A 46-year-old African American man is in an outpatient clinic for a physical examination. His blood pressure (BP) is 126 mm Hg, his body mass index (BMI) is 24, and he reports no previous medical problems. Which of the following actions should the nurse take?

Schedule his next appointment for 1 year from now.

Provide information for a weight loss plan that includes increasing physical activity.

Provide information about how to reduce risk factors of hypertension.

Schedule an appointment for a prostate-specific antigen (PSA) test.

Answer and Explanation

The Correct Answer is D

Choice A reason: Scheduling the next appointment for 1 year from now is a standard practice for patients who are considered to be in good health and have no immediate medical concerns. Given the patient's normal BP and BMI, along with no reported medical problems, this would typically be an appropriate action. However, it is essential to consider the patient's age and race, as African American men are at a higher risk for certain conditions, such as prostate cancer, which may warrant more frequent monitoring.

Choice B reason: While providing information for a weight loss plan that includes increasing physical activity is generally beneficial, it may not be necessary for this patient. His BMI is 24, which falls within the normal range (18.5-24.9), indicating that he is not overweight. Therefore, unless the patient expresses a desire to lose weight or improve fitness, this action might not be a priority.

Choice C reason:Offering information on reducing risk factors for hypertension is always a positive step in preventive healthcare. However, the patient's BP is 126 mm Hg, which is considered a normal reading (normal BP range is 90/60 mm Hg to 120/80 mm Hg). Therefore, while education on maintaining a healthy lifestyle is valuable, it may not be the most critical action for this visit.

Choice D reason:Scheduling a PSA test is recommended for African American men starting at age 45 due to their increased risk of prostate cancer. The PSA test measures the level of prostate-specific antigen in the blood, which can be an indicator of prostate cancer. Given the patient's demographic, this proactive screening measure is advisable, despite the absence of symptoms or previous medical problems.

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Correct Answer is B

Explanation

Choice A reason : An erythrocyte sedimentation rate (ESR) test is not directly related to high serum potassium levels and would not be the immediate action in response to hyperkalemia.

Choice B reason : Obtaining a 12-lead ECG is a critical step when hyperkalemia is suspected because high potassium levels can cause life-threatening cardiac arrhythmias. An ECG can quickly reveal characteristic changes associated with hyperkalemia, allowing for prompt treatment.

Choice C reason : Administering potassium gluconate would be contraindicated in a patient with hyperkalemia, as it would further increase the serum potassium levels, potentially leading to severe complications.

Choice D reason : Restricting fluid intake is not a standard treatment for hyperkalemia. The management of hyperkalemia may include medications or procedures that promote the excretion of potassium or move potassium from the blood into the cells.

A. "I will be placing some electrodes on your chest and extremities." B. "Be sure to remain still once I have attached the gel pads." C. "You might feel some slight pressure during the procedure." D. "The test will be complete in a few minutes."

Correct Answer is A

Explanation

Choice A reason : This instruction is accurate because for a standard 12-lead ECG, electrodes are placed on the patient's chest and extremities to record the electrical activity of the heart. The placement of these electrodes is crucial for accurate readings and diagnosis. The electrodes do not emit electricity; they merely record and measure the electrical activity in your heart, providing essential information to the medical provider.

Choice B reason : Remaining still during an ECG is important to prevent artifacts that can interfere with the interpretation of the heart's electrical activity. Movement can cause the readings to be inaccurate, which is why patients are advised to remain still once the electrodes are in place.

Choice C reason : While the client might feel some pressure from the electrodes, the term 'tingling' is not accurate as the ECG is a painless procedure. The electrodes may cause mild irritation upon the skin, but there is otherwise no sensation associated with the test itself.

Choice D reason : The duration of the test is indeed short, typically only a few minutes, but this is not the primary instruction. The nurse should first inform the client about the electrode placement, which is essential for the procedure. The ECG will only take a few minutes in total once the procedure is underway, not counting equipment set-up time.

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A 46-year-old African American man is in an outpatient clinic for a physical examination. His blood pressure (BP) is 126 mm Hg, his body mass index (BMI) is 24, and he reports no previous medical problems. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L. The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is B

Explanation

A nurse is preparing to perform a 12-lead electrocardiogram (ECG). Which of the following instructions should the nurse provide to the client?

Correct Answer is A

Explanation

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