A male client reports that he recently experienced an episode of chest pressure and breathlessness when he was jogging. The client expresses concern because both of his deceased parents had heart disease and his father had diabetes. He lives with his partner, is a vegetarian, and takes atenolol which maintains his blood pressure at 130/74 mm Hg. Which risk factor(s) should the nurse explore further with the client? Select all that apply.

History of hypertension.

Family health history.

Vegetarian diet.

Sexual history.

Excessive aerobic exercise.

Answer and Explanation

Correct Answer : A,B

A. History of hypertension: Although the client’s current blood pressure is controlled with atenolol, the need for medication confirms a history of hypertension. Hypertension is a major modifiable risk factor for coronary artery disease and warrants ongoing assessment.

B. Family health history: A strong family history of heart disease and diabetes, particularly in first-degree relatives, significantly increases the client’s risk for cardiovascular events. The genetic predisposition should be explored to assess early markers and implement prevention strategies.

C. Vegetarian diet: A vegetarian diet is generally associated with lower cardiovascular risk due to reduced intake of saturated fats and cholesterol. Unless the diet is poorly balanced or nutrient-deficient, it does not constitute a risk factor that requires further evaluation here.

D. Sexual history: Sexual history may be relevant in certain clinical contexts, such as evaluating HIV risk or sexually transmitted infections, but it is not directly related to the client's cardiac symptoms or concern about hereditary heart disease.

E. Excessive aerobic exercise: The client’s activity level (jogging) is not excessive and is generally healthy, unless it is associated with overtraining or extreme exertion. There is no indication here that excessive exercise is a concern, so further exploration is not needed based on this information.

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is ["1.3"]

Explanation

Rationale:

Convert the infant's weight from pounds (lb) to kilograms (kg).

Weight in kg = 22 lb / 2.2 lb/kg

= 10 kg.

Calculate the total daily desired dose in milligrams (mg).

Total daily desired dose (mg) = Desired dose (mg/kg/day) × Weight (kg)

= 20 mg/kg/day × 10 kg

= 200 mg/day.

Determine the number of doses per day.

Doses are given every 8 hours, so Number of doses per day = 24 hours / 8 hours/dose

= 3 doses/day.

Calculate the dose per administration in milligrams (mg).

Dose per administration (mg) = Total daily desired dose (mg) / Number of doses per day

= 200 mg / 3 doses

= 66.666 mg.

Available concentration of the medication = 250 mg / 5 mL.

Calculate the volume in milliliters (mL) to administer per dose.

Volume (mL) = Desired dose per administration (mg) / (Available concentration (mg) / Available volume (mL))

= 66.666 mg / (250 mg / 5 mL)

= 66.666 mg / 50 mg/mL

= 1.333 mL.

Round the answer to the nearest tenth.

= 1.3

A. A child with asthma, who takes prednisone and has a fasting serum glucose of 180 mg/dL (10 mmol/L). B. An adolescent male who has type 1 diabetes and a random glucose at 120 mg/dL (6.7 mmol/L). C. A female who has gestational diabetes and has a 1-hour postprandial glucose at 140 mg/dL (7.8 mmol/L). D. An adult who has type 2 diabetes and has a glycosylated hemoglobin (Hb A1C) at 10%.

Correct Answer is A

Explanation

A. A child with asthma, who takes prednisone and has a fasting serum glucose of 180 mg/dL (10 mmol/L): This client’s fasting glucose is well above the normal range. Prednisone can increase blood glucose levels, placing the child at risk for hyperglycemia. This indicates a need for urgent education on blood glucose management while on steroids.

B. An adolescent male who has type 1 diabetes and a random glucose at 120 mg/dL (6.7 mmol/L): This blood glucose level is within normal limits for random testing. No immediate need for change in diabetic teaching is evident based on this value.

C. A female who has gestational diabetes and has a 1-hour postprandial glucose at 140 mg/dL (7.8 mmol/L): Her result meets the upper limit range for gestational diabetes. While she requires ongoing monitoring, her values do not indicate a need for urgent intervention.

D. An adult who has type 2 diabetes and has a glycosylated hemoglobin (Hb A1C) at 10%: Although this indicates poor long-term control, it reflects a chronic issue. The child with an acutely elevated fasting glucose and corticosteroid use is at greater immediate risk and thus has higher priority for education.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["1.3"]

Explanation

Correct Answer is A

Explanation

Exhibits Click to indicate which client goal is being met by each of the client data. Each column must have at least one response selected.

Which assessment should the home health nurse include during a routine home visit for a client who was discharged home with a suprapubic catheter?

A client arrives to the emergency department with chest pain after taking sildenafil. Based on the client's history, which medication should the nurse withhold?

A client receives a prescription for itraconazole. Which statement made by the client requires additional instruction by the nurse?

The nurse observes the external genitalia of a female client in preparation for inserting an indwelling urinary catheter. At which location should the catheter be inserted? (Mark location on image)

A client who is admitted after an episode of status epilepticus is stabilized. Which finding should the nurse use to determine the client's risk for recurrence of seizure activity?

The healthcare provider prescribes the antibiotic cefdinir 300 mg PO every 12 hours for a client with a postoperative wound infection. Which foods should the nurse encourage this client to eat?

The nurse is caring for a client who underwent a right lobectomy for lung cancer 24 hours ago and has a single chest tube on the right side. Which intervention(s) should the nurse plan to implement? Select all that apply.