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Which teaching point should the nurse include for a client with coronary artery disease? Select all that apply.
- A. Exercise regularly as tolerated.
- B. Avoid all fats in the diet.
- C. Manage stress effectively.
- D. Take medications as prescribed.
- E. Monitor for chest pain.
- F. Limit physical activity.
Correct Answer: A,C,D,E
Rationale: Regular exercise, stress management, medication adherence, and monitoring for chest pain reduce complications in coronary artery disease.
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The nurse is teaching a class on atherosclerosis. Which statement describes the scientific rationale as to why diabetes is a risk factor for developing atherosclerosis?
- A. Glucose combines with carbon monoxide, instead of with oxygen, and this leads to oxygen deprivation of tissues.
- B. Diabetes stimulates the sympathetic nervous system, resulting in peripheral constriction that increases the development of atherosclerosis.
- C. Diabetes speeds the atherosclerotic process by thickening the basement membrane of both large and small vessels.
- D. The increased glucose combines with the hemoglobin, which causes deposits of plaque in the lining of the vessels.
Correct Answer: C
Rationale: Diabetes accelerates atherosclerosis by thickening vascular basement membranes (C), promoting plaque. Carbon monoxide (A), sympathetic stimulation (B), and glucose-hemoglobin (D) are incorrect mechanisms.
Which medication side effect should the nurse monitor for in a client taking an ACE inhibitor?
- A. Dry cough
- B. Weight gain
- C. Increased thirst
- D. Muscle cramps
Correct Answer: A
Rationale: ACE inhibitors commonly cause a dry cough due to increased bradykinin levels.
Which discharge instruction should the nurse discuss with the client to prevent recurrent episodes of cellulitis?
- A. Soak your feet daily in Epsom salts for 20 minutes.
- B. Wear thick white socks when working in the yard.
- C. Use a mosquito repellent when going outside.
- D. Inspect the feet between the toes for cracks in the skin.
Correct Answer: D
Rationale: Inspecting feet for cracks (D) prevents skin breakdown, a cellulitis entry point in diabetes. Epsom salts (A) are not standard, socks (B) are less specific, and repellent (C) prevents bites but not cracks.
The nurse is caring for a male client diagnosed with essential hypertension. Which information regarding antihypertensive medication should the nurse teach?
- A. Teach the client to take his blood pressure four (4) times each day.
- B. Instruct the client to have regular blood levels of the medication checked.
- C. Explain the need to rise slowly from a lying or sitting position.
- D. Demonstrate how to use a blood glucose meter daily.
Correct Answer: C
Rationale: Antihypertensives cause orthostatic hypotension; rising slowly (C) prevents falls. Frequent BP checks (A) are excessive, drug levels (B) are rarely monitored, and glucose meters (D) are irrelevant.
The nurse is administering a beta blocker to the client diagnosed with essential hypertension. Which intervention should the nurse implement?
- A. Notify the health-care provider if the potassium level is 3.8 mEq.
- B. Question administering the medication if the BP is less than 90/60 mm Hg.
- C. Do not administer the medication if the client's radial pulse is greater than 100.
- D. Monitor the client's BP while he or she is lying, standing, and sitting.
Correct Answer: B
Rationale: Beta blockers lower BP; BP <90/60 (B) indicates hypotension, warranting withholding the dose. Potassium 3.8 (A) is normal, pulse >100 (C) is not a contraindication, and orthostatic checks (D) are routine but not primary.