Which statement made by a patient with coronary artery disease after the nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further teaching is needed?

Correct Answer: D

Rationale: The correct answer is D because peanut butter is a good source of healthy fats and protein, which can be included in a TLC diet in moderation. Switching to 1% milk (A) reduces saturated fat intake, eating salmon (B) provides omega-3 fatty acids, and having a glass of wine (C) in moderation may have cardiovascular benefits. Peanut butter can be part of a heart-healthy diet, so the patient does not need to eliminate it completely.

Correct Answer: B

Rationale: The correct answer is B: Pallor and weakness of the right hand. This finding could indicate impaired circulation to the right hand due to a complication related to the radial artery graft. Impaired circulation could lead to ischemia or even graft failure, which are serious concerns post coronary artery bypass grafting. This information is crucial to communicate to the health care provider for immediate intervention to prevent further complications. Incorrect choices: A: Complaints of incisional chest pain - While chest pain is important to monitor post-surgery, it is a common occurrence and may not indicate a serious complication. C: Fine crackles heard at both lung bases - This finding may suggest fluid overload or pulmonary issues, but it is not directly related to the radial artery graft or its complications. D: Redness on both sides of the sternal incision - Redness at the incision site can be a sign of infection, but it is not as urgent as the potential circulation issue in the right hand, which could

Correct Answer: B

Rationale: To improve physical activity for a mildly obese 71-yr-old patient, the nurse should determine what physical activities the patient enjoys. This approach considers the patient's preferences, increasing the likelihood of adherence. Stressing weight loss (A) may not be motivating for everyone. Limiting exercise time (C) is not evidence-based. A warm-up (D) is important but not the initial step.

Correct Answer: B

Rationale: The correct answer is B: Dyspnea. Left-sided heart failure commonly presents with dyspnea due to fluid accumulation in the lungs (pulmonary edema). This occurs because the weakened left ventricle cannot efficiently pump blood to the body, causing fluid to back up into the lungs. Ascites (A) is more commonly associated with right-sided heart failure. Hepatomegaly (C) and jugular vein distention (D) are signs of right-sided heart failure, not left-sided heart failure. Dyspnea is a hallmark symptom of left-sided heart failure due to pulmonary congestion.

Correct Answer: C

Rationale: The correct answer is C: International Normalized Ratio (INR) of 3 to 4. INR is the standard measurement of the time it takes for blood to clot. For clients on warfarin therapy, a therapeutic INR range is typically between 2 to 3 for most indications. However, in the case of deep vein thrombophlebitis, a slightly higher range of 3 to 4 is often targeted. This range ensures adequate anticoagulation to prevent clot formation without increasing the risk of bleeding excessively. Now, let's analyze why the other choices are incorrect: A: Partial thromboplastin time (PTT) is used to monitor heparin therapy, not warfarin. B: Prothrombin time (PT) is used to monitor warfarin therapy, but the correct therapeutic range is typically 1.5 to 2.5 times the control, not 1.5 to 2 times. D