The nurse is caring for an older client with severe obstructive sleep apnea (OSA) who is reluctant to wear a bi-level positive airway pressure (BIPAP) mask. Which condition has been identified that is often associated with OSA?

Weight loss.

Hypotension.

Gastroesophageal reflux disease.

Insomnia.

Answer and Explanation

The Correct Answer is C

A. Weight loss is incorrect because obstructive sleep apnea is most commonly associated with obesity, not weight loss. Excess fat around the neck and upper airway contributes to airway collapse during sleep. In fact, weight loss is often recommended as part of treatment to improve OSA symptoms, making this option the opposite of what is typically seen.

B. Hypotension is incorrect because OSA is linked to hypertension rather than low blood pressure. Repeated episodes of airway obstruction lead to hypoxia and hypercapnia, which stimulate the sympathetic nervous system. This results in vasoconstriction and increased blood pressure over time, placing the client at risk for cardiovascular complications.

C. Gastroesophageal reflux disease (GERD) is correct because it is commonly associated with OSA. During apneic episodes, the client generates strong inspiratory efforts against an obstructed airway, creating negative intrathoracic pressure. This pressure promotes the movement of gastric contents into the esophagus, leading to reflux. Additionally, factors such as sleeping in a supine position and obesity further contribute to GERD in these clients. This well-established physiological link makes GERD a frequent comorbidity of OSA.

D. Insomnia is incorrect because, although clients with OSA experience disrupted sleep and frequent awakenings, the primary issue is airway obstruction rather than difficulty initiating sleep. Insomnia refers to a separate sleep disorder involving problems falling or staying asleep without a respiratory cause. Therefore, it is not as strongly or directly associated with OSA as GERD.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Rationale for correct choices:
• New onset angina: The client presents with chest pain described as pressure and tightness that started during activity (mowing the lawn) and was unrelieved by rest, which is consistent with unstable angina. The ECG shows ST depression, which is indicative of myocardial ischemia rather than infarction. Since troponin levels are normal, myocardial cell death has not occurred, confirming that this is likely new-onset or unstable angina rather than a myocardial infarction.

• Troponin: Troponin T and I are cardiac biomarkers used to detect myocardial injury. In this client, both troponin levels are within normal limits, indicating no myocardial necrosis has occurred, which helps differentiate angina from a myocardial infarction.

Rationale for incorrect choices:
• Myocardial infarction: Myocardial infarction is characterized by prolonged chest pain with ECG changes and elevated troponin levels indicating cardiac muscle damage. This client’s troponin levels are normal, so myocardial infarction is unlikely at this time.

• Aortic aneurysm: Aortic aneurysm typically presents with sudden, severe, and tearing chest or back pain, often radiating to the back, and is not associated with ST depression on ECG. This presentation does not fit that diagnosis.

• International normalized ratio (INR) or prothrombin time (PT): These are measures of blood coagulation and are not relevant for diagnosing myocardial ischemia or angina. Troponin is the specific biomarker needed to assess myocardial injury.

A. Provide counseling that most contraceptives protect against infection. B. Remain non-judgmental and assure the client of confidentiality. C. Clarify that all STIs are transmitted through sexual intercourse. D. Reassure that complications will not occur if the infection is treated.

Correct Answer is B

Explanation

A. Most contraceptives, such as hormonal methods or intrauterine devices, do not protect against STIs, including HPV. Only barrier methods, such as condoms, offer partial protection. Counseling that contraceptives protect against infection would be inaccurate.

B. Remaining non-judgmental and assuring confidentiality is the most appropriate response. Clients with STIs may feel embarrassment, shame, or fear of stigma. Providing a supportive, professional, and confidential environment encourages open communication, promotes adherence to treatment, and facilitates preventive education.

C. Not all STIs are transmitted exclusively through sexual intercourse. Some infections, like HPV, can also be transmitted through skin-to-skin genital contact, and others can be transmitted perinatally or through blood exposure. Overgeneralizing STI transmission is misleading.

D. Reassuring the client that complications will not occur if the infection is treated is inaccurate. HPV can lead to long-term complications such as cervical dysplasia, genital warts, or increased cancer risk even after treatment. Providing accurate education about potential risks and follow-up is essential.

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The nurse is caring for an older client with severe obstructive sleep apnea (OSA) who is reluctant to wear a bi-level positive airway pressure (BIPAP) mask. Which condition has been identified that is often associated with OSA?

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Naxlex Comprehensive Predictor Exams

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

The nurse is caring for a client with the sexually transmitted infection (STI) human papillomavirus (HPV). The client reports having had prior sexually transmitted infections. Which response should the nurse provide?

Correct Answer is B

Explanation

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