Which instruction should the nurse provide a client who was recently diagnosed with Raynaud’s disease?

Use a heating pad at night to keep feet warm.

Wear gloves when removing packages from freezer.

Wear knee-high support stockings during the day.

Walk regularly to increase circulation.

Answer and Explanation

The Correct Answer is B

Choice A reason: Using a heating pad is contraindicated in Raynaud’s, as reduced sensation from vasospasm risks burns. Raynaud’s involves cold-triggered arteriolar constriction, reducing blood flow. Heat does not address vasospasm’s pathophysiology and may cause tissue damage, making this instruction inappropriate compared to cold protection strategies.

Choice B reason: Wearing gloves when handling cold items prevents vasospasm in Raynaud’s, where cold triggers arteriolar constriction, causing ischemia and pain. Protecting extremities maintains blood flow, preventing episodes. This directly addresses the disease’s pathophysiological trigger, making it the most effective instruction for managing Raynaud’s symptoms.

Choice C reason: Knee-high support stockings improve venous return, relevant for venous insufficiency, not Raynaud’s arterial vasospasm. Stockings do not prevent cold-induced vasoconstriction, the primary trigger. Gloves for cold exposure directly mitigate vasospastic episodes, making this instruction less effective for Raynaud’s disease management.

Choice D reason: Regular walking improves overall circulation but does not prevent Raynaud’s vasospastic episodes, triggered by cold or stress. While exercise supports vascular health, avoiding cold exposure with gloves is more targeted, directly reducing arteriolar constriction and ischemic symptoms, making walking a secondary recommendation.

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Correct Answer is A

Explanation

Choice A reason: Oatmeal, raisins, and fruit with skin are high in fiber, reducing colorectal cancer risk by promoting bowel regularity and reducing carcinogen exposure. This aligns with dietary prevention strategies, per oncology and gastrointestinal health guidelines in nursing education.

Choice B reason: Potatoes, low-fat breads, and applesauce are low in fiber, offering less protection against colorectal cancer. High-fiber foods like oatmeal and fruit are preferred to reduce risk, per dietary recommendations and cancer prevention protocols in nursing care.

Choice C reason: Chicken, rice, and wheat products provide moderate fiber but lack the high-fiber content of oatmeal and fruit with skin, which better reduce colorectal cancer risk. Fiber is key, per oncology and dietary prevention standards in nursing education.

Choice D reason: Lean beef, salads, and baked potatoes offer some benefits, but beef may increase cancer risk. High-fiber oatmeal, raisins, and fruit are more effective for prevention, per colorectal cancer dietary guidelines and oncology prevention protocols in nursing care.

A. Facilitate a family meeting with the palliative care team. B. Alert the nursing staff of the client’s do not resuscitate wishes. C. Place a certified copy of the living will in the client’s electronic health record (EHR). D. Notify the healthcare provider of the client’s wishes.

Correct Answer is D

Explanation

Choice A reason: Facilitating a family meeting with palliative care discusses end-of-life goals in COPD, where airway obstruction causes respiratory failure. However, notifying the provider of the living will ensures immediate alignment with the client’s wishes, especially on ventilation, addressing the urgent need to respect legal directives in a critical scenario.

Choice B reason: Alerting staff about do-not-resuscitate (DNR) wishes assumes the living will specifies DNR, which requires confirmation. The provider must review the document first, as end-stage COPD necessitates clarity on ventilation preferences to guide urgent care, making notification the priority over premature staff alerts.

Choice C reason: Placing the living will in the EHR ensures documentation but does not immediately affect care. In end-stage COPD with respiratory distress, notifying the provider ensures the client’s wishes, like avoiding intubation, are followed promptly, preventing unwanted interventions, making this more urgent than administrative tasks.

Choice D reason: Notifying the provider of the living will is critical, as it legally specifies the client’s preferences, potentially refusing ventilation in end-stage COPD, where dyspnea results from irreversible obstruction. This ensures treatment respects autonomy, guiding immediate care to align with palliative goals, preventing inappropriate interventions during a crisis.

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Which instruction should the nurse provide a client who was recently diagnosed with Raynaud’s disease?

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