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).

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Warfarin is an anticoagulant, which increases the risk of bleeding. Activities like straining or forceful nose blowing can increase the risk of bleeding, particularly nasal or internal bleeding, so the nurse should advise the client to avoid these actions.

B. Brushing teeth vigorously is not recommended with warfarin because it can lead to bleeding gums. The nurse should suggest using a soft toothbrush and brushing gently.

C. If a dose of warfarin is missed, the client should not double the dose. They should take the missed dose as soon as they remember, unless it's close to the time for the next dose, in which case they should skip the missed dose and resume the normal dosing schedule.

D. Warfarin is an oral medication, so rotating injection sites is not applicable. This advice is more relevant for injectable medications like insulin or heparin.

A. Bilateral lower extremity reddening when legs are dangled in a dependent position. B. Shiny white skin with "hole-punch" ulcers. C. Leathery brown skin with irregular ulcers over the ankles. D. Red, swollen, tender area to one calf.

Correct Answer is C

Explanation

A. Bilateral lower extremity reddening when legs are dangled could be seen in other conditions like deep vein thrombosis (DVT) but is not typical of CVI.

B. Shiny white skin with "hole-punch" ulcers is more characteristic of arterial insufficiency rather than venous insufficiency.

C. Chronic venous insufficiency (CVI) is characterized by impaired venous return, which leads to fluid buildup, skin changes, and ulcer formation. The skin becomes leathery and brown due to hemosiderin deposition from blood pooling in the lower extremities. Ulcers often occur around the ankles and have irregular borders.

D. Red, swollen, tender areas in one calf are more indicative of DVT, not chronic venous insufficiency.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

The nurse is evaluating a client with multiple cardiovascular risk factors. Which of the following assessment findings would be most indicative of chronic venous insufficiency?

Correct Answer is C

Explanation

The nurse is assessing a client diagnosed with peripheral arterial disease. The client reports leg pain and cramping after walking 3 blocks, which is relieved when the client stops and rests. The nurse documents that the client is experiencing which clinical manifestation?

The nurse has finished teaching a patient diagnosed with chronic stable angina about the use of sublingual nitroglycerin (Nitrostat). Which patient statement indicates that the teaching has been effective?

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.

The patient diagnosed with primary hypertension asks why it is called primary and not secondary. What is the best explanation for the nurse to provide?

The nurse has received the laboratory results for a patient who developed chest pain 4 hours ago and may be having a myocardial infarction. Which of the following laboratory test results are most indicative of myocardial damage?

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