An African American 58-year-old man in good health has a blood pressure of 120/73 mm Hg at his annual physical examination. Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age?
Alter modifiable risk factors
Maintain tight glycemic control
Recognize disease in its early stages
Prevent cardiovascular disease
The Correct Answer is D
Choice A reason: Altering modifiable risk factors is a good goal for anyone who wants to improve their health and wellness, but it is not specific to the case of the African American man who already has a normal blood pressure and no apparent health problems. Modifiable risk factors are those that can be changed by lifestyle choices, such as smoking, diet, exercise, stress, or alcohol consumption.
Choice B reason: Maintaining tight glycemic control is a relevant goal for people who have diabetes or prediabetes, as it can help prevent or delay the complications of high blood sugar, such as nerve damage, kidney damage, or eye damage. However, there is no indication that the African American man has diabetes or prediabetes, so this goal is not applicable to him.
Choice C reason: Recognizing disease in its early stages is a general goal for everyone who wants to prevent or treat health problems, but it is not specific to the case of the African American man who has no signs or symptoms of any disease. Moreover, this goal is more reactive than proactive, as it implies waiting for disease to occur rather than preventing it.
Choice D reason: Preventing cardiovascular disease is the best goal for the nurse to use to assist the African American man in maintaining his health and wellness into older age, as it is specific, proactive, and evidence-based. According to the American Heart Association, high blood pressure is a major risk factor for cardiovascular disease, and it is more prevalent and severe among African Americans than other racial groups. Therefore, the nurse would advise the African American man to monitor his blood pressure regularly, follow a healthy diet, exercise moderately, avoid smoking, and take medication if needed to prevent cardiovascular disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Crushing chest pain is the classic sign of an AMI, but it can be absent in some older men with an AMI. This is because older men may have a reduced pain perception due to aging, diabetes, or other conditions that affect the nerve endings. Older men may also have atypical or silent AMIs, which do not cause chest pain or other obvious symptoms.
Choice B reason: Epigastric burning is not a classic sign of an AMI, but it can be a symptom of an AMI in some older men. Epigastric burning may be mistaken for indigestion, heartburn, or gastritis, but it can also indicate ischemia or injury to the lower part of the heart.
Choice C reason: Dyspnea and fatigue are not classic signs of an AMI, but they can be symptoms of an AMI in some older men. Dyspnea and fatigue may be attributed to aging, deconditioning, or other chronic diseases, but they can also indicate reduced oxygen supply to the heart and the body.
Choice D reason: Vague complaints are not classic signs of an AMI, but they can be symptoms of an AMI in some older men. Vague complaints may include anxiety, restlessness, nausea, dizziness, or weakness, which may be overlooked or dismissed as minor ailments, but they can also indicate a serious cardiac event.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the classic sign of an AMI that can be absent in an older man with an AMI.

Correct Answer is C
Explanation
Choice A reason: Serum sodium levels are not the best determination of hydration in this client, as they can be affected by other factors, such as fluid intake, fluid loss, kidney function, or medication use. Serum sodium levels can be normal, high, or low in a dehydrated or overhydrated client, depending on the cause and type of the fluid imbalance.
Choice B reason: BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is excreted by the kidneys. BUN is not the best determination of hydration in this client, as it can be influenced by other factors, such as protein intake, liver function, or muscle breakdown. BUN can be high or low in a dehydrated or overhydrated client, depending on the cause and type of the fluid imbalance.
Choice C reason: Urine osmolality is the best determination of hydration in this client, as it measures the concentration of solutes in the urine, which reflects the ability of the kidneys to adjust the urine output according to the fluid status. Urine osmolality can indicate the degree of dehydration or overhydration in a client, as it increases or decreases in response to the fluid balance.
Choice D reason: Urine color is not the best determination of hydration in this client, as it can be affected by other factors, such as food, medication, or infection. Urine color can be dark or light in a dehydrated or overhydrated client, depending on the cause and type of the fluid imbalance.
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