A nurse is reviewing the medical record of a client who has a history of coronary artery disease. The nurse should identify which of the following as a risk factor? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.)

Total cholesterol level

Diet

Medications

Supplement use

None

Answer and Explanation

The Correct Answer is C

Coronary artery disease (CAD) risk factors include nonmodifiable factors such as age and gender, and modifiable factors such as lipid levels, lifestyle habits, and medication use. Certain medications can increase cardiovascular risk by influencing lipid metabolism, coagulation, or vascular function. In women, hormone therapy is a well-recognized contributor to increased thrombotic and cardiovascular events. Nurses must evaluate all aspects of the patient’s history, including prescribed therapies, when identifying risk factors.

Rationale:
A. Total cholesterol level is within a desirable range and does not indicate a risk factor in this client. A total cholesterol of 150 mg/dL is considered within normal limits and does not independently increase CAD risk. Risk is more associated with elevated LDL and low HDL rather than total cholesterol alone in this case.

B. Diet is not a risk factor in this scenario because the client follows a vegan diet, which is generally associated with lower saturated fat intake and improved cardiovascular outcomes. This dietary pattern is typically considered protective rather than harmful in relation to coronary artery disease.

C. Medications are a significant risk factor because the client is taking Conjugated estrogen. Estrogen therapy is associated with increased risk of thromboembolic events and can contribute to cardiovascular complications in certain populations. In a client with existing CAD and anginal symptoms, hormone therapy is considered a modifiable risk factor that may worsen cardiovascular outcomes.

D. Supplement use is not identified as a primary risk factor in this case. The client’s use of fish oil supplements is generally associated with potential cardiovascular benefits such as triglyceride reduction. Although supplements should always be reviewed for interactions, they are not the most significant risk factor compared to estrogen therapy in this scenario.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Safe disposal of sharps after subcutaneous injections is essential to prevent needlestick injuries, infection transmission, and environmental contamination. Clients who self-administer injections at home must be taught proper handling and disposal techniques for used needles and syringes. Standard safety guidelines emphasize immediate placement of sharps into a rigid, puncture-resistant container without manipulation of the needle. Correct disposal practices protect both the client and others in the household and community.

Rationale:
A. Using a puncture-proof container is the correct method for sharps disposal because it prevents accidental needlestick injuries and exposure to bloodborne pathogens. These containers are designed to safely contain needles and syringes without risk of puncture or leakage. Immediate disposal into such a container ensures safe handling at home and complies with standard infection control practices.

B. Removing the needle from the syringe before disposal is unsafe and increases the risk of accidental needlestick injury. Manipulating used needles can expose the client or caregiver to bloodborne pathogens. Sharps should always be disposed of as a single unit without disassembly to maintain safety.

C. Placing used syringes in a plastic bag and then into household trash is inappropriate and unsafe. Plastic bags are not puncture-resistant and can easily be penetrated by needles, posing a risk to sanitation workers and others. Sharps must never be discarded in regular household waste.

D. Collecting used syringes in a marked biohazard bag is not typically recommended for home use unless specifically provided by a healthcare facility or program. Biohazard bags alone are not puncture-proof and may not provide adequate protection against needlestick injuries. Approved sharps containers are the standard and safest method for home disposal.

A. Shoe protectors B. N95 respirator C. Surgical mask D. Sterile gloves

Correct Answer is B

Explanation

Tuberculosis is a highly contagious airborne infection caused by Mycobacterium tuberculosis. It spreads through airborne droplet nuclei that remain suspended in the air and can be inhaled by others. Infection control requires strict airborne precautions to prevent transmission to healthcare workers and other patients. Proper use of personal protective equipment is essential during routine care to reduce exposure risk.

Rationale:
A. Shoe protectors are not required for tuberculosis isolation because the organism is not transmitted through contact with footwear or contaminated floors. TB spreads through airborne particles rather than environmental surface contamination. Therefore, shoe covers do not provide meaningful protection.

B. An N95 respirator is required because it filters airborne particles and protects the nurse from inhaling droplet nuclei containing Mycobacterium tuberculosis. It is specifically designed for airborne precautions and must be properly fitted to ensure effectiveness. This is the appropriate PPE for routine care of a client with active tuberculosis.

C. A surgical mask is not sufficient protection against airborne pathogens like tuberculosis because it does not filter small aerosolized particles effectively. Surgical masks are intended for droplet precautions, not airborne isolation. A surgical mask does not provide adequate protection for healthcare workers in this situation.

D. Sterile gloves are not required for routine care of a client with tuberculosis unless sterile procedures are being performed. While gloves are used for contact with body fluids, they do not protect against airborne transmission. The primary protective equipment needed is respiratory protection rather than sterile hand protection.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who requires self-administration of subcutaneous injections at home. Which of the following statements by the client indicates correct understanding of safe sharps disposal practices?

Correct Answer is A

Explanation

A nurse is assisting in the care of a client who has tuberculosis. Which of the following personal protective equipment should the nurse wear during routine care for this client?

Correct Answer is B

Explanation

A nurse in a psychiatric unit is admitting a client who has self-inflicted cuts on their forearms. Which of the following is a priority response by the nurse?

A nurse delegates a task to an assistive personnel (AP) and the AP refuses to complete the assigned task. Which of the following actions should the nurse take?

A nurse is caring for a client who is 2 days postoperative. Which of the following findings should the nurse identify as an indication of postoperative infection?

A nurse is planning care for a client who recently attempted suicide. Which of the following actions should the nurse plan to take?

A nurse is assisting with the care of a client in the clinic. Complete the following sentence by using the lists of options. The client is at greatest risk for developing dropdowndue to use ofdropdown.

A nurse is discussing the plan of care of a client who is 4 hr postoperative and has a urostomy with an assistive personnel. Which of the following statements should the nurse include in the discussion?

A nurse is reinforcing teaching with a client about a low-sodium diet. Which of the following foods should the nurse recommend?

A nurse is using the assistance of an interpreter to reinforce discharge teaching to a client who does not speak the same language as the nurse. Which of the following actions should the nurse plan to take when working with an interpreter?