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 D

Explanation

A. Antihistamines can raise blood pressure, but this is less likely to be the primary cause compared to medication non-adherence.

B. Acetaminophen is generally safe for use in hypertensive patients and is unlikely to contribute to the high blood pressure in this scenario.

C. Stress can contribute to elevated blood pressure, but non-adherence to medications is a more likely cause of the severe BP elevation in this case.

D. Poor medication adherence is a common cause of elevated blood pressure despite treatment. If the client has not been consistently taking their antihypertensive medications, this could explain the elevated BP and symptoms (headache, blurred vision).

A. "I can continue smoking but only 1 pack a week instead of 2." B. "I will be sure to include some exercise such as walking in my daily activities." C. "It is acceptable to eat red meat and cheese every day as I have been doing, as long as I cut down on the butter." D. "I will work at losing some weight so that my weight is at normal range for my age." E. "I will schedule regular doctor appointments for physical examinations and monitoring my blood pressure."

Correct Answer is ["B","D","E"]

Explanation

A. Smoking, even at a reduced rate, still significantly increases the risk of CAD, so reducing smoking to only one pack a week is not an acceptable solution.

B. Regular exercise, such as walking, is beneficial for managing coronary artery disease (CAD), improving cardiovascular fitness, and reducing risk factors like hypertension and obesity.

C. Consuming red meat and cheese daily is not recommended for CAD management due to the high saturated fat content, which can raise cholesterol levels and worsen the condition. A heart-healthy diet typically limits these foods.

D. Maintaining a healthy weight through weight loss is a key factor in managing CAD risk, as obesity contributes to hypertension, diabetes, and lipid imbalances.

E. Regular doctor appointments for physical exams and monitoring blood pressure are essential for managing CAD and preventing complications such as heart attacks or strokes.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

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.

Correct Answer is ["B","D","E"]

Explanation

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?

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