A client admitted with an acute exacerbation of Ménière's disease asks the student nurse why he was prescribed diphenhydramine. Which response by the student nurse requires correction by the primary nurse?

Choice A Reason: This is correct because clinical obesity is a risk factor for metabolic syndrome. Clinical obesity is defined by having a body mass index (BMI) of 30 or higher, or a waist circumference of more than 40 inches for men or 35 inches for women. Obesity can increase insulin resistance and inflammation, which can lead to metabolic syndrome.

Choice B Reason: This is correct because elevated blood pressure is a risk factor for metabolic syndrome. Elevated blood pressure is defined by having a systolic blood pressure of 130 mm Hg or higher, or a diastolic blood pressure of 85 mm Hg or higher. High blood pressure can damage the blood vessels and increase the risk of cardiovascular disease, which is associated with metabolic syndrome.

Choice C Reason: This is correct because high triglycerides are a risk factor for metabolic syndrome. Triglycerides are a type of fat that circulates in the blood and provides energy for the cells. High triglycerides are defined by having a level of 150 mg/dL or higher. High triglycerides can increase the risk of fatty liver disease and pancreatitis, which are related to metabolic syndrome.

Choice D Reason: This is correct because hypercholesterolemia is a risk factor for metabolic syndrome. Hypercholesterolemia is defined by having a total cholesterol level of 200 mg/dL or higher, or a low-density lipoprotein (LDL) cholesterol level of 100 mg/dL or higher. LDL cholesterol is also known as "bad" cholesterol because it can build up in the arteries and cause plaque formation and narrowing, which can lead to cardiovascular disease and metabolic syndrome.

Choice E Reason: This is correct because hyperglycemia is a risk factor for metabolic syndrome. Hyperglycemia is defined by having a fasting blood glucose level of 100 mg/dL or higher, or a hemoglobin A1c level of 5.7% or higher. Hemoglobin A1c is a measure of average blood glucose over three months. Hyperglycemia can indicate impaired glucose metabolism and insulin resistance, which are hallmarks of metabolic syndrome.

Choice A Reason: This is incorrect because drawing with crayons may be too childish or frustrating for a client with moderate Alzheimer's. Crayons may also pose a choking hazard or cause messes. The nurse should provide activities that are suitable for the client's cognitive and functional level, as well as their interests and preferences.

Choice B Reason: This is incorrect because dangling ribbons or a mobile may be too stimulating or confusing for a client with moderate Alzheimer's. These items may also trigger agitation or wandering behaviors. The nurse should provide activities that are calming and familiar for the client.

Choice C Reason: This is correct because listening to music, watching TV, or videos can be enjoyable and beneficial for a client with moderate Alzheimer's. Music can evoke memories, emotions, and positive responses. TV or videos can provide entertainment, education, and socialization. The nurse should choose music, TV shows, or videos that are appropriate and meaningful for the client.

Choice D Reason: This is incorrect because board games may be too complex or challenging for a client with moderate Alzheimer's. Board games may require memory, concentration, logic, or strategy skills that the client may have lost. The nurse should provide activities that are simple and easy for the client to follow.