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. Change the tracheostomy ties every 48 hours. B. Suction the tracheostomy every 2 hours routinely. C. Assess airway patency every shift. D. Clean the inner cannula with hydrogen peroxide daily.

Correct Answer is C

Explanation

Choice A reason: Changing tracheostomy ties every 48 hours maintains hygiene but is less critical than airway patency. Ties secure the tube, but obstruction from mucus or dislodgement risks respiratory failure. Regular patency checks ensure airflow, addressing the primary physiological need for oxygenation in tracheostomy care.

Choice B reason: Routine suctioning every 2 hours is unnecessary unless secretions obstruct the airway. Over-suctioning risks mucosal trauma or hypoxia. Assessing patency ensures the airway remains clear, guiding suctioning as needed, prioritizing respiratory function in tracheostomy clients over arbitrary suction schedules.

Choice C reason: Assessing airway patency every shift is critical, as tracheostomy tubes risk obstruction from mucus or dislodgement, causing respiratory distress. Regular checks confirm airflow, preventing hypoxia, addressing the physiological priority of oxygenation. This ensures timely intervention, maintaining airway integrity in clients with artificial airways.

Choice D reason: Cleaning the inner cannula daily prevents infection but is secondary to airway patency. Obstruction from secretions or tube displacement causes immediate respiratory failure. Patency assessment ensures airflow, guiding cleaning as needed, making it more urgent than routine cannula maintenance in tracheostomy care.

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

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