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 B

Explanation

Choice A reason: While it is important for the client to accept their new health status, this outcome is subjective and difficult to measure. The focus should be on specific, measurable outcomes related to diabetes management.

Choice B reason: A haemoglobin A1C level of less than 7.0% in 3 months is a specific, measurable outcome that indicates good control of blood glucose levels. It reflects adherence to the prescribed diabetic regimen and effective management of the condition.

Choice C reason: Educating the client's family about the signs and symptoms of diabetes is important, but it is more of a teaching objective rather than a measurable outcome for the client's plan of care.

Choice D reason: Monitoring the client's skin condition for colour changes is part of routine care but does not directly address the management of diabetes or measure the effectiveness of the treatment plan.

A. Serum potassium 5.0 me/L (5.0 mmol/L), serum sodium 138 me/L (138 mmol/L). B. Serum potassium 4.5 me/L (4.5 mmol/L), serum sodium 140 me/L (140 mmol/L). C. Serum potassium 3.5 me/L (3.5 mmol/L), serum sodium 142 me/L (142 mmol/L). D. Serum potassium 3.0 me/L (3.0 mmol/L), serum sodium 149 me/L (149 mmol/L).

Correct Answer is D

Explanation

Choice A reason: Serum potassium of 5.0 me/L and serum sodium of 138 me/L are within normal ranges and do not reflect the expected electrolyte imbalances due to dehydration from vomiting and diarrhea.

Choice B reason: Serum potassium of 4.5 me/L and serum sodium of 140 me/L are also within normal ranges. This does not reflect the typical imbalance caused by dehydration.

Choice C reason: Serum potassium of 3.5 me/L and serum sodium of 142 me/L are normal values. They do not indicate the electrolyte disturbances expected with dehydration from vomiting and diarrhea.

Choice D reason: Serum potassium of 3.0 me/L indicates hypokalaemia (low potassium), and serum sodium of 149 me/L indicates hypernatremia (high sodium). These imbalances are expected in a client with a history of fever, vomiting, and diarrhea, as these conditions can lead to loss of potassium and concentration of sodium due to dehydration.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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