You are preparing to implement discharge teaching about heart healthy diet and activity levels for a patient who has had a myocardial infarction and her husband. The patient says, 'I don't see why I need to listen to this information. I don't think that I will need to make any changes right now in my lifestyle.' Which response is most appropriate?

Correct Answer: B

Rationale: The correct answer is B because it demonstrates active listening and encourages the patient to express their reasoning, which helps in understanding their perspective. By asking the patient to explain why they don't feel the need for lifestyle changes, it opens up dialogue and allows for exploration of their beliefs and concerns. This approach can uncover underlying issues, provide insight into their readiness for change, and guide the conversation towards addressing their specific barriers or misconceptions. Choice A is incorrect as it assumes the family's desires without directly addressing the patient's concerns. Choice C jumps to conclusions about the patient's denial stage without exploring their thoughts. Choice D is directive and may come across as dismissive of the patient's autonomy and readiness for change.

Correct Answer: A

Rationale: The correct answer is A because older adults with heart and blood vessel diseases are more susceptible to thrombophlebitis due to reduced mobility, which can lead to blood pooling and clot formation in the veins. Reduced mobility can result from various reasons such as age-related muscle weakness, joint stiffness, and overall frailty. This stagnant blood flow increases the risk of clot formation, especially in the lower extremities. Choice B is incorrect because it contradicts the concept of reduced mobility in older adults. Choice C is incorrect as the use of IV drugs and chemicals is not directly linked to thrombophlebitis in this context. Choice D is incorrect as diet restrictions, although important for cardiovascular health, do not directly contribute to the susceptibility of thrombophlebitis in older adults with heart and blood vessel diseases.

Correct Answer: D

Rationale: The correct answer is D: Cerebral emboli may occur. After a TMR procedure, there is a risk of small blood clots (emboli) forming and traveling to the brain, leading to potential neurological complications. Assessing the client's mental status can help detect any signs of cerebral emboli, such as confusion or altered consciousness. Summary: A: Cerebral hemorrhage is not a common complication of TMR. B: Severe headache is not specific to cerebral emboli. C: Loss of consciousness can occur due to various reasons post-TMR, but it is not directly related to cerebral emboli.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Teaching about non-pharmacologic and pharmacologic BP management is essential for client empowerment and adherence. 2. Education on lifestyle changes and medications helps clients make informed decisions. 3. Assessing knowledge levels enables tailored interventions for optimal BP control. Summary: A: Monitoring temperature in different positions is not directly related to assessing hypertension. C: Taking BP in multiple positions is important for orthostatic hypotension assessment, not primary hypertension evaluation. D: Weighing the client daily does not directly address hypertension assessment or management.

Correct Answer: B

Rationale: The correct answer is B: Cor pulmonale. This condition is characterized by right-sided heart failure due to lung damage, leading to increased pressure in the pulmonary circulation. Lung damage can result from chronic obstructive pulmonary disease (COPD) or other lung diseases, causing the heart to work harder to pump blood through the lungs. This increased workload can eventually lead to right-sided heart failure. A: Myocardial infarction primarily affects the left side of the heart. C: Hypertension can lead to left-sided heart failure but not specifically right-sided heart failure. D: Cardiomyopathy is a broad term for diseases of the heart muscle and does not specifically predispose to right-sided heart failure due to lung damage.