A community health nurse runs a clinic that provides health screening mainly to Mexican American and Filipino American clients. The nurse wants to have a class on smoking cessation for interested adults of this group. What action should the nurse take to adjust to their time orientation?

Correct Answer: A

Rationale: To adjust to the time orientation of Mexican American and Filipino American clients, the community health nurse should organize the instructions around short-term objectives. This approach aligns with a present-focused time orientation commonly seen in these cultural groups. By emphasizing short-term benefits and goals of smoking cessation during the class, the nurse can better engage and motivate the participants, increasing the likelihood of their participation and success in quitting smoking. This approach respects and accommodates the cultural values and time perspectives of the clients, ultimately enhancing the effectiveness of the smoking cessation program.

Correct Answer: B

Rationale: The statement "Our child will need to take antibiotics prior to having dental surgery" indicates that teaching has been effective because it shows that the parents have understood the importance of antibiotic prophylaxis to prevent infective endocarditis in a child with a repaired congenital heart defect. This precaution is crucial to protect the child's heart health during dental procedures and indicates that the parents have grasped the key points of the discharge instructions regarding their child's cardiac care post-surgery. The other statements are incorrect and could potentially lead to negative outcomes if followed.

Correct Answer: C

Rationale: Cocaine causes myocardial infarction (MI) primarily by increasing sympathetic nervous system stimulation. When a person uses cocaine, it leads to an excessive release of catecholamines, such as norepinephrine and epinephrine. These catecholamines cause an increase in heart rate, blood pressure, and vasoconstriction. The increased workload on the heart, combined with the reduced oxygen supply due to vasoconstriction, can lead to myocardial ischemia and potentially result in a myocardial infarction. Thus, the significant impact of cocaine on the sympathetic nervous system is the primary mechanism by which it can cause MI.

Correct Answer: B

Rationale: In a client with disseminated intravascular coagulation (DIC) who is anxious and has decreased oxygen saturation, the priority nursing diagnosis is Impaired Gas Exchange. DIC can lead to microvascular thrombosis and bleeding, which can affect oxygenation at the cellular level. The client's decreased oxygen saturation indicates a problem with gas exchange, which is crucial for the delivery of oxygen to tissues and the removal of carbon dioxide. Prioritizing this issue is essential to prevent complications related to poor tissue oxygenation, such as organ dysfunction. Addressing the client's anxiety would also be important, but ensuring adequate gas exchange takes precedence to maintain tissue perfusion and oxygenation.

Correct Answer: A

Rationale: Systolic heart failure is characterized by the inability of the heart to effectively contract and pump out an adequate amount of blood to meet the body's demands. This results in a decrease in the ejection fraction, which is the percentage of blood ejected from the ventricle with each heartbeat. The ventricle's inadequate contraction leads to diminished cardiac output, resulting in symptoms such as fatigue, dyspnea, and decreased exercise tolerance. Therefore, understanding that systolic heart failure is primarily due to the inadequate contraction of the ventricle is crucial in planning care for clients with this condition.