A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

"I will wear gloves when removing food from the freezer"

"I will take my medications at the first sign of an attack"

"I will try to anticipate and avoid stressful situations when possible"

"I will complete the smoking cessation program I started"

Answer and Explanation

The Correct Answer is B

A. "I will wear gloves when removing food from the freezer": This statement demonstrates understanding of the need to protect the hands from cold exposure, which can trigger Raynaud's disease symptoms. Wearing gloves when handling cold objects, such as food from the freezer, helps minimize the risk of a vasospastic episode.
B. "I will take my medications at the first sign of an attack": This statement indicates a misunderstanding of the appropriate use of medications for Raynaud's disease. While medications such as calcium channel blockers may be prescribed to prevent or reduce the frequency and severity of attacks, they are typically taken regularly as part of ongoing management rather than at the first sign of symptoms. This client may need additional education on the proper use of medications for Raynaud's disease.
C. "I will try to anticipate and avoid stressful situations when possible": Stress can exacerbate symptoms of Raynaud's disease by triggering vasospasm, so anticipating and avoiding stressful situations is a proactive strategy to help prevent attacks. This statement reflects an understanding of the importance of stress management in managing the condition.
D. "I will complete the smoking cessation program I started": Smoking is a significant risk factor for Raynaud's disease and can worsen symptoms by constricting blood vessels. Committing to a smoking cessation program demonstrates the client's recognition of the importance of lifestyle modifications in managing the condition.

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Correct Answer is C

Explanation

A. Secure the restraints to the lowest bar of the side rail:
This is incorrect. Restraints should not be secured to the side rails of the bed because the client may injure themselves by attempting to climb over the side rail or if the bed adjusts, it can cause excessive pressure on the restrained limb.
B. Ensure four fingers under the restraints to prevent constriction:
This is incorrect. The nurse should be able to slide two fingers under the restraint to ensure it is not too tight, rather than four fingers. Restraining too loosely may allow the client to slip out, while restraining too tightly can cause tissue damage or compromise circulation.
C. Secure the restraints using a quick-release tie:
This is the correct action. Restraints should always have quick-release ties to allow for quick removal in case of an emergency or if the client needs to be repositioned or assisted. Velcro or buckle restraints with quick-release mechanisms are commonly used to ensure easy removal.
D. Anticipate removing the restraints every 4 hr:
While it's essential to regularly assess the need for continued restraint use and ensure restraints are not overly restrictive, there's no set time interval for removing restraints. Restraints should be removed as soon as they are no longer necessary to ensure the client's safety and comfort.

A. pH 7.55, HCO 30 mEq/L. PaCO2 31 mm Hg B. pH 7.30, HCO 26 mEq/L. PaCO, 50 mm Hg C. pH 7.50, HCD, 20 mEq/L PaCO 32 mm Hg D. pH 7.25 HCO, 19 mEq, PaCO, 30 mm Hg

Correct Answer is D

Explanation

A. pH 7.55, HCO3 30 mEq/L, PaCO2 31 mm Hg: These values indicate respiratory alkalosis with metabolic alkalosis. The pH is elevated, indicating alkalosis. The HCO3 level is elevated, indicating metabolic alkalosis, while the PaCO2 is low, indicating respiratory alkalosis. This pattern is not typically seen in chronic kidney disease.
B. pH 7.30, HCO3 26 mEq/L, PaCO2 50 mm Hg: These values indicate metabolic acidosis with respiratory acidosis. The pH is low, indicating acidosis. The HCO3 level is slightly low, indicating metabolic acidosis, while the PaCO2 is elevated, indicating respiratory acidosis. This pattern is not typically seen in chronic kidney disease.
C. pH 7.50, HCO3 20 mEq/L, PaCO2 32 mm Hg: These values indicate metabolic alkalosis with respiratory alkalosis. The pH is elevated, indicating alkalosis. The HCO3 level is elevated, indicating metabolic alkalosis, while the PaCO2 is slightly low, indicating respiratory alkalosis. This pattern is not typically seen in chronic kidney disease.
D. pH 7.25, HCO3 19 mEq/L, PaCO2 30 mm Hg: These values indicate metabolic acidosis. The pH is low, indicating acidosis. The HCO3 level is decreased, indicating metabolic acidosis, while the PaCO2 is within the normal range. In chronic kidney disease, impaired kidney function leads to the retention of metabolic acids, resulting in metabolic acidosis. This pattern is consistent with chronic kidney disease.

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A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

Nursing Test Bank

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