A client with coronary artery disease is hospitalized with unstable angina. To reduce cardiac workload, which intervention should the nurse include in the client's plan of care?

Encourage active range of motion exercises.

Assist with ambulation in the hallway.

Provide a bedside commode for toileting.

Teach to sleep in a side lying position.

Answer and Explanation

The Correct Answer is C

A.   Range of motion exercises are important for overall mobility and prevention of complications from immobility. However, they can increase cardiac workload, especially if performed actively and without supervision.
B.   Ambulation, or walking in the hallway, increases cardiac workload and can exacerbate symptoms in a client with unstable angina. This activity should be minimized or restricted until the client's condition stabilizes. The focus should be on reducing activities that put additional stress on the heart.

C.   Using a bedside commode helps reduce the need for the client to walk to the bathroom, which can be physically demanding and increase cardiac workload. By minimizing the effort required for toileting, the client can avoid unnecessary physical strain.
D.   Sleeping in a side-lying position is not directly related to reducing cardiac workload. The client's position during sleep generally does not have as significant an impact on cardiac workload as other interventions.

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Correct Answer is C

Explanation

A. While excessive consumption of certain beverages can potentially affect urinary health, diet drinks are generally not a primary risk factor for UTIs. The key risk factors for UTIs typically involve issues related to urinary retention, hygiene, and anatomical predispositions rather than beverage consumption alone.
B. Not voiding when the urge occurs, also known as urinary retention, can increase the risk of UTIs. When urine is retained in the bladder for extended periods, it can provide an environment where bacteria can proliferate, leading to infections. This behavior is a significant risk factor for developing UTIs, as it contributes to urinary stasis.
C. A multipara with a history of pyelonephritis is at increased risk for future UTIs. A history of pyelonephritis indicates that the client has experienced a serious urinary infection in the past, which could make her more susceptible to recurrent infections. This is a significant risk factor for developing UTIs again.
D. Urinary incontinence, especially in older adults, can be associated with increased risk for UTIs due to factors like poor hygiene, the presence of residual urine, and possible skin breakdown. While incontinence is a risk factor, it is often considered less directly related to recurrent UTIs compared to issues like urinary retention or a history of severe infections.

A. Plan to assess the client's cognition after returning to his room. B. Confirm that this is an effective technique to help with ambulation. C. Reorient the client to his present location and circumstances. D. Assist the client to a carpeted area where he can walk more easily.

Correct Answer is B

Explanation

A. While assessing cognition is important for understanding the client’s overall functioning, the immediate issue of "freezing" during ambulation is more related to motor symptoms rather than cognitive impairment. "Freezing" in Parkinson's disease is a common motor symptom where the client feels as if their feet are glued to the floor.
B. The technique of pretending to step over an imaginary object (like a crack) is known to be a helpful strategy for managing "freezing" in Parkinson's disease. This technique provides a cognitive cue that can help the client initiate movement and overcome the freezing episodes. Confirming that this is an effective technique acknowledges the client's strategy and supports their efforts to improve mobility.

C. Reorienting the client to their location and circumstances can be helpful in situations where confusion or disorientation is an issue. However, in the case of "freezing" during ambulation, this response does not directly address the motor symptoms associated with Parkinson's disease. The problem here is more about movement initiation rather than orientation.
D. Moving to a carpeted area might help with traction and reduce the risk of slipping, but it does not directly address the issue of "freezing" episodes. The freezing phenomenon in Parkinson's disease is related to motor control rather than the type of flooring. While providing a safer walking environment is beneficial, it doesn’t target the underlying motor symptoms as directly as addressing the client’s technique.

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A client with coronary artery disease is hospitalized with unstable angina. To reduce cardiac workload, which intervention should the nurse include in the client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is developing a teaching handout for female clients who return to the clinic for recurring urinary tract infections (UTI). Which client has the greatest risk for developing a UTI?

Correct Answer is C

Explanation

The nurse assists a client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to "freeze" and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?

Correct Answer is B

Explanation

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