The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

Keep toenails trimmed short.

Apply heating pad to soothe leg pain.

Enrol in a smoking cessation program.

Reduce intake of high saturated fats and salt.

Answer and Explanation

The Correct Answer is C

Choice A reason: Keeping toenails trimmed short is important for foot care, especially in clients with PAD, but it is not the highest priority.

Choice B reason: Applying a heating pad to soothe leg pain can provide temporary relief but does not address the underlying issue of PAD or reduce cardiovascular risk.

Choice C reason: Enrolling in a smoking cessation program is the highest priority. Smoking significantly exacerbates PAD and increases the risk of further cardiovascular events, including heart attacks. Quitting smoking is crucial for improving vascular health and reducing the risk of complications.

Choice D reason: Reducing intake of high saturated fats and salt is important for overall cardiovascular health but is not as immediate or impactful as smoking cessation in reducing the risk of complications from PAD and MI.

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Correct Answer is A

Explanation

Choice A reason: Keeping the client NPO (nothing by mouth) is essential to prevent further irritation of the gastrointestinal tract and to allow the postoperative stricture to heal. When the client is experiencing significant symptoms like nausea and vomiting, keeping them NPO can help manage these symptoms and prevent complications such as aspiration or worsening of the stricture.

Choice B reason: Administering daily vitamin supplements may be necessary for long-term nutritional management, especially after bariatric surgery. However, in the immediate setting of nausea, vomiting, and a postoperative stricture, this is not the priority intervention.

Choice C reason: Providing protein-enriched shakes may be beneficial for maintaining nutrition in the long term, but it is not appropriate when the client is experiencing nausea, vomiting, and anorexia. Oral intake should be limited until the symptoms subside and the stricture is addressed.

Choice D reason: Encouraging small frequent meals may be beneficial for managing long-term nutritional needs after bariatric surgery, but it is not appropriate during an acute episode of nausea, vomiting, and anorexia. The client should be kept NPO to prevent further complications and allow for proper healing.

A. Tachycardia. B. Edem of the ankles. C. Dyspneal. D. Unilateral diminished breath sounds.

Correct Answer is C

Explanation

Choice A reason: Tachycardia, or a rapid heart rate, can be a symptom associated with COPD, especially during exacerbations or due to medication effects. However, it is not the primary symptom used to evaluate the effectiveness of COPD treatment.

Choice B reason: Edem of the ankles can occur in COPD patients due to right-sided heart failure (cur pulmonale) associated with chronic lung disease. While it is an important symptom to monitor, it is not the primary indicator of COPD treatment effectiveness.

Choice C reason: Dyspneal, or difficulty breathing, is the most significant and primary symptom of COPD. The primary goal of COPD treatment is to improve the client's breathing and reduce dyspneal. Assessing the client's level of breathlessness provides direct insight into how well the treatment is managing the condition.

Choice D reason: Unilateral diminished breath sounds can indicate localized issues such as pneumothorax or pleural effusion rather than the overall effectiveness of COPD treatment. Bilateral lung sounds and general respiratory status are more relevant to evaluating COPD management.

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The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

During a home visit, the nurse should evaluate the effectiveness of a client's treatment for chronic obstructive pulmonary disease (COPD) by assessing for which primary symptom?

Correct Answer is C

Explanation

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