Which action by the patient with newly diagnosed Raynaud's phenomenon best demonstrates that the nurse's teaching about managing the condition has been effective?
The patient takes pseudoephedrine (Sudafed) for cold symptoms.
The patient exercises indoors during the winter months.
The patient immerses hands in hot water when they turn pale.
The patient avoids taking nonsteroidal antiinflammatory drugs (NSAID)
The Correct Answer is B
Rationale:
A. The patient takes pseudoephedrine (Sudafed) for cold symptoms: Pseudoephedrine is a vasoconstrictor and can worsen vasospasms in clients with Raynaud’s phenomenon. Its use increases the risk of triggering attacks and should be avoided in this condition.
B. The patient exercises indoors during the winter months: Exercising indoors during cold weather helps minimize exposure to low temperatures, which are a common trigger for vasospastic episodes. This action shows that the patient understands how to reduce environmental risk factors that exacerbate Raynaud’s phenomenon.
C. The patient immerses hands in hot water when they turn pale: Immersing hands in very hot water may cause burns or skin damage due to impaired circulation and altered sensation. Warming hands gradually with warm (not hot) water or using gloves is the safer approach.
D. The patient avoids taking nonsteroidal antiinflammatory drugs (NSAID): NSAIDs are not contraindicated in Raynaud’s phenomenon and are sometimes used to manage associated pain or inflammation. Avoiding them does not demonstrate effective disease management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Check your urine for ketones when blood glucose levels are greater than 240 mg/dL: Monitoring for ketones when hyperglycemia occurs helps detect early diabetic ketoacidosis. Identifying ketones allows for timely medical intervention and prevents worsening acidosis and dehydration.
B. Withhold your usual daily dose of insulin: Insulin should never be withheld during illness because the body typically needs more insulin to counteract stress hormones. Stopping insulin increases the risk of severe hyperglycemia and development of DKA.
C. Test your blood glucose level every 8 hours: During illness, blood glucose levels can fluctuate rapidly, requiring monitoring every 2–4 hours. Testing only every 8 hours would delay recognition and treatment of dangerously high glucose levels.
D. Drink 240 to 360 milliliters of calorie-free liquids every 8 hours: Fluid intake is important to prevent dehydration, but the recommended frequency is every hour rather than every 8 hours. Frequent fluids help maintain hydration and reduce ketone concentration in the urine.
Correct Answer is B
Explanation
Rationale:
A. Increased serum bicarbonate level: In diabetic ketoacidosis, bicarbonate levels are decreased because bicarbonate is consumed as it buffers the excess ketone acids. An increased bicarbonate level would not be consistent with DKA.
B. Decreased blood pH: The accumulation of ketone bodies in DKA leads to metabolic acidosis. A decreased blood pH, typically below 7.35, is one of the most definitive laboratory findings indicating diabetic ketoacidosis.
C. Elevated blood glucose level: Hyperglycemia is present in DKA, often exceeding 250 mg/dL. However, elevated glucose alone is not specific to DKA since it also occurs in hyperosmolar hyperglycemic state (HHS). The distinguishing factor in DKA is acidosis.
D. Elevated blood urea nitrogen (BUN) level: Increased BUN may occur in DKA due to dehydration and reduced renal perfusion. While it supports the diagnosis, it is not the most specific indicator of DKA compared with blood pH changes.
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