When assessing both lower extremities (BLE) of a client who has chronic venous insufficiency, the nurse identifies bilateral stasis dermatitis and an ulcer on the medial surface of the left ankle. To promote effective self-care, which client teaching should the nurse provide?

Apply compression stockings before ambulation.

Soak feet to soften nails before trimming.

Keep legs dependent to promote blood flow.

Medicate inflamed skin areas with an antibiotic ointment.

Answer and Explanation

The Correct Answer is A

Choice A: Applying compression stockings before ambulation is a key aspect of self-care for a client with chronic venous insufficiency. Compression stockings help improve venous return and reduce edema.

Choice B: Soaking feet to soften nails before trimming is not a specific intervention for chronic venous insufficiency and should be done with caution in individuals with open ulcers.

Choice C: Keeping legs dependent to promote blood flow is not advisable in chronic venous insufficiency, as it can worsen venous pooling and edema.

Choice D: Medicating inflamed skin areas with an antibiotic ointment may be part of wound care but does not address the primary intervention of using compression stockings for chronic venous insufficiency.

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Correct Answer is C

Explanation

Choice A: Sitting quietly in her mother's lap may be a sign of shyness or caution in a healthcare setting, but it is not necessarily a typical behavior for a 4-year-old child.

Choice B: Drawing a picture of oneself with facial features is a more advanced skill and may be seen in older preschool-aged children. It is not a typical behavior for a 4- year-old.

Choice C: Talking to an imaginary friend is a normal and developmentally appropriate behavior for a 4-year-old child. Imaginary friends can provide comfort and companionship during times of stress or change.

Choice D: Ignoring other children in the play area may be a sign of shyness or introverted behavior but is not necessarily indicative of normal behavior for a 4-year-old. Social interaction with peers can vary widely among children.

A. Client receiving 30% oxygen via a non-rebreather face mask. B. Client with a nasogastric tube to low, intermittent suction. C. Client experiencing dysphagia who is prescribed a full liquid diet. D. Client who has sensory aphasia and is receiving a clear liquid diet.

Correct Answer is C

Explanation

Choice A: A client receiving 30% oxygen via a non-rebreather face mask may be at risk for oxygen toxicity, but it does not necessarily indicate a higher risk of aspiration.

Choice B: A client with a nasogastric tube to low, intermittent suction may be at risk for aspiration if the tube is not functioning properly, but it does not represent the greatest risk compared to the other options.

Choice C: A client experiencing dysphagia who is prescribed a full liquid diet is at the greatest risk for aspiration. Dysphagia can lead to difficulty swallowing, increasing the risk of food or liquids entering the airway during swallowing.

Choice D: A client who has sensory aphasia and is receiving a clear liquid diet may have difficulty understanding or communicating about their dietary needs, but this does not necessarily indicate a higher risk of aspiration compared to a client with dysphagia.

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When assessing both lower extremities (BLE) of a client who has chronic venous insufficiency, the nurse identifies bilateral stasis dermatitis and an ulcer on the medial surface of the left ankle. To promote effective self-care, which client teaching should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 4-year-old girl returns to the pediatrician's office for a postoperative visit following hospitalization for minor surgery. When observing the child in the waiting area, which behavior should-the nurse consider normal for this age child

Correct Answer is C

Explanation

Which client is at greatest risk for aspiration?

Correct Answer is C

Explanation

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