In counseling the patient about sexual activity following an MI, what should the nurse do?

Correct Answer: B

Rationale: In counseling a patient about sexual activity following a myocardial infarction (MI), the nurse should choose option B: Discuss sexual activity while teaching about other physical activities. This option is correct because it acknowledges the importance of addressing the topic of sexual activity as part of the overall conversation about physical activity after an MI. Option A is incorrect because waiting for the patient to ask about resuming sexual activity may result in the topic not being addressed at all, leading to potential misunderstandings or concerns for the patient. Option C is also incorrect as it places the responsibility on the healthcare provider to initiate the discussion about sexual activity, when it is within the scope of nursing practice to provide this guidance. Option D is incorrect because while impotence can be a long-term complication following an MI, it is not appropriate to assume this outcome for all patients and to present it as a common certainty. In an educational context, it is crucial for healthcare providers, including nurses, to address the topic of sexual activity following an MI as it is an important aspect of a patient's quality of life and recovery. By integrating this discussion into the overall education about physical activity and lifestyle changes post-MI, nurses can provide comprehensive support to patients in their recovery journey. This approach helps normalize the conversation around sexual health and encourages open communication between patients and healthcare providers.

Correct Answer: C

Rationale: In auscultating over a peripheral artery, the sound of a bruit would suggest obstruction of the artery. A bruit is an abnormal swooshing or whooshing sound caused by turbulent blood flow through a narrowed or obstructed artery. This indicates a potential blockage or stenosis in the vessel, disrupting the smooth flow of blood. Option A, dullness, is incorrect because it typically refers to a percussion sound indicating consolidation in underlying tissue, not related to vascular obstruction. Option B, tympany, is a percussion sound associated with air-filled structures and is not indicative of arterial obstruction. Option D, vibrations, are not typically associated with arterial obstruction but may be felt in conditions like thrill or palpable murmur. In an educational context, understanding the significance of different sounds heard during auscultation is crucial for healthcare professionals in diagnosing and managing cardiovascular conditions. Recognizing the specific sound of a bruit can prompt further investigation for atherosclerosis, arterial stenosis, or other vascular issues, leading to timely interventions and improved patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) avoiding consumption of alcoholic beverages. When teaching a patient about hydrochlorothiazide, it is crucial to emphasize avoiding alcohol because both hydrochlorothiazide and alcohol can lead to dehydration and electrolyte imbalance, particularly low potassium levels. Alcohol can amplify the diuretic effect of hydrochlorothiazide, potentially causing excessive fluid loss and electrolyte disturbances. Educating Mr. Jones on this interaction is essential to prevent adverse effects and ensure the medication's effectiveness. Option B) restricting potassium intake is incorrect because hydrochlorothiazide can actually lead to potassium loss, so restricting potassium intake could further exacerbate this electrolyte imbalance. Option C) increasing fluid intake is also incorrect as it is generally beneficial to stay hydrated while taking a diuretic like hydrochlorothiazide. Option D) restricting physical activity is not necessary unless advised by a healthcare provider based on individual circumstances. In an educational context, it is important for healthcare providers to provide comprehensive teaching to patients about their medications to promote safety and efficacy. Understanding potential drug interactions and lifestyle modifications is crucial for patients to manage their health effectively. Patients should be empowered with knowledge to make informed decisions and actively participate in their care.

Correct Answer: A

Rationale: In the context of caring for a patient following a myocardial infarction (MI), addressing psychologic aspects like fear, stress, and hopefulness is crucial for their overall well-being and recovery. The correct answer, A) acceptance, is the most appropriate therapeutic goal during the acute phase post-MI. Acceptance allows Mrs. Payer to acknowledge her condition, cope with the emotional impact of the MI, and work towards understanding and adapting to the changes in her life. It fosters a positive mindset, reduces resistance to treatment, and promotes engagement in rehabilitation efforts. Option B) rehabilitation, while important in the long-term recovery process, focuses more on physical aspects rather than immediate psychologic needs. Option C) slowing down and Option D) dependence are not appropriate goals as they do not empower the patient or address the emotional challenges she may be facing. Educationally, understanding the psychologic impact of a cardiac event like an MI is vital for healthcare providers to deliver holistic care. By prioritizing psychologic well-being alongside physical health, patients are better supported in their recovery journey, leading to improved outcomes and quality of life.

Correct Answer: B

Rationale: In the context of Mrs. G., who has a history of compensated congestive heart failure, the most realistic discharge goal is option B) Absence of signs of congestive failure. This is the correct answer because in managing heart failure, the goal is to prevent exacerbations and maintain a stable condition. Having an absence of signs of congestive failure indicates that the patient's condition is stable and well-controlled. Option A) Knowledge of illness and treatment is important for patient education, but the priority in this case is to maintain a stable condition. Option C) Total decompensation for failure is not a realistic goal as it would signify a worsening of the condition. Option D) Avoidance of all stress is vague and not directly related to managing congestive heart failure. Educationally, this question highlights the importance of setting realistic and achievable goals in managing chronic conditions like heart failure. It emphasizes the need for patients to understand the signs and symptoms of their condition while striving for stability and symptom control as part of their overall care plan.