The client with a left-sided mastectomy is diagnosed with elephantiasi

Peripheral Vascular Disease NCLEX

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Question 1 of 5.

The client with a left-sided mastectomy is diagnosed with elephantiasis of the left arm. Which signs/symptoms should the nurse expect to assess?

A. Edematous arm from the axillary area to the fingertips.

B. Painful, edematous, reddened lower forearm.

C. Tented skin turgor over the entire left arm.

D. Nipple retraction and peau d'orange skin.

Explanation: Elephantiasis causes chronic lymphedema, leading to arm edema from axilla to fingertips (A). Pain/redness (B) suggests infection, tented turgor (C) is dehydration, and nipple changes (D) are breast cancer signs.

Question 2 of 5.

The nurse is teaching the client recently diagnosed with essential hypertension. Which instruction should the nurse provide when discussing heart healthy exercise?

A. Walk at least 30 minutes a day on flat surfaces.

B. Perform light weight lifting three (3) times a week.

C. Recommend high-intensity aerobics daily.

D. Encourage the client to swim laps once a week.

Explanation: Walking 30 minutes daily (A) is aerobic, safe, and effective for hypertension. Light weight lifting (B) is less ideal, high-intensity aerobics (C) is too strenuous, and weekly swimming (D) is insufficient.

Question 3 of 5.

The male client diagnosed with essential hypertension has been prescribed an alpha-adrenergic blocker. Which intervention should the nurse discuss with the client?

A. Eat at least one (1) banana a day to help increase the potassium level.

B. Explain that impotence is an expected side effect of the medication.

C. Take the medication on an empty stomach to increase absorption.

D. Change position slowly when going from a lying to sitting position.

Explanation: Alpha blockers cause orthostatic hypotension; changing positions slowly (D) prevents falls. Bananas (A) are unrelated, impotence (B) is possible but not expected, and empty stomach (C) is not required.

Question 4 of 5.

The nurse is teaching the Dietary Approaches to Stop Hypertension (DASH) diet to a client diagnosed with essential hypertension. Which statement indicates that the client understands teaching concerning the DASH diet?

A. I should eat at least four (4) to five (5) servings of vegetables a day.'

B. I should eat meat that has a lot of white streaks in it.'

C. I should drink no more than two (2) glasses of whole milk a day.'

D. I should decrease my grain intake to no more than twice a week.'

Explanation: The DASH diet emphasizes 4-5 servings of vegetables daily (A) to lower BP. Marbled meat (B) is high-fat, whole milk (C) is limited, and grains (D) are encouraged (6-8 servings daily).

Question 5 of 5.

The intensive care department nurse is calculating the total intake for a client diagnosed with hypertensive crisis. The client has received 880 mL of D5W, IVPB of 100 mL of 0.9% NS, 8 ounces of water, 4 ounces of milk, and 6 ounces of chicken broth. The client has had a urinary output of 1,480 mL. What is the total intake for this client?

Answer: 1180

Explanation: Total intake = IV fluids (880 mL D5W + 100 mL NS) + oral fluids (8 oz water + 4 oz milk + 6 oz broth). 1 oz = 30 mL, so oral = (8+4+6) X 30 = 540 mL. Total = 880 + 100 + 540 = 1,180 mL. Output (1,480 mL) is not included in intake.