The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?
Inspect for sacral edema.
Measure urinary output.
Auscultate all lung fields.
Check mental acuity.
Check mental acuity.
The Correct Answer is C
When assessing an older client with left-sided heart failure (HF), the most important intervention for the practical nurse (PN) to implement is to auscultate all lung fields. Left-sided heart failure is characterized by the inability of the left ventricle to effectively pump blood, leading to fluid accumulation in the lungs. Auscultating all lung fields allows the PN to assess for the presence of abnormal lung sounds such as crackles, indicating pulmonary congestion.
In summary, when assessing an older client with left-sided heart failure, the most important intervention for the practical nurse (PN) to implement is to auscultate all lung fields. This allows for the detection of abnormal lung sounds associated with pulmonary congestion, a hallmark sign of left-sided heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
- Minimize the number of refined grains in the diet: Refined grains, such as white bread, white rice, and pasta, have had their bran and germ removed, resulting in a loss of fiber and nutrients. Including more whole grains in the diet, such as whole wheat bread, brown rice, and whole grain pasta, can help maintain stable blood sugar levels and reduce the risk of type 2 diabetes.
- Eliminate sugary beverages and juices from the diet: Sugary beverages, including soda, fruit juices, and sweetened teas, can contribute to weight gain and an increased risk of type 2 diabetes. Encouraging the client to choose water, unsweetened tea, or other sugar-free beverages can help reduce the intake of added sugars.
- Increase the amount of dietary fiber: Fiber-rich foods, such as fruits, vegetables, whole grains, legumes, and nuts, can help regulate blood sugar levels and improve insulin sensitivity. Encouraging the client to include these foods in their diet can be beneficial in reducing the risk of type 2 diabetes.
Incorrect:
D- Double the usual amount of protein in the diet: While protein is an essential nutrient, doubling the usual amount of protein in the diet may not be necessary or appropriate for everyone. It is important to follow individualized dietary recommendations and consult with a healthcare provider or registered dietitian for specific protein needs.
E- Only select food items with no fat: It is not necessary or advisable to eliminate all fat from the diet. Healthy fats, such as those found in avocados, nuts, seeds, and olive oil, are important for overall health. Choosing foods with healthier fats and moderating intake of saturated and trans fats is a more balanced approach to nutrition.
F- Take a cinnamon supplement: While cinnamon has been studied for its potential effects on blood sugar control, it is not a proven or recommended treatment for reducing the risk of type 2 diabetes. It's important to focus on overall dietary patterns and lifestyle factors rather than relying solely on supplements
Correct Answer is B
Explanation
Stomatitis refers to the inflammation of the mouth and oral mucosa, which can cause pain and difficulty swallowing. In the context of a client receiving chemotherapy, stomatitis is a common side effect that can occur due to the effects of chemotherapy on rapidly dividing cells, including those in the oral cavity. When a client develops stomatitis, it is important for the practical nurse (PN) to obtain information about the client's ability to swallow during a focused assessment. This is because stomatitis can significantly impact a client's ability to eat and drink comfortably, which can lead to dehydration and malnutrition. Assessing the client's ability to swallow helps determine the extent of the issue and guides appropriate interventions and support.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today