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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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Review the need for the UAP to wear a face mask while in close contact with the client: Influenza is transmitted through respiratory droplets, so the UAP should wear a mask in addition to gown and gloves when assisting the client.

B. Remind the UAP to apply a fitted respirator mask before entering the client's room:
A fitted respirator mask (e.g., N95) is generally used for airborne precautions such as tuberculosis which requires droplet precautions. A face mask is sufficient in this case.

C. Assign the UAP to provide care for another client and assume full care of the client:
While it may be necessary to adjust staffing, this is an extreme response. The UAP can continue caring for the client with proper precautions.

D. Instruct the UAP to notify the nurse of any changes in the client's respiratory status:
While it is always important for the UAP to report changes in the client’s condition, this action does not address the immediate concern about PPE use.

A. Wear closed-toe shoes that are comfortable and fit well. B. Obtain an A1C blood test every year to monitor glucose control. C. Check blood sugar levels every four to six hours every day. D. Restrict alcoholic beverages to no more than 1 to 2 per week.

Correct Answer is A

Explanation

A. Wear closed-toe shoes that are comfortable and fit well: Wearing well-fitting shoes helps prevent foot injuries and complications, which are common in people with diabetes due to neuropathy and poor circulation. Foot care is crucial for diabetes management.

B. Obtain an A1C blood test every year to monitor glucose control: The A1C test should be done at least twice a year if the client’s blood sugar is under control, or more often if adjustments are needed.

C. Check blood sugar levels every four to six hours every day: Most individuals with type 2 diabetes need to check blood sugar based on specific times like before meals or once daily, not every few hours.

D. Restrict alcoholic beverages to no more than 1 to 2 per week: Moderate alcohol intake may be allowed in some cases, but more frequent consumption can affect blood sugar. The goal is to limit intake, not restrict to a specific number per week.

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Naxlex Comprehensive Predictor Exams

An older adult client with a history of heart failure is admitted with influenza and requests assistance to sit up in bed to eat lunch. The nurse observes the unlicensed assistive personnel (UAP) wearing a gown and gloves to assist the client. Which action should the nurse take?

Correct Answer is A

Explanation

The nurse is providing teaching to a client newly diagnosed with type 2 diabetes mellitus about disease management. Which response by the client indicates understanding?

Correct Answer is A

Explanation

Exhibits The client has started to wake up more, opening her eyes without stimulation and looking around the room. Which should the nurse do as the client becomes more aware of her surroundings? Select all that apply.

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.

The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

Exhibits Which information from the history and physical, nurses' note, and flow sheet requires further evaluation? Select all that apply.

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?