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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The DASH eating plan does not recommend excluding grains from the daily diet. In fact, whole grains are an important part of the DASH diet.
Choice B reason: Enjoying fat-free yogurt as an occasional snack food aligns with the DASH diet's emphasis on low-fat dairy products. This behaviour indicates adherence to the dietary guidelines for reducing hypertension.
Choice C reason: Using lactose-free dairy products is not specifically related to the DASH diet. It may be relevant for individuals who are lactose intolerant, but it does not indicate adherence to the DASH diet principles.
Choice D reason: Carefully cleaning and peeling fresh fruits and vegetables is a good practice for food safety but does not specifically indicate adherence to the DASH diet. The DASH diet encourages the consumption of fruits and vegetables, but how they are cleaned and prepared is less relevant than the overall dietary choices.
Correct Answer is B
Explanation
Choice A reason: Assessing peripheral pulses is important for understanding the client's overall circulatory status, but it is not the most urgent assessment in this situation. The client's symptoms suggest a possible thyrotoxic crisis, which requires immediate evaluation of critical vital signs.
Choice B reason: Obtaining vital signs is the most important initial assessment. The client's report of anxiety, heart racing, and pounding could indicate a severe exacerbation of hyperthyroidism, potentially leading to a thyrotoxic crisis (thyroid storm). Vital signs will provide essential information on the client's heart rate, blood pressure, temperature, and overall stability, which are crucial for immediate management.
Choice C reason: The presence of a goitre can indicates thyroid gland enlargement, which is relevant for long-term management of hyperthyroidism. However, it does not provide immediate information on the client's current acute condition.
Choice D reason: Assessing emotional status is important for comprehensive care, but it is not the priority in this acute scenario. The client's physiological status needs to be stabilized first, as indicated by their vital signs, before focusing on their emotional state.
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