A client who has high blood pressure is having difficulty following their treatment plan. Which of the following factors should the nurse recognize as being the greatest barrier to the client's ability to be compliant?
Dietary salt restriction
Absence of symptoms
Addition of a new medication
A detailed plan of care
The Correct Answer is B
A. Dietary salt restriction can be challenging, but patients often adapt over time with education and support; it is not usually the greatest barrier.
B. Many clients with high blood pressure feel well despite elevated readings, so the absence of symptoms can lead them to underestimate the seriousness of their condition and skip medications, making this the most significant barrier.
C. Adding a new medication may complicate the regimen, but understanding its purpose can improve adherence; it is less influential than asymptomatic disease.
D. A detailed plan of care is intended to guide the client, and while complexity can be a barrier, it is typically easier to address with education and support than the lack of perceived need due to no symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Dietary salt restriction can be challenging, but patients often adapt over time with education and support; it is not usually the greatest barrier.
B. Many clients with high blood pressure feel well despite elevated readings, so the absence of symptoms can lead them to underestimate the seriousness of their condition and skip medications, making this the most significant barrier.
C. Adding a new medication may complicate the regimen, but understanding its purpose can improve adherence; it is less influential than asymptomatic disease.
D. A detailed plan of care is intended to guide the client, and while complexity can be a barrier, it is typically easier to address with education and support than the lack of perceived need due to no symptoms.
Correct Answer is D
Explanation
A. Attach the client's NG tube to low intermittent suction: Suction may be used after lavage for decompression, but during lavage, the focus is on instilling and withdrawing solution manually to clear the stomach of blood or contents.
B. Instill the lavage solution into the client's NG tube in volumes of 500 mL at a time: This volume is excessive and could increase the risk of aspiration or discomfort. Typically, 100–200 mL is used per instillation.
C. Instill chilled lavage solution into the client's NG tube: Chilled solutions are not recommended as they may induce hypothermia and have not been shown to effectively control bleeding. Room-temperature solution is preferred.
D. Use 0.9% sodium chloride for irrigation of the NG tube: Isotonic saline is the recommended solution for gastric lavage, as it helps prevent electrolyte imbalance and irritation.
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