A nurse in a community clinic is assessing a client during a visit for routine health maintenance. Which of the following findings indicates the client is at an increased risk for developing heart disease?

The client has a body mass index of 23.

The client recently started vaping.

The client includes insoluble fiber foods in their diet.

The client limits dietary intake of high sugar foods.

Answer and Explanation

The Correct Answer is B

A. The client has a body mass index of 23: A BMI of 23 falls within the normal healthy range (18.5–24.9), which is associated with a lower risk of heart disease compared to overweight or obesity.

B. The client recently started vaping: Vaping introduces nicotine and other harmful chemicals that can increase heart rate, blood pressure, and promote inflammation, all of which elevate the risk for cardiovascular disease. Although often perceived as safer than smoking, vaping still poses significant heart health risks.

C. The client includes insoluble fiber foods in their diet: Insoluble fiber supports digestive health and can indirectly reduce heart disease risk by promoting overall healthy eating habits, but it does not directly increase cardiovascular risk.

D. The client limits dietary intake of high sugar foods: Reducing high sugar intake helps prevent obesity, diabetes, and dyslipidemia, all of which decrease the risk of heart disease, so this behavior is protective rather than a risk factor.

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Correct Answer is A

Explanation

A. Zoster: The zoster vaccine is recommended for older adults, typically starting at age 50 or 60 depending on the specific vaccine formulation (e.g., Shingrix), to prevent shingles and its complications. Older adults are at greater risk for shingles due to declining immunity with age.

B. Rotavirus: The rotavirus vaccine is given in infancy to prevent severe diarrhea caused by the virus. It is not indicated for older adults as they are not at high risk of contracting or being seriously affected by rotavirus.

C. Human papillomavirus: HPV vaccination is primarily recommended for adolescents and young adults, usually up to age 26. It may be considered up to age 45 based on risk, but it is not routinely recommended for older adults.

D. Inactivated poliovirus: The inactivated poliovirus vaccine is typically administered in childhood. Adults rarely need it unless they are traveling to areas where polio is endemic or are at occupational risk, making it unnecessary for routine older adult vaccination.

A. Durable medical power of attorney B. Do-not-resuscitate prescription C. Organ donation card D. A living will

Correct Answer is D

Explanation

A. A durable medical power of attorney designates a trusted person to make healthcare decisions on behalf of the client if they become unable to do so. While important, it focuses on decision-making authority rather than specific treatment preferences.

B. A do-not-resuscitate (DNR) prescription specifically addresses whether resuscitation efforts should be initiated but does not cover broader end-of-life care preferences or wishes. It is one component of advance care planning but not the comprehensive document for overall wishes.

C. An organ donation card expresses the client’s wishes regarding donation of organs after death. Although valuable, it does not address broader end-of-life care decisions or treatments.

D. A living will is a legal document that details the client’s preferences for end-of-life care, including treatments they want to accept or refuse. It ensures that their wishes are honored when they cannot communicate, making it the most appropriate document for this purpose.

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A nurse in a community clinic is assessing a client during a visit for routine health maintenance. Which of the following findings indicates the client is at an increased risk for developing heart disease?

Nursing Test Bank

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