The nurse is reviewing the laboratory data of a client diagnosed with coronary artery disease. Which set of laboratory results indicates a need for client teaching regarding dietary modifications?
Cholesterol 200 mg/dL; HDL 35 mg/dL; triglycerides 190 mg/dL
Cholesterol 120 mg/dL; HDL 50 mg/dL; triglycerides 140 mg/dL
Cholesterol 180 mg/dL; HDL 40 mg/dL; triglycerides 220 mg/dL
Cholesterol 165 mg/dL; HDL 54 mg/dL; triglycerides 160 mg/dL
The Correct Answer is C
Choice A reason: This option is not correct because the cholesterol level is within the normal range of less than 200 mg/dL¹, the HDL level is slightly low but not too far from the recommended level of over 40 mg/dL for men and over 50 mg/dL for women¹, and the triglyceride level is also within the normal range of less than 150 mg/dL¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice B reason: This option is not correct because the cholesterol level is low, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice C reason: This option is correct because the cholesterol level is high, the HDL level is low, and the triglyceride level is high. These are all unfavorable results that reflect a high risk of coronary artery disease¹. High cholesterol and triglycerides can lead to plaque buildup in the arteries, which can cause atherosclerosis and reduce blood flow to the heart². Low HDL can also increase the risk of heart disease because it does not help remove LDL (bad cholesterol) from the arteries². Therefore, this set of laboratory results indicates a need for dietary modifications, such as reducing saturated and trans fats, increasing fiber, and limiting alcohol³.
Choice D reason: This option is not correct because the cholesterol level is normal, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Avoiding strenuous activity and standing up slowly is not a relevant response to the client's complaint of headache. These actions may help prevent or reduce orthostatic hypotension, which is another possible side effect of nitroglycerin, but not headache.
Choice B reason: Headache is expected and should subside with continued use is a correct and appropriate response to the client's complaint of headache. The nurse should explain that headache is a common and transient side effect of nitroglycerin, which is caused by the vasodilation effect of the drug. The nurse should also advise the client to take over-the-counter analgesics, such as acetaminophen, to relieve the headache.
Choice C reason: Reducing the dosage to help relieve this side effect is not a correct or appropriate response to the client's complaint of headache. The nurse should not suggest any changes in the prescribed dosage of nitroglycerin, as this may compromise the effectiveness of the drug and increase the risk of angina or myocardial infarction. The nurse should also remind the client to follow the instructions for applying and removing the Nitropatch.
Choice D reason: You will have this side effect as long as you are taking nitroglycerin is not a correct or appropriate response to the client's complaint of headache. The nurse should not discourage or alarm the client by implying that the headache is inevitable and permanent. The nurse should reassure the client that the headache will likely diminish over time as the body adapts to the drug.
Correct Answer is D
Explanation
Choice A reason: I will call dietary to bring you breakfast is not the best response by the nurse. This response may imply that the nurse is willing to compromise the test results or the client's safety by allowing them to eat before the test. The nurse should explain the rationale for fasting and offer the client some water or ice chips if allowed.
Choice B reason: Food may interact with the dye that is used for the test is not the best response by the nurse. This response may be partially true, but it is not specific or clear enough to justify the need for fasting. The nurse should explain that food can affect the absorption and distribution of the radioactive tracer that is injected into the bloodstream for the test, and that eating can also interfere with the quality of the images.
Choice C reason: I will ask the health care provider if the test can be rescheduled is not the best response by the nurse. This response may suggest that the nurse is not confident or knowledgeable about the test protocol or the client's condition. The nurse should explain the importance and urgency of the test and reassure the client that they will be able to eat after the test is done.
Choice D reason: The procedure is usually completed on an empty stomach is the best response by the nurse. This response is accurate and concise, and it informs the client of the standard preparation for the test. The nurse should also provide more details about the test procedure and the expected duration, and answer any questions or concerns that the client may have.
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