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":"C","dropdown-group-2":"A"}
Explanation
Rationale for correct choices
• an endoscopy: The client reports a 3-week history of gnawing, burning epigastric pain that radiates to the back, worsens after meals, and is accompanied by one episode of dark, tarry stool. These symptoms suggest a possible peptic ulcer or gastrointestinal bleeding. An endoscopy is the definitive diagnostic procedure to visualize the gastric mucosa, identify ulcers, and assess for bleeding.
• stool test results: The presence of a dark, tarry stool indicates possible gastrointestinal bleeding (melena). Stool testing, such as a fecal occult blood test, provides objective evidence of bleeding and guides the urgency and necessity of endoscopy. This finding is a key indicator for further gastrointestinal evaluation.
Rationale for incorrect choices
• oxygen via nonrebreather mask: The client’s respiratory assessment shows bilateral clear breath sounds and no signs of hypoxia. Oxygen therapy is not indicated based on current findings, as there is no respiratory compromise.
• an antifungal prescription: There is no evidence of fungal infection. The client’s symptoms are consistent with gastrointestinal pathology, not a fungal etiology. Prescribing an antifungal would be inappropriate without clinical or laboratory indications.
• respiratory rate: The respiratory rate is normal and does not correlate with the presenting gastrointestinal symptoms. It is not a primary indicator for diagnostic intervention in this case.
• temperature: The client does not report fever or signs of infection at this time. While monitoring temperature is standard, it is not a primary indicator for diagnosing peptic ulcer disease or gastrointestinal bleeding in this scenario.
Correct Answer is B
Explanation
Rationale:
A. Dietary intake: The client ate 75% of breakfast, which indicates adequate oral intake. While monitoring nutrition is important in schizophrenia, this finding does not pose an immediate safety concern or require urgent reporting.
B. Sore throat: A sore throat in a client taking clozapine is significant because clozapine can cause agranulocytosis, a potentially life-threatening reduction in white blood cells. Any signs of infection, such as sore throat or fever, must be reported immediately to prevent serious complications.
C. Heart rate: A heart rate of 98/min is slightly elevated but within acceptable limits for many adults. This finding alone does not indicate an urgent issue requiring immediate provider notification.
D. Blood pressure: A blood pressure of 102/56 mm Hg is slightly low but may be within the client’s normal range, particularly if the client experiences dizziness when changing positions. While it should be monitored, it does not require urgent reporting unless symptoms worsen.
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