A nurse is assessing a client with peripheral artery disease (PAD). The client states that walking five blocks is possible without pain.
What query asked next by the nurse will give the best information?
"Could you walk further than that a few months ago?".
"Do you walk mostly uphill, downhill, or on flat surfaces?".
"Have you ever considered swimming instead of walking?".
"How much pain medication do you take each day?"
The Correct Answer is A
Choice A rationale
This question directly assesses for intermittent claudication, a hallmark symptom of peripheral artery disease (PAD). A decrease in walking distance before the onset of pain (claudication) over time indicates a progressive worsening of the arterial stenosis. This is a critical piece of information for staging the disease and evaluating the effectiveness of treatment.
Choice B rationale
The type of terrain (uphill, downhill, flat) can influence the workload on the leg muscles and therefore affect the onset of pain. However, this is a secondary factor. The most important clinical indicator for the progression of PAD is a change in the pain-free walking distance over time, regardless of the terrain.
Choice C rationale
Suggesting swimming instead of walking is a recommendation for a different exercise modality, but it does not provide diagnostic information about the client's current condition. The purpose of the initial assessment is to gather objective data on the progression of the disease, not to provide alternative lifestyle recommendations at this stage.
Choice D rationale
Asking about pain medication usage is important for pain management, but it does not provide specific information about the severity or progression of the peripheral artery disease itself. The primary symptom of PAD is pain upon exertion, and the key assessment is to determine the distance a person can walk before experiencing this pain, as well as if that distance is changing. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Tazarotene, a retinoid, increases photosensitivity by thinning the stratum corneum, the skin's outermost layer. This reduces the protective barrier against ultraviolet (UV) radiation, making the skin more susceptible to sunburn and UV-induced DNA damage. Patients must be educated to use sun protection, but it is not the most critical question.
Choice B rationale
While a history of skin cancer can influence dermatological treatment plans, it is not the primary contraindication for tazarotene. Tazarotene is an analog of vitamin A, and its mechanism involves regulating cell proliferation and differentiation, which is not directly related to a personal or family history of skin cancer.
Choice C rationale
Tazarotene is a potent teratogen, meaning it can cause severe congenital malformations if taken during pregnancy. This teratogenic risk necessitates that all female patients of child-bearing potential use reliable contraception to prevent pregnancy. A pregnancy test is also required before initiation of therapy.
Choice D rationale
While some medications interact with alcohol, tazarotene is a topical retinoid primarily metabolized in the liver to its active form, tazarotenic acid. There is no significant systemic absorption or direct interaction with alcohol consumption that would cause a major adverse effect, making it a less critical question than contraception.
Correct Answer is A
Explanation
Choice A rationale
African Americans have a disproportionately high prevalence and severity of hypertension compared to other racial groups. This is due to a complex interplay of genetic predispositions, socioeconomic factors, and systemic health disparities. Targeting this community through culturally competent outreach at churches is highly effective.
Choice B rationale
While some Asian populations have a genetic predisposition to certain health conditions, hypertension prevalence is not as markedly high in this group as in African Americans. Community outreach for hypertension screening should focus on populations with the highest risk to maximize public health impact.
Choice C rationale
High school sports camps primarily target a young, generally healthy population. While health education is always valuable, the prevalence of hypertension is much lower in this demographic than in older adult populations. Screening resources would be better allocated to older, higher-risk groups.
Choice D rationale
Women's health clinics serve a broad population, but hypertension affects both genders. While important, this venue does not specifically target the population with the highest prevalence and risk, which data indicates are African-American communities, especially older adults.
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