A home health nurse teaches a client who has been discharged after an ischemic stroke about lifestyle modifications to prevent future strokes.
Which statement by the client indicates that further education is needed?
I plan to start a daily exercise routine, as advised by my doctor.
I will stop smoking, as it increases my risk of stroke.
I will reduce my intake of high-fat foods and increase my intake of fruits and vegetables.
I can continue to take over-the-counter aspirin if I have joint pain.
The Correct Answer is D
Post stroke education focuses on secondary prevention through risk factor modification. Applying knowledge of pharmacology and lifestyle changes is necessary to ensure the patient understands how to manage hypertension, smoking cessation, and safe medication use to avoid recurrence.
Choice A rationale
Daily exercise is a recommended lifestyle modification that helps manage weight and lower blood pressure. It improves cardiovascular health and reduces the risk of recurrent ischemic events by enhancing vascular tone and reducing systemic inflammation.
Choice B rationale
Smoking cessation is critical because nicotine causes vasoconstriction and accelerates atherosclerosis. Stopping tobacco use significantly lowers the risk of thrombus formation and further ischemic damage to the cerebral vasculature in post stroke patients.
Choice C rationale
Reducing high fat intake and increasing fruits and vegetables helps manage cholesterol levels. Lowering low density lipoprotein levels prevents the progression of carotid artery plaque, which is a major contributor to the occurrence of ischemic strokes.
Choice D rationale
While aspirin is often prescribed for its antiplatelet properties, clients should not self medicate with over the counter versions without clinical supervision. Aspirin increases bleeding risks, and its use must be coordinated with other prescribed anticoagulants..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Assessing electrolyte imbalances in pancreatitis requires understanding how calcium sequestration affects cardiac conduction. Knowledge of cardiac electrophysiology is applied to identify how low serum calcium, typically below 8.5 mg/dL, alters the duration of ventricular depolarization and repolarization.
Choice A rationale
Peaked T-waves are classically associated with hyperkalemia, not hypocalcemia. Hyperkalemia involves potassium levels > 5.0 mEq/L. This ECG change reflects rapid repolarization and is not an anticipated finding for a client experiencing a deficit in calcium.
Choice B rationale
A shortened QT interval is a characteristic finding in hypercalcemia, where serum calcium levels exceed 10.5 mg/dL. Excess calcium accelerates the plateau phase of the action potential, leading to faster ventricular repolarization and a shortened interval.
Choice C rationale
A widened QRS complex is usually seen in hyperkalemia or bundle branch blocks. While severe electrolyte shifts can affect the QRS, it is not the primary or most common ECG manifestation of isolated low calcium.
Choice D rationale
Hypocalcemia slows the entry of calcium into cardiac cells during the plateau phase. This delay lengthens the ST segment and the QT interval. A prolonged QT interval increases the risk for lethal ventricular arrhythmias like Torsades.
Correct Answer is A
Explanation
This scenario requires the application of electrocardiography interpretation skills to identify specific cardiac arrhythmias based on rhythm regularity, presence of P waves, and heart rate. Recognizing atrial fibrillation is essential for determining appropriate anticoagulation and rate control interventions for telemetry clients.
Choice A rationale
Atrial fibrillation is characterized by an irregularly irregular rhythm and a lack of discernible P waves. The rapid, disorganized electrical activity in the atria leads to ineffective pumping and increased risk for thromboembolic events or symptomatic palpitations.
Choice B rationale
Sinus tachycardia follows a regular rhythm with identifiable P waves preceding every QRS complex. The rate is typically between 101 and 150 beats per minute. This does not match the irregularly irregular rhythm or absent P waves described.
Choice C rationale
First degree heart block involves a delayed conduction through the atrioventricular node, resulting in a prolonged PR interval greater than 0.20 seconds. However, the rhythm remains regular with a 1 to 1 ratio of P waves to QRS.
Choice D rationale
Ventricular tachycardia presents as three or more consecutive premature ventricular contractions with a rate usually exceeding 100 per minute. It shows wide, bizarre QRS complexes and is typically a regular rhythm, which is inconsistent with this client strip.
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