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 A
Explanation
Answer and explanation
The correct answer is Choice A.
Choice A rationale
Primary prevention includes measures that prevent the occurrence of a specific disease or health condition. In the context of sexually transmitted infections (STIs), primary prevention would involve education on safe sex practices. This could include information on the use of condoms, the importance of regular STI testing, and the risks associated with having multiple sexual partners. Given the client’s history of multiple sexual partners and recurrent symptoms suggestive of STIs, education on safe sex practices would be an appropriate preventive strategy.
Choice B rationale
Secondary prevention involves early detection and intervention to prevent the progression of a disease or health condition. Regular screenings for STIs fall under this category. However, given that the client has visited the clinic three times in the past 12 months with similar concerns but no STIs were diagnosed, secondary prevention may not be the most appropriate focus for this client.
Choice C rationale
Tertiary prevention involves managing disease post diagnosis to slow or stop disease progression through measures such as medication management and lifestyle changes. Education regarding prescribed treatments for STIs would fall under this category. However, since the client has not been diagnosed with an STI in her previous visits, tertiary prevention would not be the most appropriate focus for this client.
Choice D rationale
Quaternary prevention involves strategies to reduce or avoid unnecessary interventions in the health care system. This could include avoiding unnecessary diagnostic tests or treatments.
Given the client’s history and current symptoms, focusing on quaternary prevention would not be appropriate as it is important to identify the cause of her symptoms and provide appropriate treatment.
Correct Answer is A
Explanation
Answer and explanation
The correct answer is Choice A.
Choice A rationale
Respite care is a service that provides temporary relief to primary caregivers, allowing them time to rest and take care of their own needs. It can be provided in the client’s home, a healthcare facility, or an adult day care center. This service is especially beneficial for caregivers who are feeling exhausted, as it offers them a break while ensuring that their loved ones continue to receive care. Therefore, suggesting that social services be contacted to find a respite care facility for the client would be the best information for the nurse to provide.
Choice B rationale
Hiring a private nurse, also known as concierge nursing, is another option for providing relief to caregivers. However, this option might not be feasible for all families due to the potential cost. Moreover, it might not provide the caregiver with the same level of relief as respite care, as the caregiver might still feel obligated to be involved in the client’s care.
Choice C rationale
A case management evaluation of the client’s home environment could be helpful in assessing the client’s needs and identifying potential resources or modifications that could make caregiving easier. However, this does not directly address the caregiver’s need for rest and relief from their duties.
Choice D rationale
Recommending that the client’s family return to the area to help provide assistance could potentially provide some relief to the caregiver. However, this might not be a feasible or immediate solution, as it depends on the family’s availability and willingness to relocate or travel.
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