the nurse is teaching a client with hypertension about lifestyle modifications what topic is most important
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Nursing Elites

HESI LPN

Adult Health Exam 1 Chamberlain

1. The client with hypertension is being taught about lifestyle modifications. What topic is most important?

Correct answer: B

Rationale: Reducing salt intake is crucial for managing hypertension. Excessive salt consumption can lead to fluid retention, increasing blood pressure. While stress management, regular physical activity, and weight loss are beneficial for overall health, reducing salt intake is the most important lifestyle modification for controlling hypertension. Stress management may help reduce overall stress levels but does not directly impact blood pressure as salt intake does. Regular physical activity and weight loss can also benefit blood pressure control, but the immediate impact of reducing salt intake is more significant.

2. During a tonic-clonic seizure, what is the nurse's priority intervention?

Correct answer: D

Rationale: During a tonic-clonic seizure, the nurse's priority intervention is to protect the client's head from injury. This is crucial to prevent trauma, as head injuries can be severe during a seizure. Inserting an oral airway may cause injury or obstruction during the seizure and is not recommended. Administering oxygen via nasal cannula can be done after ensuring the client's safety. Restraining the client's arms and legs is also not recommended as it can lead to further injury or harm.

3. A client with a diagnosis of hypertension is prescribed a thiazide diuretic. Which potential side effect should the nurse monitor for?

Correct answer: C

Rationale: The correct answer is C: 'Hypokalemia.' Thiazide diuretics commonly cause potassium loss, which can lead to hypokalemia. Monitoring potassium levels is essential when a client is taking thiazide diuretics to prevent complications such as cardiac dysrhythmias. Choices A, B, and D are incorrect. Hyperkalemia (choice A) is an elevated level of potassium, which is not typically associated with thiazide diuretics. Hypernatremia (choice B) is an elevated level of sodium, and hypoglycemia (choice D) is low blood sugar, neither of which are directly linked to thiazide diuretic use.

4. The nurse observes that a post-operative client's surgical wound has reddened edges and is oozing. What is the appropriate nursing action?

Correct answer: D

Rationale: The correct action when a post-operative client's surgical wound has reddened edges and is oozing is to notify the surgeon immediately. Reddened, oozing wound edges can indicate an infection that requires prompt evaluation and intervention by the surgical team. Applying an antibiotic ointment (Choice A) without proper assessment and guidance can be inappropriate. Cleaning the wound with sterile saline (Choice B) and covering it with a sterile dressing (Choice C) may not address the potential infection adequately, and the client may require more specialized care that the surgeon can provide.

5. A client with a diagnosis of chronic heart failure is receiving digoxin. What is the most important instruction the nurse should provide?

Correct answer: B

Rationale: The most important instruction the nurse should provide is to monitor pulse rate daily before taking the medication. Digoxin can lead to bradycardia, so it is crucial to assess the pulse rate before administering the medication. This practice helps ensure that the heart rate is not too low for the safe use of digoxin. Choice A is incorrect as there is no specific requirement to take digoxin with a high-fiber meal. Choice C is also incorrect because there is no need to avoid dairy products while on digoxin. Choice D is incorrect since blurred vision is not a common side effect of digoxin; hence, it is not the most critical instruction to provide.

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