The nurse is assessing a 39-year-old client with a blood pressure (BP) of 120/78 mm Hg at rest, a total cholesterol level of 210 mg/dL, HDL cholesterol of 58 mg/dL, triglycerides of 120 mg/dL, and a fasting blood glucose level of 98 mg/dL. Which risk factor for coronary artery disease requires further follow-up?

Diabetes

HDL cholesterol

Triglycerides

Total cholesterol

Answer and Explanation

The Correct Answer is D

A. A fasting blood glucose level of 98 mg/dL is within the normal range (70–99 mg/dL), indicating no immediate concern for diabetes.

B. An HDL cholesterol level of 58 mg/dL is considered protective against CAD, as higher HDL levels are associated with a lower risk of heart disease.

C. Triglyceride levels of 120 mg/dL are within the normal range (less than 150 mg/dL), so they do not require follow-up.

D. A total cholesterol level of 210 mg/dL is slightly above the recommended level of less than 200 mg/dL. Elevated cholesterol, particularly LDL cholesterol, is a key modifiable risk factor for coronary artery disease (CAD).

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Correct Answer is C

Explanation

A. Taking another nitroglycerin tablet without medical supervision is inappropriate and can lead to unsafe drops in blood pressure. This situation requires immediate evaluation by emergency services.

B. Advising the client to come to the office is not appropriate because the client needs immediate emergency care, which cannot be provided in a typical provider’s office.

C. Nitroglycerin is typically used to relieve chest pain from angina, but if the pain persists after taking it, this may indicate a myocardial infarction (MI). The client should call 911 immediately for emergency medical care as chest pain not relieved by nitroglycerin is a critical sign.

D. Antacids are not appropriate for chest pain associated with possible MI, as this pain is not due to acid reflux. Immediate medical intervention is necessary.

A. "I should cut my toenails straight across when clipping them." B. "I should wear shoes and socks instead of open toed shoes." C. 1 should inspect my feet daily for any cuts." D. "I should raise my legs above the level of my heart periodically."

Correct Answer is D

Explanation

A. Cutting toenails straight across is an appropriate action for PAD clients because it prevents injury or infection, as clipping nails too short or rounding the edges can cause cuts or ingrown nails.

B. Wearing shoes and socks instead of open-toed shoes is recommended to protect the feet from injury, as individuals with PAD have decreased sensation in their feet, increasing the risk of unnoticed injury.

C. Inspecting the feet daily for cuts is a crucial step in PAD management to detect early signs of infection or injury, which can lead to complications such as gangrene or amputation.

D. Raising the legs above the heart level can worsen symptoms in PAD by further reducing arterial blood flow to the lower extremities, where circulation is already compromised. This technique is typically used in venous insufficiency, not PAD.

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Naxlex Comprehensive Predictor Exams

A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse?

Correct Answer is C

Explanation

The home care nurse has given instructions to a client who was recently discharged from the hospital regarding the care of their extremities due to peripheral arterial disease. The nurse determines that there is a need for further teaching if the client makes which statement?

Correct Answer is D

Explanation

A patient who has recently started taking simvastatin (Zocor) reports several symptoms to the nurse. Which assessment finding is most important to communicate to the health care provider?

A patient is taking an ACE inhibitor for hypertension. The patient reports a constant, dry, hacking cough. The nurse would expect the provider to change the current treatment to which of the following medications?

The nurse teaches a client at risk for coronary artery disease about necessary lifestyle changes. The nurse determines that the client understands the education if the client makes which statements? Select all that apply.

A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?

The nurse is reviewing laboratory values for a client receiving a continuous heparin infusion. Which of the following laboratory values should the nurse monitor?

The nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. Which items would the nurse include on a list of suggestions for the client? Select all that apply.