The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

Mild left ventricular hypertrophy on x-ray

Total cholesterol of 210 mg/dL

Hemoglobin A1C of 7.5%

Sodium level of 138

Creatinine level of 1.6

Oxygen saturation of 95% on room air

Answer and Explanation

Correct Answer : A,B,C,E

Choice A reason: Mild left ventricular hypertrophy indicates cardiac strain from chronic hypertension, increasing risk for heart failure or infarction. It reflects structural change, elevating cardiovascular morbidity as pressure overload progresses, a known precursor to serious events.

Choice B reason: Total cholesterol of 210 mg/dL exceeds optimal (<200 mg/dL), promoting atherosclerosis. Lipid plaques narrow arteries, raising risks for coronary artery disease and stroke, a well-established cardiovascular risk factor needing intervention.

Choice C reason: Hemoglobin A1C of 7.5% shows poor glycemic control (>6.5% is diabetes), damaging vessels via glycation. This accelerates atherosclerosis and microvascular complications, significantly increasing cardiovascular event risk in uncontrolled diabetes.

Choice D reason: Sodium of 138 mEq/L is normal (135-145 mEq/L), not impacting cardiovascular risk directly. It influences fluid balance, but this value doesn’t suggest hypertension or heart strain, making it irrelevant here.

Choice E reason: Creatinine of 1.6 mg/dL (>1.2 mg/dL) signals renal impairment, often from hypertension or diabetes. Kidney dysfunction raises cardiovascular risk by disrupting fluid and pressure regulation, contributing to heart disease progression.

Choice F reason: Oxygen saturation of 95% on room air is normal (95-100%), indicating adequate lung function. It doesn’t suggest hypoxia or cardiovascular compromise, so it’s not a risk factor in this context.

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Correct Answer is C

Explanation

Choice A reason: Titrating nitroprusside requires adjusting IV infusion based on MAP, a skilled nursing task. Assistants can’t perform this, as it involves pharmacology and critical judgment beyond their scope in a crisis.

Choice B reason: Setting up a BP machine to monitor every 15 minutes is a technical task within an assistant’s role. It requires no interpretation, supporting the RN’s management of hypertensive crisis safely and effectively.

Choice C reason: Teaching stress relief demands nursing expertise in patient education and psychology. Assistants lack training to deliver this, making it an RN duty to ensure comprehension and relevance in care.

Choice D reason: Evaluating nitroprusside’s effect involves analyzing BP trends and drug response, a clinical skill. Delegation is inappropriate, as assistants can’t assess therapeutic outcomes or adjust care in this critical scenario.

A. The patient is sitting in the tripod position. B. The patient’s pulse oximetry shows a 90% O2 saturation. C. The patient has bibasilar lung crackles. D. The patient’s respiratory rate is 9 breaths/min.

Correct Answer is D

Explanation

Choice A reason: Tripod position aids breathing in COPD by stabilizing accessory muscles, a common adaptation. It signals distress but isn’t immediately life-threatening compared to respiratory rate, as it reflects chronic compensation rather than acute decompensation requiring urgent intervention.

Choice B reason: O2 saturation of 90% is low but typical in COPD due to ventilation-perfusion mismatch. It warrants monitoring, yet it’s less critical than respiratory rate, as supplemental oxygen can correct it, and it’s not an immediate danger sign.

Choice C reason: Bibasilar crackles suggest fluid or infection, uncommon in pure COPD exacerbations, which show wheezing. This finding needs attention but is less urgent than respiratory rate, as it may indicate pneumonia rather than immediate respiratory failure.

Choice D reason: Respiratory rate of 9 breaths/min is alarmingly low in COPD, where tachypnea (20-30 breaths/min) is expected during exacerbation. Bradypnea indicates potential respiratory depression or fatigue, risking CO2 retention and hypoxia, necessitating immediate reporting for intervention.

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The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside. Which nursing action can the nurse delegate to an experienced nursing assistant?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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