During a home visit, the nurse evaluates discharge teaching provided to a patient recovering from an acute kidney injury. Which patient statement indicates that teaching has been effective?

Correct Answer: B

Rationale: The correct answer is B. The statement "I will avoid taking drugs that may harm my kidneys" indicates that the patient understands the importance of protecting their kidneys and is willing to make informed choices about medications. Acute kidney injury can make the kidneys more vulnerable to damage from certain medications, so avoiding drugs that may harm the kidneys is crucial in preventing further injury and promoting recovery. This statement demonstrates that the patient has understood the teaching about kidney health and is committed to following the instructions provided.

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: C

Rationale: Blood pressure is influenced by the pumping action of the heart, peripheral vascular resistance, and blood volume. The heart rate, although related to the pumping action of the heart, is not a direct determinant of blood pressure. Heart rate can affect blood pressure indirectly through its impact on cardiac output, but it is not a primary factor influencing blood pressure regulation. Factors such as the amount of blood pumped by the heart (stroke volume), the elasticity of blood vessels, and the volume of blood in the circulatory system (blood volume) have more direct and significant effects on blood pressure regulation.

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.