Which of the following nursing interventions should the nurse perform to help the client manage self-care and moderate activity?

Correct Answer: C

Rationale: The correct answer is option C) Intersperse periods of activity with rest. This nursing intervention is essential for helping the client manage self-care and moderate activity because it promotes a balanced approach to activity levels. By alternating periods of activity with rest, the client can engage in necessary tasks while preventing overexertion, which is crucial for individuals with cardiovascular issues. Option A) Assist the client to lie flat is incorrect as it does not promote self-care or moderate activity. In fact, lying flat for extended periods can lead to deconditioning and may not be suitable for all clients with cardiovascular concerns. Option B) Caution the client against lifting heavy objects is important, but it does not address the holistic approach of managing self-care and moderate activity. While lifting heavy objects should be avoided, there are other activities and considerations to be mindful of in promoting overall health and well-being. Option D) Instruct the client to avoid competitive sports is also important, especially for individuals with cardiovascular issues. However, this option does not encompass the comprehensive approach of interspersing activity with rest to manage self-care effectively. In an educational context, understanding the importance of balancing activity levels and rest is crucial for nurses caring for clients with cardiovascular conditions. By implementing appropriate strategies like interspersing activity with rest, nurses can help clients maintain their independence, improve their quality of life, and prevent complications related to overexertion. It is essential for nurses to provide individualized care plans that consider the unique needs and limitations of each client to promote optimal health outcomes.

Correct Answer: C

Rationale: The correct answer is C) Diabetes. When managing hypertension in a client with diabetes, prescribing an ACE inhibitor as the first line of antihypertensive therapy is crucial. This is because ACE inhibitors not only lower blood pressure but also offer renal protection, making them especially beneficial for individuals with diabetes who are at risk for diabetic nephropathy. Option A) Chronic kidney disease is a condition where ACE inhibitors may be used due to their renal protective effects, but it is not the primary indication for choosing an ACE inhibitor as the first-line therapy for hypertension in a client with hypertension. Option B) Heart failure is another condition where ACE inhibitors are commonly used due to their ability to improve cardiac function and reduce mortality in heart failure patients. However, it is not the primary reason for choosing an ACE inhibitor as the first-line therapy for hypertension in a client with hypertension. Option D) High CVD risk is a broad category that may include various risk factors, but it is not a specific condition that would necessitate the use of an ACE inhibitor as the first-line therapy for hypertension in a client with hypertension. Educationally, understanding the rationale behind choosing specific antihypertensive medications based on the client's comorbidities is essential for healthcare professionals. This knowledge ensures optimal management of hypertension, considering not only blood pressure control but also the potential benefits specific medications can offer based on individual patient needs and conditions.

Correct Answer: B

Rationale: The correct answer is B) Off-pump coronary artery bypass (OPCAB). This procedure involves performing the bypass surgery without the use of a heart-lung machine, which helps to shorten the operative time to around 2 hours compared to the traditional on-pump CABG that typically takes 3 to 6 hours. OPCAB has shown promise in reducing mortality from complications associated with traditional CABG, such as stroke and renal failure, as it avoids the potential risks linked to the heart-lung machine. This procedure is particularly beneficial for patients with comorbidities that make them high-risk candidates for conventional CABG. Option A) Minimally invasive direct coronary artery bypass (MIDCAB) is a different technique that involves accessing the heart through a smaller incision but does not specifically address the shortened operative time or decreased mortality mentioned in the question. Option C) Conventional coronary artery bypass graft (CABG) is the traditional method involving the use of a heart-lung machine, which is not associated with the time and mortality benefits highlighted in the question. Option D) Port access coronary artery bypass (PACAB) is a newer technique that utilizes small incisions and specialized port access, but it does not specifically focus on the reduced operative time and mortality improvements seen with OPCAB. Educationally, understanding the different techniques for coronary artery bypass grafting is crucial for healthcare providers to make informed decisions about the most appropriate procedure for each patient based on their individual characteristics and the desired outcomes. OPCAB represents a significant advancement in cardiac surgery and offers a valuable alternative for certain patient populations.

Correct Answer: D

Rationale: The correct answer is D) walk as tolerated. Intermittent claudication is a condition characterized by cramping leg pain that occurs with exercise and is relieved by rest. Encouraging the patient to walk as tolerated helps improve blood flow to the lower extremities, promoting collateral circulation and increasing the patient's pain-free walking distance over time. This exercise helps build endurance and can alleviate symptoms of intermittent claudication. Option A) applying graduated compression stockings before getting out of bed is not the most appropriate intervention for intermittent claudication. While compression stockings can help with venous circulation, they do not directly address the underlying arterial insufficiency causing intermittent claudication. Option B) elevating the legs when sitting can be beneficial for patients with venous insufficiency, but it is not the primary intervention for intermittent claudication. Elevating the legs may relieve symptoms temporarily but does not address the need for exercise to improve arterial circulation. Option C) refraining from exercising is contraindicated for patients with intermittent claudication. Regular exercise, specifically walking, is a key component of managing this condition as it helps improve circulation and walking distance over time. Educationally, it is important for nurses to understand the rationale behind recommending walking for patients with intermittent claudication. By promoting exercise, nurses can empower patients to take an active role in managing their condition and improving their quality of life. It is crucial for nurses to provide accurate and evidence-based recommendations to optimize patient outcomes and promote overall cardiovascular health.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) obtain a 12-lead electrocardiogram. The rationale behind this choice is that even though the patient has negative troponins and stress test results, the recurrence of chest pain similar to their initial presentation raises concern for possible cardiac issues. A 12-lead ECG can provide immediate information on the patient's cardiac status, helping to identify any acute changes or abnormalities in the heart's electrical activity. Option A) to activate the cardiac catheterization team may be premature without further diagnostic information from the ECG. Option B) to administer analgesics should not be the initial response as it does not address the underlying cause of the chest pain. Option D) to promote relaxation and monitor the response is not appropriate in this case as it does not address the urgent need to assess the patient's cardiac status. In an educational context, understanding the importance of timely and appropriate diagnostic interventions in cardiovascular nursing is crucial for providing safe and effective patient care. Nurses need to be able to recognize concerning symptoms, prioritize interventions based on evidence-based practice, and collaborate with the healthcare team to ensure optimal patient outcomes.