A male client reports that he recently experienced an episode of chest pressure and breathlessness when he was jogging. The client expresses concern because both of his deceased parents had heart disease and his father had diabetes. He lives with his partner, is a vegetarian, and takes atenolol which maintains his blood pressure at 130/74 mm Hg. Which risk factor(s) should the nurse explore further with the client? Select all that apply.

History of hypertension.

Family health history.

Vegetarian diet.

Sexual history.

Excessive aerobic exercise.

Answer and Explanation

Correct Answer : A,B

A. History of hypertension: Although the client’s current blood pressure is controlled with atenolol, the need for medication confirms a history of hypertension. Hypertension is a major modifiable risk factor for coronary artery disease and warrants ongoing assessment.

B. Family health history: A strong family history of heart disease and diabetes, particularly in first-degree relatives, significantly increases the client’s risk for cardiovascular events. The genetic predisposition should be explored to assess early markers and implement prevention strategies.

C. Vegetarian diet: A vegetarian diet is generally associated with lower cardiovascular risk due to reduced intake of saturated fats and cholesterol. Unless the diet is poorly balanced or nutrient-deficient, it does not constitute a risk factor that requires further evaluation here.

D. Sexual history: Sexual history may be relevant in certain clinical contexts, such as evaluating HIV risk or sexually transmitted infections, but it is not directly related to the client's cardiac symptoms or concern about hereditary heart disease.

E. Excessive aerobic exercise: The client’s activity level (jogging) is not excessive and is generally healthy, unless it is associated with overtraining or extreme exertion. There is no indication here that excessive exercise is a concern, so further exploration is not needed based on this information.

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Correct Answer is A

Explanation

A. Maintain the client on an NPO status: After bariatric surgery, vomiting and the inability to tolerate food and liquids could indicate complications such as gastric outlet obstruction or stenosis. Maintaining NPO status allows the gastrointestinal system to rest while the cause of the symptoms is investigated and treated.

B. Determine if the client is over-hydrating to feel satiated: While over-hydration can cause discomfort, the immediate concern is the client's inability to tolerate food and liquids, which may suggest a more serious issue.

C. Administer daily vitamin supplements: While vitamin supplementation is essential after bariatric surgery to prevent deficiencies, it does not directly address the current issue of vomiting and inability to tolerate food and liquids.

D. Encourage positive self accolades for dietary adherence: Though reinforcing positive behavior is important in long-term weight loss management, it is not the priority at this moment. The immediate focus is addressing the client's symptoms and ensuring they are medically managed.

A. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation B. Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation C. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L) D. Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L)

Correct Answer is ["A","C","D"]

Explanation

Rationale for correct findings:

Fasting 1-hour glucose screen: 164 mg/dL (9.1 mmol/L): The fasting glucose of 164 mg/dL is elevated, indicating impaired glucose metabolism, which suggests the possibility of gestational diabetes.
3-hour glucose tolerance test: Fasting blood sugar 168 mg/dL (9.3 mmol/L): The fasting blood sugar of 168 mg/dL is above the normal threshold of 140 mg/dL, reinforcing the suspicion of gestational diabetes.
2-hour postprandial glucose: 220 mg/dL (12.2 mmol/L): A postprandial glucose level of 220 mg/dL is significantly above the normal limit of 140 mg/dL, further indicating gestational diabetes.
Fourth child with macrosomia: 9 pounds (4.08 kg) at 41 weeks gestation: Macrosomia is often associated with gestational diabetes. The fourth child weighing 9 pounds suggests the possibility of undiagnosed gestational diabetes during the previous pregnancy, which could be recurring in the current pregnancy.

Rationale for incorrect Findings:

Client is at 28 weeks and has been receiving prenatal care since 8 weeks gestation: The client’s consistent prenatal care since 8 weeks indicates early and regular monitoring, reducing the likelihood of other major complications.

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Naxlex Comprehensive Predictor Exams

A client who had bariatric surgery 2 months ago is admitted because of vomiting and inability to tolerate food and liquids. The client is pain free. Which intervention should the nurse include in the client's plan of care?

Correct Answer is A

Explanation

Correct Answer is ["A","C","D"]

Explanation

The mental health nurse is leading a group about relaxation and explains the benefits of deep breathing for relaxation. As a female client begins to explain how she uses yoga to relax, another client interrupts and asks, "What's yoga?" Which is the nurse's best response?

The nurse is teaching a client's family member about seizure precautions. Which action described by the family member indicates the need for additional teaching?

To evaluate the effectiveness of a male client's new prescription for ezetimibe, which action should the clinic nurse implement?

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.