The nurse is caring for a client with peripheral arterial disease. Which statement, by the client, indicates that they need additional teaching?

"I should not exercise if I develop a leg ulcer."

"I should buy my shoes in the afternoon."

"I should dangle my legs when sitting."

"I must wear compression stockings at all times."

Answer and Explanation

The Correct Answer is D

A.   While it's true that ulcers can be a serious complication of PAD and require careful management, exercise is generally encouraged in patients with PAD as long as it is safe and supervised. Patients should consult their healthcare provider about appropriate exercise, but not exercising altogether can worsen their condition.
B.   Buying shoes in the afternoon is advisable because feet can swell throughout the day. It helps ensure a better fit and reduces the risk of blisters or skin breakdown, which is particularly important for clients with PAD.
C.   This statement is generally correct, as dangling the legs can help improve circulation in some cases. Clients with PAD often experience relief when their legs are in a dependent position, as it may help increase blood flow to the extremities. However, they should also be encouraged to avoid prolonged periods of sitting.
D.   This statement may indicate a misunderstanding. Compression stockings are typically used for venous issues rather than arterial diseases like PAD. In patients with PAD, wearing compression stockings may not be appropriate and could potentially compromise arterial blood flow.

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Correct Answer is A

Explanation

A. This is a significant finding that warrants immediate notification. Changes in mental status in elderly patients can indicate a variety of issues, including infection (such as a urinary tract infection), dehydration, or other acute illnesses. Given that elderly patients are at higher risk for delirium and other cognitive changes, this finding should be taken seriously.
B. These vital signs are largely within normal limits for an elderly patient. While the blood pressure is on the higher side, the heart rate and respiratory rate are within acceptable ranges. Therefore, this does not warrant immediate notification unless other symptoms are present.
C. This statement is reassuring and suggests that the client is not experiencing complications related to the indwelling catheter, such as infection or obstruction. It does not indicate any need for immediate notification of the provider.
D. Cloudy urine with sediment can be indicative of a urinary tract infection (UTI) or other complications related to the indwelling catheter. While this finding is concerning and may require further evaluation, it is not as urgent as a change in mental status. It should still be reported to the healthcare provider but may not necessitate immediate action.

A. Obtain a prescription for stool occult blood testing B. Encourage intake of oral fluids to 3000 mL/day C. Assess the temperature every four hours D. Provide oral hygiene every two hours

Correct Answer is C

Explanation

A. This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B. While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C. Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D. While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

The nurse is caring for a client with peripheral arterial disease. Which statement, by the client, indicates that they need additional teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an elderly female client who has an indwelling catheter. Which data in the assessment warrants notification of the health care provider?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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