The nurse is reviewing laboratory values of a client who was discharged two weeks ago after experiencing a myocardial infarction. Which finding most requires follow-up with the client?

Reference Range:

Triglycerides [40 to 160 mg/dL (0.45 to 1.81 mmol/L)]

Lipase [0 to 160 units/L (0 to 2.67 μkat/L)]

Low-density lipoproteins (LDL) [less than 130 mg/dL (3.36 mmol/L)]

High-density lipoproteins (HDL) [greater than 45 mg/dL (greater than 1.16 mmol/L)]

Low-density lipoproteins (LDL) 185 mg/dL (4.79 mmol/L).

Triglycerides 155 mg/dL (1.75 mmol/L).

Lipase 50 units/L (0.83 μkat/L).

High-density lipoproteins (HDL) 60 mg/dL (1.55 mmol/L).

Answer and Explanation

The Correct Answer is A

A. Low-density lipoproteins (LDL) 185 mg/dL (4.79 mmol/L): This LDL value is significantly above the recommended level for a client with a history of myocardial infarction. Elevated LDL contributes to atherosclerotic plaque formation and increases the risk of further cardiac events.

B. Triglycerides 155 mg/dL (1.75 mmol/L): Although this value is at the higher end of the normal range, it is still within acceptable limits. While elevated triglycerides are a cardiovascular risk factor, this level alone does not require urgent follow-up.

C. Lipase 50 units/L (0.83 μkat/L): This lipase level is well within the normal range and is not relevant to cardiac health. Lipase is typically used to evaluate pancreatic function and has no direct bearing on post-myocardial infarction follow-up.

D. High-density lipoproteins (HDL) 60 mg/dL (1.55 mmol/L): This HDL value is above the recommended minimum and is actually considered protective against heart disease. No follow-up is needed for this value, as it reflects favorable cardiovascular risk status.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Encourage the use of an albuterol inhaler: Although asthma is part of the client’s history, administering albuterol without assessment might delay recognition of a more serious complication, such as pulmonary embolism.

B. Administer a PRN dose of alprazolam: Anxiety may worsen shortness of breath, but treating symptoms as psychological without an assessment may overlook critical conditions like hypoxia or embolism.

C. Observe the incision for bleeding or dehiscence: While checking the incision is important, it is not the priority in a client with acute respiratory symptoms. Incisional issues are unlikely to cause sudden-onset dyspnea and restlessness following ambulation.

D. Evaluate vital signs including oxygen saturation: The priority action is to assess the client’s current respiratory and circulatory status. Acute shortness of breath and restlessness may indicate hypoxia, pulmonary embolism, or another life-threatening event, and vital signs will help guide urgent interventions.

A. A description of the chest pain when client is at rest. B. A demonstration of the activity that precipitates pain. C. A complete seven (7) day diet history of client's oral intake. D. The client's blood pressures sitting and standing.

Correct Answer is A

Explanation

A. A description of the chest pain when client is at rest: Determining whether the pain occurs at rest helps differentiate stable from unstable angina. Stable angina typically resolves with rest and is exertion-related, while pain at rest may suggest unstable angina.

B. A demonstration of the activity that precipitates pain: While understanding what provokes the pain is helpful, a physical demonstration is unnecessary and potentially dangerous, especially if it might trigger another anginal episode.

C. A complete seven (7) day diet history of client's oral intake: Dietary intake is not immediately relevant for evaluating recent angina symptoms. Priority should be placed on identifying acute features that may signal unstable angina or myocardial infarction.

D. The client’s blood pressures sitting and standing: Assessing for orthostatic hypotension is useful in evaluating dizziness or syncope but does not directly address the nature or severity of chest pain. It is not the priority assessment for symptoms of angina pectoris following exertion.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of anxiety and asthma had an open cholecystectomy 3 days ago. Shortly after ambulating to the bathroom, the client is restless and troubled by shortness of breath. Which action should the nurse implement first?

Correct Answer is D

Explanation

The nurse at a primary healthcare provider's (HCPs) office is assessing a middle aged client who describes having symptoms of angina pectoris that occured while doing yard work. Which additional finding should the nurse obtain?

Correct Answer is A

Explanation

At midnight, an older male client with heart failure who is receiving 02 at 4 L/minute suddenly awakens with dyspnea. The nurse determines that he has audible rhonchi, tachycardia, and is cold and clammy. Which action should the nurse implement first?

The nurse is monitoring the client's cardiac rhythm. Based on this strip, which is the correct interpretation of this rhythm?

A client with pneumonia is dyspneic, and the nurse positions the client in a high Fowler's position. The oxygen flow rate is 3 L/minute, and the client's pulse oximeter reading is 96%. An hour later the pulse oximeter reading is 88%. Which action should the nurse take first?

The nurse auscultates a client's heart sounds and hears a midsystolic click associated with mitral valve prolapse. Which diagnostic test should the nurse prepare the client to expect the healthcare provider (HCP) to prescribe?

A male client with angina pectoris is being discharged from the hospital. Which instruction should the nurse plan to include in his discharge teaching?

A client is admitted with chest pain and is rubbing the left arm. The nurse initiates oxygen at 4 L/minute, and administers a dose of aspirin PO, nitroglycerin sublingually, and morphine sulfate IV. Which additional assessment should the nurse consider for a myocardial infarction (MI)?