An older client with peripheral vascular disease (PVD) is explaining the daily foot care regimen to the family practice clinic nurse.
What statement by the client may indicate a barrier to proper foot care?
"I nearly always wear comfy sweatpants and house shoes.”.
"I'm glad I get energy assistance so my house isn't so cold.”.
"My daughter makes sure I have plenty of lotion for my feet.”.
"My hands shake when I try to do things requiring coordination.”.
The Correct Answer is D
Choice A rationale
Wearing comfy sweatpants and house shoes is generally not a barrier to proper foot care. In fact, wearing loose-fitting, comfortable clothing and footwear that does not restrict circulation is beneficial for clients with peripheral vascular disease (PVD). Tight clothing or shoes can impair blood flow, exacerbating the symptoms of PVD and increasing the risk of skin breakdown and ulceration.
Choice B rationale
Receiving energy assistance to keep the house warm is a positive factor for a client with PVD. Cold temperatures cause vasoconstriction, which further reduces blood flow to the extremities. Maintaining a warm environment helps promote vasodilation, improving circulation and reducing the risk of pain, tissue damage, and compromised wound healing.
Choice C rationale
Having plenty of lotion available is a supportive factor for proper foot care. Clients with PVD often have dry, cracked skin due to poor circulation. Using non-alcohol-based lotions can help maintain skin integrity, prevent fissures, and reduce the risk of infection. The daughter’s support facilitates adherence to this aspect of the foot care regimen.
Choice D rationale
Tremors or shaking hands, which indicate a lack of fine motor coordination, pose a significant barrier to proper foot care. This deficit makes it difficult to perform essential tasks such as meticulously inspecting the feet for cuts, blisters, or other injuries, clipping toenails correctly, and applying lotion without causing skin damage. This can lead to missed injuries and delayed treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Assessing the client's specific fears about warfarin is the best action. The client's refusal stems from their perception of the drug's danger. By understanding the underlying fear, the nurse can provide targeted, accurate education about the drug's mechanism, safety protocols, and the benefits of anticoagulation, empowering the client to make an informed decision.
Choice B rationale
While laboratory monitoring (e.g., INR) is a critical component of warfarin therapy, simply reminding the client about it does not address the underlying emotional and psychological barriers to compliance. The client must first accept the drug and its importance before they can be educated on the practical aspects of its management.
Choice C rationale
Vague assurances about drug safety are unhelpful and can erode client trust. The client's concern is specific and real to them. The nurse must provide a scientific explanation of how warfarin works, its therapeutic benefits in preventing clot propagation, and how modern monitoring has made it safer, directly addressing their fears.
Choice D rationale
Warning the client about consequences can be perceived as an intimidating or judgmental approach, which can create a negative therapeutic relationship and increase resistance. A better strategy is to use a collaborative, non-coercive approach that focuses on client education and informed consent rather than using fear as a motivator. .
Correct Answer is ["31.25"]
Explanation
Step 1 is 500 mg ÷ 1000 mg/g = 0.5 g.
Step 2 is 0.5 g ÷ (4 g/250 mL) = 31.25 mL. The final answer is 31.25 mL/hr.
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