A nurse is reviewing discharge instructions with a client who has Raynaud's disease. Which of the following client statements indicates an understanding of the teaching?
"I should not drive in the winter months."
"I am going to take a stress management class."
"I plan to use nicotine gum to help me quit smoking."
"I will limit myself to only two cups of coffee in the morning."
The Correct Answer is B
Choice A reason: Avoiding driving in winter is not necessary unless it is a personal trigger for Raynaud's attacks. It's more important to keep warm and manage stress.
Choice B reason: Stress management classes can teach techniques to control stress, which is beneficial for clients with Raynaud's disease as stress can trigger episodes.
Choice C reason: Using nicotine gum to quit smoking is a positive step for overall health, but it is not directly related to the management of Raynaud's disease.
Choice D reason: Limiting coffee intake may help some individuals with Raynaud's disease, as caffeine can constrict blood vessels, but it is not a universal recommendation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Decreased blood pressure can be a sign of many conditions, including gastrointestinal perforation, but it is not specific and can occur in various other medical situations.
Choice B reason: Hyperactive bowel sounds are generally not associated with gastrointestinal perforation. They can occur in conditions like gastroenteritis or early bowel obstruction.
Choice C reason: Sudden abdominal pain, especially in the upper abdomen, can be a sign of gastrointestinal perforation. This pain is often severe and can be accompanied by signs of peritonitis.
Choice D reason: Tachycardia, or rapid heart rate, may occur as a compensatory mechanism in response to internal bleeding or infection, which can be secondary to gastrointestinal perforation.
Correct Answer is A
Explanation
Choice A reason: Right lower quadrant.
McBurney's point is located in the right lower quadrant of the abdomen, which is one-third of the distance from the anterior superior iliac spine to the umbilicus. This is the area where tenderness is most likely to be maximal in cases of acute appendicitis.
Choice B reason: Left lower quadrant
The left lower quadrant is not typically associated with appendicitis pain, as the appendix is located in the right lower quadrant of the abdomen.
Choice C reason: Right upper quadrant
The right upper quadrant is generally associated with other conditions such as gallbladder issues, not appendicitis.
Choice D reason: The left upper quadrant
The left upper quadrant is also not associated with appendicitis pain, as it is on the opposite side of the typical location of the appendix.
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