A nurse is reinforcing discharge teaching with a client who has heart failure. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Alternate activity and rest.

Reduce sodium intake to 2 g per day.

Consume a low-fiber diet.

Gradually increase activity each day.

Eat small, frequent meals each day.

Answer and Explanation

Correct Answer : A,B,D,E

A. Alternate activity and rest. Clients with heart failure should balance activity and rest to prevent overexertion and minimize cardiac workload. Frequent rest periods help conserve energy and reduce symptoms such as dyspnea and fatigue.
B. Reduce sodium intake to 2 g per day. Limiting sodium intake helps prevent fluid retention and reduces the risk of worsening heart failure. Excess sodium contributes to increased blood volume and exacerbates symptoms such as edema and shortness of breath.
C. Consume a low-fiber diet. A low-fiber diet is not necessary for heart failure management. Adequate fiber intake is beneficial for preventing constipation, which can increase strain during bowel movements and lead to hemodynamic stress. A high-fiber diet is generally encouraged.
D. Gradually increase activity each day. Clients should slowly increase their activity level based on tolerance to improve cardiovascular function. Overexertion should be avoided, but regular, controlled exercise helps maintain mobility and enhance overall heart health.
E. Eat small, frequent meals each day. Eating smaller meals reduces gastric distension and minimizes pressure on the diaphragm, which can help alleviate shortness of breath. Large meals can increase metabolic demands and contribute to discomfort in clients with heart failure.

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Correct Answer is C

Explanation

A. "Occasional small clots in the urine." Small clots in the urine can be expected in the first 24 to 48 hours following a vaginal hysterectomy due to minor bleeding from surgical manipulation. However, large or persistent clots should be reported as they may indicate active bleeding.
B. "Frequent urge to urinate." A frequent urge to urinate is common after surgery due to bladder irritation, inflammation, or the effects of anesthesia. However, if accompanied by pain, burning, or difficulty urinating, it could indicate a urinary tract infection or urinary retention requiring further evaluation.
C. "Dark red urine." Dark red urine suggests active bleeding, which is not an expected postoperative finding and requires immediate evaluation. This may indicate excessive surgical site bleeding or trauma to the urinary tract, necessitating prompt intervention by the provider.
D. "Urine output of 300 mL over 8 hr." While this is lower than the expected urine output (at least 30 mL/hr or 240 mL in 8 hours), it is not critically low. The nurse should encourage fluid intake and monitor for signs of dehydration or urinary retention before escalating the concern to the provider.

A. Administer oxygen at 10 L/min via non-rebreather face mask as needed. B. Position the client in lateral side-lying position. C. Administer magnesium sulfate IV. D. Encourage the client to void every 2 hr. E. Administer prophylactic IV antibiotic. F. Evaluate the client for uterine tachysystole.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

Anticipated:

Administer oxygen at 10 L/min via non-rebreather face mask as needed: The client has late decelerations, indicating possible fetal hypoxia. Providing supplemental oxygen can enhance placental oxygenation and improve fetal status.
Position the client in lateral side-lying position: This position improves uteroplacental perfusion by relieving compression of the inferior vena cava, which can help resolve late decelerations and improve fetal oxygenation.
Encourage the client to void every 2 hr: A full bladder can impede fetal descent and contribute to labor discomfort. Regular voiding helps prevent bladder distention and promotes labor progress.
Administer prophylactic IV antibiotic: The client is positive for Group B streptococcus (GBS), which necessitates prophylactic antibiotic administration during labor to reduce the risk of neonatal infection.
Evaluate the client for uterine tachysystole: The client's contractions have increased in frequency and intensity. Assessing for excessive uterine activity is critical to prevent fetal distress and complications such as uterine rupture.

Contraindicated:

Administer magnesium sulfate IV: Magnesium sulfate is used for seizure prophylaxis in preeclampsia or for tocolysis in preterm labor. The client does not have preeclampsia, and labor is at term, making this intervention unnecessary.

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A nurse is reinforcing discharge teaching with a client who has heart failure. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is 1 day postoperative following a vaginal hysterectomy. Which of the the following findings should the nurse report to the provider?

Correct Answer is C

Explanation

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Explanation

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