A client has just been diagnosed with an aneurysm. When planning discharge teaching for this client, what instructions should the nurse provide to the client?

Take an herbal form of feverfew

Take opioid analgesics

Avoid heavy lifting

Include peanut butter, bread, or tart foods in the diet

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Feverfew, an herbal supplement, is sometimes used for migraines but has no proven role in aneurysm management. It may affect platelet function, increasing bleeding risk if an aneurysm ruptures, making it an inappropriate and potentially harmful recommendation for this client’s condition.

Choice B reason: Opioid analgesics are not routinely recommended for aneurysm management unless severe pain from rupture occurs. Prophylactic use is inappropriate, as it does not prevent aneurysm complications and may mask symptoms, delaying intervention. Lifestyle measures like avoiding strain are more relevant for prevention.

Choice C reason: Avoiding heavy lifting is critical for clients with an aneurysm, as increased intra-abdominal or thoracic pressure from lifting can elevate blood pressure, risking aneurysm rupture. This lifestyle modification reduces mechanical stress on the aneurysm wall, promoting safety and preventing catastrophic bleeding events.

Choice D reason: Including peanut butter, bread, or tart foods in the diet is unrelated to aneurysm management. Dietary choices do not directly affect aneurysm stability or rupture risk. Blood pressure control and avoiding strain, like heavy lifting, are more critical to prevent aneurysm complications.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Seizures can occur post-stroke due to cortical irritation, but they are not the primary complication of t-PA. Thrombolytics increase bleeding risk, particularly intracranial hemorrhage, which is more immediate and life-threatening, making seizure monitoring secondary to vigilant observation for bleeding signs.

Choice B reason: Septicemia is not a direct complication of t-PA or ischemic stroke. While infections may occur later due to immobility or hospitalization, t-PA’s primary risk is bleeding due to its fibrinolytic action, making septicemia a less urgent concern in the immediate post-treatment period.

Choice C reason: Bleeding, particularly intracranial hemorrhage, is the most critical complication to monitor post-t-PA in ischemic stroke. t-PA dissolves clots, increasing the risk of bleeding in the brain or other sites, which can lead to neurological deterioration or death, requiring close monitoring in the ICU.

Choice D reason: Acute pain is not a primary complication of t-PA or ischemic stroke. Pain may occur in stroke from spasticity or other causes, but bleeding is the most immediate and severe risk of thrombolytic therapy, requiring prioritized monitoring over pain assessment.

A. Hemoglobin A B. Hemoglobin S C. Hemoglobin M D. Hemoglobin F

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Hemoglobin A is the normal adult hemoglobin, comprising two alpha and two beta chains. In sickle cell anemia, a mutation in the beta-globin gene produces hemoglobin S, not hemoglobin A, which does not cause sickling or the vaso-occlusive crises characteristic of the disease.

Choice B reason: Hemoglobin S is the abnormal hemoglobin in sickle cell anemia, resulting from a point mutation in the beta-globin gene. This causes red blood cells to sickle under stress, leading to hemolysis and vaso-occlusion, resulting in pain, organ damage, and the clinical features of sickle cell crises.

Choice C reason: Hemoglobin M is a rare hemoglobin variant causing methemoglobinemia, not sickle cell anemia. It results from mutations affecting heme iron, leading to cyanosis, not the sickling and vaso-occlusion seen with hemoglobin S, making it irrelevant to the client’s condition.

Choice D reason: Hemoglobin F, or fetal hemoglobin, is present in newborns and persists in small amounts in adults. In sickle cell anemia, increased hemoglobin F can reduce sickling, but it is not the cause. Hemoglobin S drives the disease’s pathophysiology, not hemoglobin F.

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A client has just been diagnosed with an aneurysm. When planning discharge teaching for this client, what instructions should the nurse provide to the client?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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