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Which instruction should the nurse include when providing discharge instructions to a client diagnosed with peripheral arterial disease?
- A. Encourage the client to use a heating pad on the lower extremities.
- B. Demonstrate to the client the correct way to apply elastic support hose.
- C. Instruct the client to walk daily for at least 30 minutes.
- D. Tell the client to check both feet for red areas at least once a week.
Correct Answer: C
Rationale: Daily walking for 30 minutes (C) promotes collateral circulation in PAD. Heating pads (A) risk burns, elastic hose (B) are for venous disease, and weekly checks (D) are insufficient (daily needed).
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Which complication of uncontrolled hypertension should the nurse include in client teaching? Select all that apply.
- A. Stroke
- B. Kidney failure
- C. Heart attack
- D. Liver cirrhosis
- E. Vision loss
- F. Peripheral neuropathy
Correct Answer: A,B,C,E
Rationale: Uncontrolled hypertension can damage blood vessels, leading to stroke, kidney failure, heart attack, and vision loss.
The nurse is caring for a client who is receiving heparin therapy intravenously. Which assessment data would indicate to the nurse the client is developing heparin-induced thrombocytopenia (HIT)? Select all that apply.
- A. The client has spontaneous bleeding from around the IV site.
- B. The client complains of chest pain on inspiration and has become restless.
- C. The client’s platelet count on admission was 420 (103) and now is 200 (103).
- D. The client complains that the gums bleed when brushing the teeth.
- E. The client has developed skin lesions at the IV site.
Correct Answer: A,C,D
Rationale: HIT causes thrombocytopenia and bleeding: IV site bleeding (A), platelet drop from 420 to 200 (C), and gum bleeding (D) are signs. Chest pain/restlessness (B) suggests PE, and skin lesions (E) are not typical.
Which laboratory value should the nurse monitor closely in a client with heart failure? Select all that apply.
- A. B-type natriuretic peptide (BNP)
- B. Serum potassium
- C. Blood urea nitrogen (BUN)
- D. Hemoglobin A1c
- E. Serum sodium
- F. Platelet count
Correct Answer: A,B,C,E
Rationale: BNP indicates heart failure severity, potassium and sodium affect fluid balance and medication safety, and BUN reflects renal perfusion.
Which medical treatment would be prescribed for the client with an AAA less than 3 cm?
- A. Ultrasound every six (6) months.
- B. Intravenous pyelogram yearly.
- C. Assessment of abdominal girth monthly.
- D. Repair of abdominal aortic aneurysm.
Correct Answer: A
Rationale: Small AAAs (<3 cm) are monitored with ultrasound every 6 months (A). IV pyelogram (B) is irrelevant, girth (C) is not standard, and repair (D) is for larger AAAs (>5.5 cm).
The client asks the nurse, 'My doctor just told me that atherosclerosis is why my legs hurt when I walk. What does that mean?' Which response by the nurse would be the best response?
- A. The muscle fibers and endothelial lining of your arteries have become thickened.'
- B. The next time you see your HCP, ask what atherosclerosis means.'
- C. The valves in the veins of your legs are incompetent so your legs hurt.'
- D. You have a hardening of your arteries that decreases the oxygen to your legs.'
Correct Answer: D
Rationale: Atherosclerosis causes arterial hardening, reducing leg oxygen (D), a clear explanation for claudication. Thickening (A) is technical, deferring (B) avoids teaching, and venous valves (C) are unrelated.