A home health nurse is examining the lab results of several patients with a history of heart failure (HF). Which patient’s finding should the nurse immediately report to the healthcare provider?
Potassium level of 3.7 mEq/L (3.7 mmol/L).
B-type natriuretic peptide (BNP) level of 550 pg/mL (550 ng/L).
Total cholesterol level of 190 mg/dL (4.92 mmol/L).
Glycosylated hemoglobin (A1C) level of 7%.
The Correct Answer is B
Answer and explanation
The correct answer is Choice B.
Choice A rationale
A potassium level of 3.7 mEq/L (3.7 mmol/L) is within the normal range, which is typically between 3.6 and 5 mEq/L12. Therefore, this result does not need to be reported immediately to the healthcare provider.
Choice B rationale
B-type natriuretic peptide (BNP) levels are used to diagnose and monitor heart failure. A BNP level of 550 pg/mL (550 ng/L) is significantly higher than the normal range, which is less than 100 pg/mL34. High BNP levels indicate that the heart is working harder than normal, which is a common occurrence in heart failure. Therefore, this result should be reported immediately to the healthcare provider.
Choice C rationale
A total cholesterol level of 190 mg/dL (4.92 mmol/L) is considered borderline high. While it’s important to manage cholesterol levels in patients with heart failure, this result is not critical and does not need to be reported immediately to the healthcare provider.
Choice D rationale
A glycosylated hemoglobin (A1C) level of 7% is at the threshold for the diagnosis of diabetes. Diabetes can complicate the management of heart failure and increase the risk of cardiovascular events. However, this result is not critical and does not need to be reported immediately to the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Answer and explanation
The correct answer is Choice D.
Choice A rationale
Reviewing the child's medical history for any allergies or sensitivities is always a good practice during a routine check-up³?³?³?³?. However, in this case, the child's symptoms of difficulty focusing in school and decreased appetite may not necessarily be related to allergies or sensitivities. These symptoms could be indicative of various conditions, including emotional distress, sleep disorders, or other health issues²².
Choice B rationale
Examining the child's torso and arms for any signs of physical trauma is an important step if there is suspicion of physical abuse³?[^40^]?¹?². However, the symptoms described by the mother do not necessarily suggest physical trauma. Therefore, while a physical examination is part of a routine check-up, it may not directly address the child's reported symptoms.
Choice C rationale
Permethrin is a medication used to treat scabies and lice¹³¹?. There is no indication in the scenario provided that the child has these conditions. Therefore, advising the parents to initiate treatment with permethrin would not be appropriate based on the information given.
Choice D rationale
Given the child's symptoms of difficulty focusing in school and decreased appetite, it would be appropriate to recommend the parents to seek further medical evaluation for the child²?²?²?. These symptoms could be indicative of various conditions, including emotional distress, sleep disorders, or other health issues, which would require further investigation²².
Correct Answer is D
Explanation
Answer and explanation The correct answer is D. Choice A rationale
While the discussion of food exchanges and calories being well-attended indicates interest and engagement in the class, it does not necessarily reflect an improvement in the clients’ management of their diabetes.
Choice B rationale
Parking convenience for attendees, while important for accessibility and attendance, does not provide information about the effectiveness of the classes in improving diabetes management.
Choice C rationale
Demonstrating the use of a blood glucose meter can be an effective teaching strategy, but it does not provide measurable outcomes related to the clients’ diabetes control.
Choice D rationale
Fasting blood glucose average readings being 20% lower at the end of the classes is a direct and measurable outcome that indicates improved diabetes control. This suggests that the classes were effective in teaching clients how to better manage their type 2 diabetes.
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