A client diagnosed with peripheral vascular disease (PVD) is obese, has a 30-year history of cigarette smoking, and works as a contractor. When discussing risk factors for PVD, which statement by the nurse is appropriate?

Correct Answer: A

Rationale: The statement "Nicotine causes vasospasms, which reduce blood flow to the legs" is the most appropriate response when discussing risk factors for PVD with a client who is obese, has a history of smoking, and works as a contractor. Nicotine in cigarette smoke can lead to constriction or narrowing of blood vessels, including those in the legs, which can reduce blood flow to the lower extremities. This can contribute to the development and progression of peripheral vascular disease (PVD) in individuals with a history of smoking. Identifying and educating the client about this specific risk factor related to their smoking history is important in managing their condition and preventing further complications.

Correct Answer: A

Rationale: A transient ischemic attack (TIA) is often considered a warning sign that the individual is at an increased risk for a future ischemic stroke. TIAs are brief episodes of neurological dysfunction caused by a temporary disruption in blood supply to the brain. While the symptoms of a TIA typically resolve within 24 hours, they should not be ignored as they indicate an underlying vascular issue that needs to be addressed to prevent a more severe stroke in the future. Therefore, the client is at risk for an ischemic thrombotic stroke and should receive appropriate interventions and follow-up care to manage this risk.

Correct Answer: C

Rationale: Documenting the client's questions after the teaching session is important because it demonstrates the client's understanding of the information provided during the teaching session. It also helps to identify any areas where the client may need further clarification or education. This information is crucial for evaluating the effectiveness of the teaching session and ensuring that the client is able to perform tracheostomy care safely and effectively. Additionally, documenting the client's questions allows for continuity of care by providing insight into the client's concerns and educational needs.

Correct Answer: C

Rationale: In a pregnant woman, a hematocrit level of 24% is cause for concern as it is lower than the normal range during pregnancy. A lower than normal hematocrit level may indicate anemia in the pregnant woman, which can lead to complications for both the mother and the baby. Anemia during pregnancy can result in inadequate oxygen reaching the tissues, fatigue, increased risk of preterm birth, and low birth weight for the baby. Therefore, this finding should be further evaluated and managed promptly to ensure the well-being of the pregnant woman and her baby.

Correct Answer: B

Rationale: In eclampsia, seizures can occur due to the underlying hypertensive crisis affecting the brain. A classic grand mal seizure consists of two phases: the tonic phase and the clonic phase. During the tonic phase, there is a sudden loss of consciousness and muscle tone, leading to the person falling down. The clonic phase follows the tonic phase and is characterized by rhythmic, repetitive muscle contractions and relaxation. Therefore, the accurate statement about the characteristics of a grand mal seizure in the context of eclampsia is that the clonic phase is evidenced by muscular contraction and rigidity.

Correct Answer: A

Rationale: Morning headaches that extend into the neck and subside as the day progresses can be indicative of elevated blood pressure, which is a common cause of morning headaches. Increased blood pressure can cause headaches that are usually worse in the morning due to the body's natural circadian rhythms. Monitoring the client's blood pressure and assessing for other signs of hypertension would be important in this case. Tachycardia, otitis media, and swollen lymph nodes are less likely to be associated with the described symptoms.

Correct Answer: A

Rationale: Patients with hypothyroidism often exhibit rough, dry skin as a result of decreased thyroid hormone levels impacting the skin's ability to retain moisture. This condition, known as myxedema, can lead to skin changes such as dryness, scaling, and thickening. The skin may also appear pale or yellowish due to reduced blood flow. Therefore, the nurse should expect the patient with newly diagnosed hypothyroidism to present with rough, dry skin during assessment.

Correct Answer: C

Rationale: Bladder cancer is a health problem that can result from a combination of genetic and environmental factors. Genetic mutations can predispose individuals to developing bladder cancer, while environmental factors such as smoking, exposure to certain chemicals, and chronic bladder irritation can also contribute to the development of the disease. Hematuria (blood in the urine) can be a symptom of bladder cancer, but it is not specific to this type of cancer and can also occur in other renal system disorders. Incontinence and kidney infections are not typically associated with genetic predisposition as much as bladder cancer.

Correct Answer: D

Rationale: Disseminated intravascular coagulation (DIC) is a serious condition characterized by both excessive clotting and bleeding throughout the body. The primary goal of care for a client with DIC is to manage and balance the clotting and bleeding tendencies. A key indicator of successful care for a client with DIC is the absence of bleeding, as this suggests that the coagulation process has been stabilized and there is no ongoing clot breakdown leading to bleeding. Monitoring for signs of bleeding, such as petechiae, purpura, ecchymosis, hematuria, and gastrointestinal bleeding, is essential in evaluating the effectiveness of care in a client with DIC. Therefore, the absence of bleeding is the most significant finding that indicates successful care in a client with DIC.