The nurse is evaluating a client for cardiovascular risk factors. Which laboratory result places the client at increased risk for cardiovascular disease?

HD cholesterol 60 mg/di

Total cholesterol 210 mg/at

LDL cholesterol 110 me di

Hgb A1C 5.3%

Answer and Explanation

The Correct Answer is C

A) "HDL cholesterol 60 mg/dL":
This is not a risk factor. High-density lipoprotein (HDL) is often referred to as "good cholesterol" because it helps remove excess cholesterol from the bloodstream, lowering the risk of atherosclerosis and cardiovascular disease. An HDL level of 60 mg/dL is considered protective against cardiovascular disease, as higher levels of HDL are associated with a lower risk of heart disease.

B) "Total cholesterol 210 mg/dL":
This is not a significant risk factor on its own. While total cholesterol above 200 mg/dL is a general indicator for cardiovascular risk, it is not as important as the breakdown of individual lipid components (HDL, LDL). A total cholesterol of 210 mg/dL is only slightly above the ideal less than 200 mg/dL, and on its own, it is not a strong indicator of increased cardiovascular risk without considering other factors like LDL and HDL levels.

C) "LDL cholesterol 110 mg/dL":
. Low-density lipoprotein (LDL) is known as "bad cholesterol" because it can lead to the buildup of plaque in the arteries, increasing the risk for atherosclerosis, heart disease, and stroke. An LDL level of 110 mg/dL is considered to be above optimal. For individuals at risk for cardiovascular disease, the target LDL cholesterol level is usually less than 100 mg/dL, and for those with high risk, it may be less than 70 mg/dL. Therefore, this level of LDL cholesterol places the client at increased risk for cardiovascular disease.

D) "Hgb A1C 5.3%":
This is not a risk factor. An Hgb A1C of 5.3% is within the normal range for glycemic control. The American Diabetes Association defines normal A1C as below 5.7%. A1C levels between 5.7% and 6.4% are considered pre-diabetes, and a level of 6.5% or higher indicates diabetes. A normal A1C level indicates no significant elevated blood glucose, which would be a risk factor for cardiovascular disease.

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Correct Answer is C

Explanation

A) Strains are associated with fractured bone that are tearing blood vessels:
Strains refer to injuries of muscles or tendons due to overuse, overstretching, or tearing. A strain does not typically involve fractured bones or tearing blood vessels. Sprains, on the other hand, involve ligaments, not muscles or tendons, and may or may not involve fractures or tearing of blood vessels.

B) "A strain should be treated with heat in the first 24 hours then ice after:
. The general recommendation for the initial treatment of a strain (and sprain) is rest, ice, compression, and elevation (R.I.C.E.) within the first 24-48 hours. Ice should be applied during this period to reduce swelling and inflammation, not heat. Heat may be used after the first 48 hours to promote healing and reduce muscle stiffness, but it should not be used during the acute phase of the injury.

C) A sprain involves stretching or tearing or tearing of ligaments at a joint:
This is the correct statement. A sprain is an injury to a ligament, which is the tissue connecting bones to other bones. It is typically caused by stretching, overextension, or tearing of the ligament, often resulting from a sudden or awkward movement at a joint. Sprains commonly occur at areas such as the ankle, knee, and wrist.

D) A sprain involves tearing of a muscle body or tendon:
. A sprain involves damage to a ligament, not a muscle or tendon. Damage to muscles or tendons is classified as a strain, not a sprain. Strains refer to overuse or tearing of muscle fibers or tendons, not ligaments.

A. Pernicious anemia B. Blood loss anemia C. Sickle cell anemia D. Aplastic anemia

Correct Answer is B

Explanation

A. Pernicious anemia:
Pernicious anemia is primarily caused by a deficiency in vitamin B12, often due to a lack of intrinsic factor needed for absorption in the gut. It typically presents with symptoms like weakness, fatigue, and neurological manifestations such as numbness or tingling. However, the client’s presentation does not suggest a vitamin B12 deficiency or neurological signs. Additionally, pernicious anemia is not typically associated with heavy menstrual periods,
which are more indicative of blood loss anemia.

B. Blood loss anemia:
Blood loss anemia is the most likely diagnosis in this case, especially in the context of heavy menstrual periods, which can cause significant blood loss over time. The client’s hemoglobin level of 6.9 g/dL indicates severe anemia, which is consistent with the cumulative effects of chronic blood loss. This type of anemia results from a decrease in red blood cell count due to bleeding, which can lead to symptoms like weakness, fatigue, and pallor.

C. Sickle cell anemia:
Sickle cell anemia is a genetic condition characterized by abnormally shaped red blood cells, which can lead to hemolysis and episodes of pain. While it can cause symptoms like fatigue and weakness, sickle cell anemia typically presents earlier in life and is more associated with episodes of severe pain and organ damage. Additionally, the patient’s history does not mention episodes of pain or other hallmark signs of sickle cell disease, such as swelling in the hands or feet or recurrent infections.

D. Aplastic anemia:
Aplastic anemia occurs when the bone marrow fails to produce enough blood cells, including red blood cells, white blood cells, and platelets. It presents with symptoms like weakness, fatigue, frequent infections, and bruising. Although this client does have anemia, the lack of additional signs (such as petechiae, infections, or bleeding) makes this diagnosis less likely. Aplastic anemia is also usually diagnosed with bone marrow biopsy, which is not suggested by this client's presentation.

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The nurse is evaluating a client for cardiovascular risk factors. Which laboratory result places the client at increased risk for cardiovascular disease?

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