A nurse in a community clinic is caring for a female client who is Muslim. Which of the following actions should the nurse take?

Encourage cultural practices to be incorporated into their care.

Incorporate hot and cold practices into the client's care.

Acknowledge that the client may be cared for by a male provider.

Have the client remove any face coverings to obtain their history.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Encourage cultural practices to be incorporated into their care: Respecting and incorporating a Muslim client’s cultural and religious practices promotes culturally competent and patient-centered care. This approach fosters trust, comfort, and cooperation between the client and healthcare team.

B. Incorporate hot and cold practices into the client's care: Hot and cold theory is typically associated with Hispanic, Asian, and Middle Eastern folk medicine traditions, but not all Muslim clients follow this practice. Care should be based on the client’s individual beliefs.

C. Acknowledge that the client may be cared for by a male provider: Many Muslim women prefer to be cared for by female providers due to religious and cultural values of modesty. The nurse should make reasonable efforts to accommodate this preference whenever possible.

D. Have the client remove any face coverings to obtain their history: Muslim women who wear a niqab or hijab may choose to keep their face covered for modesty. The nurse should not insist on removal unless necessary for identification or assessment, and even then, it should be done privately with sensitivity to religious beliefs.

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Correct Answer is []

Explanation

Rationale for Correct Choices

• Heart failure: The client has classic signs of heart failure, including S3 heart sound, bilateral crackles, lower extremity edema, elevated BNP, and cool extremities, indicating fluid overload and decreased cardiac output. Early identification allows timely interventions to prevent decompensation.

• Obtain a prescription for a diuretic: Diuretics reduce fluid retention, alleviate pulmonary congestion, and improve oxygenation. Administering a diuretic helps manage the client’s edema, dyspnea, and fatigue, reducing cardiac workload.

• Educate the client about sodium restriction : Limiting dietary sodium prevents further fluid retention and helps control blood pressure, reducing the risk of exacerbating heart failure symptoms and hospital readmission.

• Blood pressure: Monitoring BP is essential in heart failure to detect hypotension from decreased cardiac output or over-diuresis. Maintaining safe BP ensures adequate perfusion and guides treatment adjustments.

• Daily weight: Daily weights are a sensitive measure of fluid status. Rapid increases indicate fluid accumulation, allowing early interventions with diuretics or fluid management to prevent worsening heart failure.

Rationale for Incorrect Choices

• Aortic stenosis: Aortic stenosis primarily causes systolic murmur, angina, syncope, and sometimes heart failure over time. This client’s presentation is dominated by fluid overload and elevated BNP, with no auscultatory evidence of stenotic valve disease.

• Endocarditis : Endocarditis is associated with fever, positive blood cultures, heart murmurs, and skin lesions like Janeway lesions or Osler nodes. This client has no signs of infection, making endocarditis unlikely.

• Mitral stenosis : Mitral stenosis produces a diastolic murmur, pulmonary congestion, and sometimes atrial fibrillation. While some pulmonary signs may overlap with heart failure, this client lacks the characteristic murmur and risk factors for mitral stenosis.

• Prepare the client for cardioversion : Cardioversion is indicated for arrhythmias such as atrial fibrillation with rapid ventricular response. The client’s heart rhythm is regular, making this action unnecessary.

• Administer antibiotics as prescribed : Antibiotics are used for infections such as endocarditis or sepsis. This client has no fever, abnormal labs, or signs of systemic infection, so antibiotics are not indicated.

• Educate the client about valve replacement : Valve replacement education is relevant only if the client has significant valvular disease. This client’s data show no evidence of aortic or mitral valve pathology, so this action is not needed.

• Fever : Monitoring for fever is critical in infection or sepsis. Since the client’s temperature is normal, this is not an immediate concern.

• Blood cultures : Blood cultures identify bacteremia or endocarditis. The client has no infection indicators; therefore, this parameter is unnecessary.

• Skin lesions : Skin lesions such as Osler nodes or Janeway lesions indicate infective endocarditis. The client shows no such lesions, making monitoring irrelevant in this scenario.

A. "Supplement breastfeedings with water every 12 hours." B. "Limit the time your infant feeds to 10 minutes on each breast." C. "Begin each feeding using the same breast." D. "Offer your infant the breast when he shows signs of hunger."

Correct Answer is D

Explanation

Rationale:
A. "Supplement breastfeedings with water every 12 hours.": Breastfed infants do not require water supplementation because breast milk provides adequate hydration. Giving water can reduce milk intake, interfere with nutrition, and increase the risk of electrolyte imbalance.

B. "Limit the time your infant feeds to 10 minutes on each breast.": Feeding duration should be guided by the infant’s cues rather than a strict time limit. Limiting feeds can prevent the infant from receiving the hindmilk, which is richer in fat and essential for growth.

C. "Begin each feeding using the same breast.": Alternating the starting breast for each feeding helps ensure equal stimulation and milk production in both breasts. Starting with the same breast consistently may lead to uneven milk supply.

D. "Offer your infant the breast when he shows signs of hunger.": Responsive, cue-based feeding supports adequate nutrition, growth, and bonding. Feeding on demand—such as rooting, sucking on hands, or fussiness—helps establish and maintain milk supply and meets the infant’s needs effectively.

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A nurse in a community clinic is caring for a female client who is Muslim. Which of the following actions should the nurse take?

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