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 C

Explanation

Choice A reason: Elevated glucose (190 mg/dL) in pancreatitis needs monitoring but is less urgent than severe neutropenia (ANC <500/mm3), which risks life-threatening infections. Glucose can be managed with insulin, per diabetes and pancreatitis care protocols, but neutropenia requires immediate intervention.

Choice B reason: Hemoglobin of 7.0 g/dL in a GI bleed is critical but less immediate, as the client is receiving a transfusion. Neutropenia (ANC <500/mm3) poses an urgent infection risk, requiring isolation. Transfusion addresses anemia, per bleeding and hematology care standards.

Choice C reason: An ANC <500/mm3 indicates severe neutropenia, posing an immediate infection risk in cancer patients, requiring urgent isolation and antibiotics. This rapid drop from 2,000/mm3 demands priority intervention to prevent sepsis, per oncology and infection control protocols in nursing practice.

Choice D reason: Elevated bilirubin in hepatitis is concerning but less urgent than neutropenia (ANC <500/mm3), which risks sepsis. Jaundice requires monitoring and treatment, but severe infection risk takes precedence, per liver disease and critical care prioritization standards in nursing practice.

A. Enroll in a smoking cessation program. B. Reduce intake of high saturated fats and salt. C. Keep toenails trimmed short. D. Apply heating pad to soothe leg pain.

Correct Answer is A

Explanation

Choice A reason: Smoking exacerbates PAD via nicotine-induced vasoconstriction and endothelial damage, reducing blood flow and worsening atherosclerosis, especially post-MI. Cessation is critical to halt vascular damage, improve endothelial function, and prevent further MI or limb ischemia, addressing the primary pathophysiological driver of disease progression in this high-risk client.

Choice B reason: Reducing saturated fats and salt lowers LDL cholesterol and blood pressure, mitigating atherosclerosis in PAD and MI. However, smoking directly causes vasoconstriction and plaque progression, making cessation more urgent. Dietary changes are secondary, as nicotine’s immediate vascular effects pose a greater risk to perfusion and cardiovascular health.

Choice C reason: Trimming toenails short prevents injury in PAD, where poor perfusion impairs healing. However, smoking cessation is more critical, as nicotine’s vasoconstrictive effects directly reduce arterial flow, worsening ischemia. Nail care is a minor preventive measure compared to addressing smoking, the primary contributor to PAD’s pathophysiology.

Choice D reason: Applying a heating pad is contraindicated in PAD, as reduced sensation increases burn risk, and heat doesn’t improve arterial insufficiency. Smoking cessation is paramount, as nicotine exacerbates vasoconstriction, reducing blood flow and risking tissue necrosis. Cessation directly addresses PAD’s vascular pathology, making it the priority instruction.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which client’s laboratory value requires immediate intervention by a nurse? Reference Range: Hemoglobin (Hgb) [14 to 18 g/dL (8.7 to 11.2 mmol/L)]; Fasting Blood Glucose [70 to 110 mg/dL (3.9 to 6.1 mmol/L)]; Neutrophils (ANC) [55 to 70%: 2,500 to 8,000/mm3 (2.5 to 5.8 x109/L)]

Correct Answer is C

Explanation

The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the highest priority?

Correct Answer is A

Explanation

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