Which statement, made by the client with coronary artery disease, alerts the nurse that the client may be experiencing difficulty adapting to the illness?
"I feel a little anxious when I get chest discomfort."
"I know that I should carry my medication with me in case I develop chest pain."
"My wife and I will learn to cook using the 'good' cooking oils."
"I usually wait about two hours after I feel chest discomfort to seek medical attention."
The Correct Answer is D
Choice A reason: This is not an alarming statement. Feeling a little anxious when experiencing chest discomfort is a normal and understandable reaction. Chest discomfort can be a sign of angina, which is a condition where the heart muscle does not get enough oxygen due to reduced blood flow. Angina can cause pain, pressure, or tightness in the chest, and can be triggered by physical or emotional stress. The client should try to relax and take their medication as prescribed to relieve the discomfort.
Choice B reason: This is not an alarming statement. Knowing that they should carry their medication with them in case they develop chest pain is a sign of good self-care and awareness. The client should have a quick-relief medication, such as nitroglycerin, that can dilate the coronary arteries and improve the blood flow to the heart. The client should take the medication as soon as they feel chest pain and follow the instructions on how to use it.
Choice C reason: This is not an alarming statement. Learning to cook using the "good" cooking oils is a sign of positive lifestyle change and adaptation. The client should avoid or limit the intake of saturated and trans fats, which can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should use unsaturated fats, such as olive oil, canola oil, or sunflower oil, which can lower the LDL cholesterol and increase the high-density lipoprotein (HDL) cholesterol. HDL cholesterol is also known as the "good" cholesterol because it can remove the excess cholesterol from the arteries and transport it to the liver.
Choice D reason: This is the alarming statement. Waiting about two hours after feeling chest discomfort to seek medical attention is a sign of denial and delay. Chest discomfort can be a symptom of a heart attack, which is a life-threatening emergency where the blood flow to the heart is blocked and the heart muscle begins to die. The client should seek immediate medical attention if they experience chest pain that lasts more than a few minutes, or if it is accompanied by other signs, such as shortness of breath, nausea, sweating, or arm or jaw pain. The sooner the client receives treatment, the better the chance of survival and recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Decreased hair is most likely a hereditary condition and nail changes are related to fungus is not the statement that describes the cause of this finding. This statement is not based on evidence and does not explain the relationship between peripheral vascular disease and the observed changes in the legs and feet.
Choice B reason: A blood clot may be forming and the client needs immediate intervention is not the statement that describes the cause of this finding. This statement is an alarmist and inaccurate interpretation of the finding. A blood clot would cause more acute and severe symptoms, such as pain, swelling, redness, and warmth in the affected area.
Choice C reason: Decreased oxygen to the tissues causes changes in hair growth and nail texture is the statement that describes the cause of this finding. This statement is based on the pathophysiology of peripheral vascular disease, which is a chronic condition that reduces the blood flow to the extremities due to atherosclerosis or inflammation of the blood vessels. The reduced blood flow leads to tissue ischemia and necrosis, which can manifest as hair loss, thickening and yellowing of the nails, skin ulcers, and gangrene.
Choice D reason: Depending on the client's age, the findings may be normal is not the statement that describes the cause of this finding. This statement is a vague and dismissive response that does not address the underlying problem of peripheral vascular disease. The findings are not normal for any age group and require further assessment and intervention.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer. Stool for occult blood is a diagnostic test that detects the presence of hidden blood in the feces. This can indicate bleeding in the gastrointestinal tract, which is the most common cause of chronic iron deficiency anemia. Iron deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells.
Choice B reason: Vitamin B12 level is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Vitamin B12 level is a blood test that measures the amount of vitamin B12 in the body. Vitamin B12 is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause pernicious anemia, a type of megaloblastic anemia where the red blood cells are large and immature.
Choice C reason: Schilling's test is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Schilling's test is a urine test that evaluates the absorption of vitamin B12 in the body. It involves giving the client an oral dose of radioactive vitamin B12 and an intramuscular injection of non-radioactive vitamin B12. The urine is then collected and measured for the amount of radioactive vitamin B12. Schilling's test can help diagnose pernicious anemia and other causes of vitamin B12 malabsorption.
Choice D reason: Bone marrow aspiration study is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Bone marrow aspiration study is a procedure that involves taking a sample of bone marrow from the hip or sternum and examining it under a microscope. Bone marrow is the soft tissue inside the bones that produces blood cells. Bone marrow aspiration study can help diagnose various blood disorders, such as leukemia, lymphoma, and aplastic anemia.
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