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A client who has high blood pressure is having difficulty following their treatment plan. Which of the following factors should the nurse recognize as being the greatest barrier to the client's ability to be compliant?

A.

Dietary salt restriction

B.

Absence of symptoms

C.

Addition of a new medication

D.

A detailed plan of care

Answer and Explanation

The Correct Answer is B

Rationale: 

 

A. Dietary salt restriction is challenging but is a specific intervention that can be managed with education and support. 

 

B. The absence of symptoms can significantly hinder compliance because clients may not perceive the need to adhere to a treatment plan if they do not feel unwell. This perception can lead to underestimating the importance of managing their blood pressure. 

 

C. The addition of a new medication may pose some challenges, but clients often adapt to new medications with proper guidance. 

 

D. A detailed plan of care can enhance understanding and compliance, making it less likely to be a barrier compared to the lack of symptomatic cues indicating a need for treatment.


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Correct Answer is B

Explanation

Rationale:

A. Cytomegalovirus (CMV) is not nationally notifiable, though it can have significant effects, especially in pregnant women.

B. Foodborne botulism is a nationally notifiable condition due to its potential for widespread outbreaks and severe health consequences.

C. Erythema infectiosum, or fifth disease, is not a nationally notifiable disease, although it is recognized in clinical settings.

D. Herpes simplex virus type 1 (HSV-1) is common and not considered a nationally notifiable infectious disease.

Correct Answer is A

Explanation

Rationale:

A. Assisting with deep breathing and coughing is the priority action. This is crucial in preventing respiratory complications, such as atelectasis or pneumonia, especially following abdominal surgery. Deep breathing exercises can help expand the lungs and promote ventilation.

B. Monitoring the incision site for signs of infection is important, but it is not the immediate priority. The client’s respiratory function takes precedence in the early postoperative period.

C. Assessing fluid intake is important for overall recovery, but it is not as critical as ensuring the client can breathe effectively and prevent complications.

D. While ambulation is beneficial for recovery and preventing complications such as deep vein thrombosis, the nurse must first ensure the client can manage their airway and breathing.

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