A client with left-sided heart failure is experiencing dyspnea and orthopnea. Which position should the nurse place the client in to relieve these symptoms?

Correct Answer: A

Rationale: The correct answer is A: High Fowler's position. Placing the client in a High Fowler's position helps reduce dyspnea and orthopnea by facilitating lung expansion and improving ventilation. In this position, the client's head and chest are elevated at a 90-degree angle, allowing for maximal chest expansion and improved oxygenation. This position also helps reduce the workload on the heart by decreasing venous return, which can help alleviate symptoms of left-sided heart failure. Summary: - A: High Fowler's position is correct as it facilitates lung expansion and improves ventilation. - B: Supine position would not be ideal as it can exacerbate symptoms by increasing pressure on the lungs and heart. - C: Trendelenburg position would worsen symptoms by increasing venous return and fluid overload. - D: Sims' position is used for procedures or to facilitate drainage, not for relieving dyspnea and orthopnea.

Correct Answer: C

Rationale: The correct answer is C: Take the medication on an empty stomach. Omeprazole is a proton pump inhibitor that works best when taken on an empty stomach, about 30 minutes before meals. This allows the medication to be absorbed effectively and provides optimal therapeutic effects in reducing stomach acid production. Taking it with food (choice A) may decrease its efficacy. Taking it at bedtime (choice B) is not ideal as it may not coincide with the peak acid production in the stomach. Taking it as needed for pain relief (choice D) is not appropriate as omeprazole is a scheduled medication for the management of peptic ulcer disease, not for immediate pain relief.

Correct Answer: C

Rationale: The correct answer is C: Episodes of cyanosis and pallor in the fingers. Raynaud's phenomenon is characterized by vasospasms of small arteries, leading to reduced blood flow and color changes in the digits. Cyanosis (bluish discoloration) and pallor (pale color) are common during episodes. Thickened and hardened skin (A) is associated with scleroderma. Painless ulcers on the fingertips (B) are seen in advanced stages of systemic sclerosis. Red, scaly patches on the hands (D) are indicative of psoriasis, not Raynaud's phenomenon.

Correct Answer: C

Rationale: The correct instruction is C: Use this medication twice daily for long-term control. Salmeterol is a long-acting beta-agonist used for maintenance therapy in asthma to provide long-term control of symptoms and prevent exacerbations. It should not be used for acute asthma attacks as it does not provide quick relief like rescue inhalers such as albuterol (choice A). It is not meant to replace albuterol, so it should not be used before using albuterol (choice B). Using salmeterol as needed for wheezing (choice D) is not appropriate as it is a maintenance medication and not a rescue medication.

Correct Answer: A

Rationale: The correct answer is A: Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, causing neurological symptoms like confusion and unsteady gait (Wernicke's encephalopathy). Thiamine is crucial for brain function and alcohol interferes with its absorption. Vitamin B12 (choice B) deficiency can also cause neurological symptoms but is less likely in this case. Folic acid (choice C) deficiency can lead to anemia and neural tube defects, not directly related to the symptoms described. Vitamin D (choice D) deficiency typically presents with bone pain and muscle weakness, not confusion and gait issues.