Correct Answer: A
Rationale: The DASH diet, rich in fruits, vegetables, and low-fat dairy, is proven to lower blood pressure.
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The client with atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor?
- A. Platelet count
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Red blood cell count
Correct Answer: B
Rationale: Warfarin's anticoagulant effect is monitored using INR to ensure therapeutic levels and prevent bleeding or clotting.
The client diagnosed with peripheral vascular disease is overweight, has smoked two (2) packs of cigarettes a day for 20 years, and sits behind a desk all day. What is the strongest factor in the development of atherosclerotic lesions?
- A. Being overweight.
- B. Sedentary lifestyle.
- C. High-fat, high-cholesterol diet.
- D. Smoking cigarettes.
Correct Answer: D
Rationale: Smoking (D) is the strongest risk factor for atherosclerosis, causing endothelial damage and plaque formation. Obesity (A), sedentary lifestyle (B), and diet (C) contribute but are less potent.
The client with peripheral venous disease is scheduled to go to the whirlpool for a dressing change. Which is the nurse’s priority intervention?
- A. Escort the client to the physical therapy department.
- B. Medicate the client 30 minutes before going to the whirlpool.
- C. Obtain the sterile dressing supplies for the client.
- D. Assist the client to the bathroom prior to the treatment.
Correct Answer: B
Rationale: Pain management with medication 30 minutes prior (B) ensures comfort during whirlpool therapy for venous disease. Escorting (A), supplies (C), and bathroom (D) are secondary.
The nurse and an unlicensed assistive personnel (UAP) are caring for a 64-year-old client who is four (4) hours postoperative bilateral femoral-popliteal bypass surgery. Which nursing task should be delegated to the UAP?
- A. Monitor the continuous passive motion machine.
- B. Assist the client to the bedside commode.
- C. Feed the client the evening meal.
- D. Elevate the foot of the client's bed.
Correct Answer: C
Rationale: Feeding the client (C) is within the UAP’s scope and safe post-bypass. Monitoring CPM (A), assisting to commode (B), and elevating bed (D) require nursing judgment due to circulation concerns.
The nurse is teaching a class to clients diagnosed with hypertension. Which should the nurse teach the clients?
- A. The blood pressure target range should be 120/80.
- B. Take the medication even when feeling well.
- C. Get up quickly when rising from a recumbent position.
- D. Consume a 3,000-mg sodium diet.
Correct Answer: B
Rationale: Hypertension requires lifelong medication, even when asymptomatic (B). Target BP (A) is <130/80, rapid rising (C) risks orthostasis, and 3,000 mg sodium (D) is too high (aim <2,000 mg).