A nurse is caring for a client in an outpatient clinic.
Click to highlight the findings that are risk factors for the client developing a complication. To deselect a finding, click on the finding again.
Nurses' Notes
3 months ago:
61-year-old male client presents with reports of dizziness, palpitations, fatigue. and dyspnea with exertion. Reports that dizziness and palpitations started 2 months ago. Fatigue and dyspnea with exertion started 1 week ago. Has smoked 1 pack of cigarettes per day for 40 years.
Past medical history.
History of hyperlipidemia.
Walks at least a mile three times a week. Reports drinking two to three beers each evening
Client reports he follows the Dietary Approaches to Stop Hypertension (DASH) diet.
Family history.
Biological father has a history of hyperlipidemia and hypertension. Biological mother has history of renal failure requiring dialysis.
Physical examination:
- Weight 88.6 kg (195.3 lb)
- Height 170.2 cm (5 ft 7 in)
- BMI 30.5
61-year-old male
Has smoked 1 pack of cigarettes per day for 40 years.
History of hyperlipidemia.
Walks at least a mile three times a week.
Reports drinking two to three beers each evening
Client reports he follows the Dietary Approaches to Stop Hypertension (DASH) diet.
Biological father has a history of hyperlipidemia and hypertension.
Biological mother has history of renal failure requiring dialysis.
BMI 30.5
The Correct Answer is ["A","B","C","E","G","H","I"]
Rationale for correct choices
• 61-year-old male: Advanced age and male sex increase the risk of cardiovascular complications such as coronary artery disease, heart failure, and stroke. Aging contributes to arterial stiffness, reduced cardiac reserve, and higher likelihood of comorbidities, all of which elevate the risk profile for this client.
• Has smoked 1 pack of cigarettes per day for 40 years: Chronic smoking is a major modifiable risk factor for atherosclerosis, myocardial infarction, stroke, and peripheral arterial disease. Long-term tobacco use promotes endothelial damage, increases LDL cholesterol, and impairs oxygen delivery, significantly increasing cardiovascular risk.
• History of hyperlipidemia: Elevated cholesterol and triglycerides predispose the client to plaque formation in arteries, contributing to atherosclerosis and cardiovascular disease. Hyperlipidemia is a key risk factor for complications such as myocardial infarction and stroke, especially when combined with other comorbidities.
• Reports drinking two to three beers each evening: Excessive alcohol consumption contributes to hypertension, cardiomyopathy, and arrhythmias. Chronic alcohol intake can also exacerbate hyperlipidemia and increase the risk of liver disease, compounding cardiovascular and systemic complications.
• BMI 30.5: A BMI above 30 classifies the client as obese, which increases the risk for hypertension, type 2 diabetes, heart disease, and stroke. Obesity contributes to metabolic syndrome and further stresses the cardiovascular system, making the client more prone to complications.
• Family history: Biological father with hyperlipidemia and hypertension, Biological mother with renal failure: A strong family history of cardiovascular and renal disease increases the client’s genetic susceptibility to these conditions. Inherited risk factors, when combined with lifestyle factors, significantly elevate the likelihood of developing complications such as heart failure, chronic kidney disease, or stroke.
Rationale for incorrect choices
• Walks at least a mile three times a week: Regular physical activity is protective, not a risk factor, for cardiovascular and metabolic complications. Exercise helps improve lipid profile, blood pressure, and overall cardiovascular health, mitigating some of the client’s other risk factors.
• Client reports he follows the DASH diet: Adhering to the DASH diet is a positive lifestyle behavior that reduces blood pressure, supports heart health, and lowers the risk of stroke or heart disease. It is not a risk factor; rather, it is a mitigating factor against cardiovascular complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A","dropdown-group-3":"A"}
Explanation
Rationale for correct choices
• deep vein thrombosis (DVT): The client displays classic findings of DVT, including unilateral leg swelling, warmth, inflammation, and increased calf circumference. These findings, paired with a sedentary lifestyle and recent trauma to the leg, strongly indicate development of a thrombus in the affected extremity.
• Unequal leg circumference: The right calf measures 45.72 cm while the left measures 40.64 cm, showing significant unilateral swelling. A difference greater than 3 cm is strongly associated with DVT due to venous obstruction and impaired return, causing fluid accumulation and increased limb girth.
• Ultrasound results: The duplex ultrasound shows loss of venous compressibility and a thrombus in the right leg. These findings are diagnostic for DVT, confirming venous obstruction and establishing the cause of the client’s symptoms and leg swelling.
Rationale for incorrect choices
• undiagnosed fracture: A fracture would typically produce severe pain, deformity, or inability to bear weight, none of which are strongly present. The ultrasound confirms thrombosis, and the symptoms align more with venous obstruction than bone injury.
• cellulitis of a leg bone: Cellulitis usually presents with diffuse skin redness, warmth, and often fever. Although the leg is warm and inflamed, the presence of a venous thrombus on ultrasound and significant calf size difference more accurately support DVT rather than an infectious process.
• Difficulty walking: Difficulty walking can occur from many causes, such as arthritis or recent injury, and is not specific enough to confirm DVT. Objective findings like limb circumference and ultrasound imaging better demonstrate the underlying condition.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Rationale for correct choices
• Limb immobilization: Immobilization is the primary treatment for a nondisplaced fracture to maintain bone alignment, promote healing, and prevent further injury. Splints, casts, or braces may be used depending on the fracture location and stability. Proper immobilization also helps reduce pain and swelling by limiting movement of the injured extremity.
• Pain medication: Pain management is essential to ensure comfort and facilitate cooperation with care. Mild to moderate pain from a nondisplaced fracture can be managed with acetaminophen or ibuprofen. Effective analgesia also helps the child maintain mobility of unaffected areas and reduces stress associated with the injury.
Rationale for incorrect choices
• Antibiotics: Antibiotics are not routinely prescribed for closed fractures unless there is an open wound or risk of infection. The child’s abrasion on the knee may require topical care, but systemic antibiotics are not indicated for the fracture itself.
• Bed rest: Strict bed rest is not necessary for a nondisplaced upper extremity fracture. The child can usually participate in age-appropriate activities while the limb is immobilized, as long as the extremity is protected.
• Surgical consultation: Surgical intervention is typically reserved for displaced fractures, open fractures, or fractures with neurovascular compromise. This child’s fracture is nondisplaced and stable, so surgery is not anticipated at this stage.
• Skin traction: Skin traction is generally used for lower extremity fractures or severe fractures requiring alignment before surgical intervention. It is not indicated for a stable, nondisplaced forearm fracture in a child.
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