Nokea
Which of the following factors would the nurse identify as a modifiable risk factor for the development of varicose veins?
- A. Mother and maternal grandmother had varicose veins
- B. Employed as an over-the-road truck driver
- C. Weight gained during past pregnancies
- D. History of thrombophlebitis in both extremities
Correct Answer: B
Rationale: Over-the-road truckers sit for long periods of time, and because prolonged sitting should be avoided, employment change could modify the risk associated with varicose vein aggravation. Varicose veins have a familial tendency, but this cannot be modified. Weight gained during previous pregnancies and history of thrombophlebitis cannot be changed.
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The nurse provides care to a menopausal client who states, 'I read a news article that says I am at risk for coronary vascular disease due to inflammation.' Which method should the nurse suggest to the client to aid in the prevention of inflammation that can lead to atherosclerosis?
- A. Addressing obesity
- B. Avoiding the use of caffeine
- C. Taking a daily multivitamin
- D. Drinking at least 2 liters of water a day
Correct Answer: A
Rationale: The 2019 ACC/AHA Guideline on the Primary Prevention of Coronary Vascular Disease (CVD) indicates a relationship between body fat and the production of inflammatory and thrombotic (clot-facilitating) proteins. This information suggests that decreasing obesity and body fat stores via exercise, dietary modification, or developing drugs that target proinflammatory proteins may reduce risk factors for heart disease. The risk for CVD accelerates for clients after menopause due to withdrawal of endogenous estradiol levels, which can worsen many traditional CVD risk factors, including body fat distribution. Avoiding the use of caffeine, using a multivitamin, and drinking at least 2 liters of water a day are not actions that will address the prevention of inflammation that can lead to atherosclerosis.
A client who is diagnosed with Raynaud syndrome reports cold and numbness in the fingers. Which finding should the nurse identify as an early sign of vasoconstriction?
- A. Pallor
- B. Cyanosis
- C. Gangrene
- D. Ulceration
Correct Answer: A
Rationale: Pallor is the initial symptom in Raynaud syndrome followed by cyanosis and aching pain. Gangrene and ulceration can occur with persistent attacks and interference of blood flow.
A client comes to the emergency department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client?
- A. Coronary artery disease
- B. Raynaud syndrome
- C. Cardiogenic shock
- D. Venous occlusive disease
Correct Answer: A
Rationale: The classic symptom of CAD is chest pain (angina) or discomfort during activity or stress. Such pain or discomfort typically is manifested as sudden pain or pressure that may be centered over the heart (precordial) or under the sternum (substernal). Raynaud syndrome in the hands presents with symptoms of hands that are cold, blanched, and wet with perspiration. Cardiogenic shock is a complication of an MI. Venous occlusive disease occurs in the veins, not the arteries.
The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?
- A. Assess the client's mental and emotional status
- B. Assess the skin of the client
- C. Assess the characteristics of chest pain
- D. Assess for any kind of drug abuse
Correct Answer: C
Rationale: The nurse should assess the characteristics of chest pain for a client with CAD. Assessing the client's mental and emotional status, skin, or for drug abuse will not assist the nurse in evaluating the client for CAD. The assessment should be aimed at evaluating for adequate blood flow to the heart.
Which nursing problem statement is most significant in planning the care for a client with Raynaud syndrome?
- A. Acute Pain
- B. Coping Impairment
- C. ADL Deficit
- D. Activity Intolerance
Correct Answer: A
Rationale: The hallmark symptom of Raynaud syndrome is acute pain related to the arterial insufficiency. ADL Deficit, Coping Impairment, and Activity Intolerance can occur but are less significant than Acute Pain.