How it Works
Try Naxlex NCLEX-RN (Free-Trial)

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.

A.

History of hypertension.

B.

Family health history.

C.

Vegetarian diet.

D.

Sexual history.

E.

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.


Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Free Nursing Study Resources

Related Questions

Correct Answer is ["A","B","C","D","E","G"]

Explanation

Rationale for Correct Findings:

  • The client dilates quickly to 10 cm and feels a strong urge to push: Rapid dilation and the strong urge to push indicate that the client is progressing effectively through labor, with no signs of obstruction or delays.
  • The fetal heart rate is reassuring with a baseline of 145 and moderate variability: A reassuring fetal heart rate with moderate variability is a good sign that the baby is not experiencing any distress during labor, indicating a healthy fetal condition.
  • The head is born easily over an intact perineum: The ease of the baby's head being born over an intact perineum suggests that the delivery is progressing smoothly, with minimal risk of perineal trauma.
  • Apgar of 7 at 1 minute, then 9 at 5 minutes: The Apgar scores of 7 at 1 minute and 9 at 5 minutes show a positive outcome in neonatal assessment, with a good recovery.
  • The fasting blood glucose (FSBG) is 86 (4.8 mmol/L): A fasting blood glucose of 86 mg/dL is within the normal range (74 to 106 mg/dL), indicating that the client’s blood glucose levels are well-controlled, which is a positive sign for managing her gestational diabetes.

Rationale for Negative Finding:

  • The infant weighs 9 lbs. 9 oz (4.34 kgs): Macrosomia (a term used for babies born weighing more than 4 kg) can be associated with gestational diabetes, which increases the likelihood of delivering a larger baby. Macrosomia may lead to potential complications such as shoulder dystocia or increased risk for cesarean delivery.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

Rationale:

  • Pain: The client is reporting intense pain (10 on a 0 to 10 scale) in his left arm, and he is unable to move it. This suggests a possible fracture or significant soft tissue injury. Managing this pain is the priority to ensure the client’s comfort and prevent further complications.
  • Compartment syndrome: Given the swelling, bruising, and coolness to the touch in the left arm, compartment syndrome is a serious risk. This occurs when swelling or bleeding in a muscle compartment increases pressure, potentially compromising blood flow to muscles and nerves. Immediate interventions are required to prevent tissue damage.

Rationale for Incorrect Options:

  • Swelling: While swelling is present, it is a natural part of the healing process and not the primary concern in this case. The risk of compartment syndrome is much more urgent than managing swelling.
  • Mobility: The client’s mobility is impaired due to pain, but pain management must be prioritized before focusing on restoring mobility. Only once pain is controlled should mobility be addressed.
  • Fat embolism syndrome: Although fat embolism syndrome is a risk in traumatic fractures, especially with long bone injuries, the symptoms of this client (swelling, bruising, cool arm) point more directly to the risk of compartment syndrome rather than fat embolism syndrome.
  • Venous thromboembolism (VTE): VTE is a concern in immobilized patients, but in the acute phase, compartment syndrome poses a more immediate threat. The priority is to manage the current trauma and risk for compartment syndrome before considering VTE prevention.

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Register