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Exhibits

The nurse is reviewing the client's medical record.

Select the 2 findings the nurse should identify as placing the client at risk for cardiovascular disease.

A.

Exercise

B.

Diet

C.

LDL level

D.

BMI

E.

HDL level

Answer and Explanation

Correct Answer : C,D

Rationale for Correct Answers:

  • LDL level: An LDL level of 145 mg/dL exceeds the recommended limit (<130 mg/dL), increasing the client’s risk for atherosclerosis and coronary artery disease. Elevated LDL contributes to plaque buildup in arterial walls, narrowing the vessels and raising the likelihood of myocardial infarction and stroke.
  • BMI: A BMI of 29.8 falls in the overweight range (25–29.9), nearing obesity. Excess body weight, particularly visceral fat, is associated with hypertension, insulin resistance, and dyslipidemia, all of which are significant risk factors for cardiovascular disease.

Rationale for Incorrect Answers:

  • Exercise: The client walks 30 minutes 5 days a week, meeting the American Heart Association’s guidelines for physical activity. Regular aerobic exercise reduces blood pressure, improves lipid profiles, and strengthens cardiac function.
  • Diet: The client reports following a Mediterranean diet, which is associated with lower cardiovascular risk due to its emphasis on fruits, vegetables, whole grains, lean protein, and healthy fats. Although wine consumption is noted, moderation aligns with Mediterranean patterns.
  • HDL level: The client’s HDL is 58 mg/dL, which is above the desired threshold (>55 mg/dL). Higher HDL levels offer cardioprotective effects by helping remove cholesterol from the bloodstream and reducing the risk of plaque buildup.


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Related Questions

Correct Answer is D

Explanation

A. Seizure: While seizures may occur in severe cases of hypernatremia, they are more typically associated with hyponatremia, where cerebral edema is more prominent due to water shifts into brain cells.
B. Elevated hematocrit: An elevated hematocrit may be seen with dehydration, which can accompany hypernatremia, but it is not a direct or reliable indicator of sodium imbalance itself.
C. Bradypnea: Respiratory changes like bradypnea are not characteristic of hypernatremia. This condition primarily affects the neurological system, not the respiratory system.
D. Personality change: Hypernatremia causes cellular dehydration, particularly in brain cells, leading to neurological symptoms such as confusion, agitation, irritability, and personality changes.

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

Explanation

Rationale for Correct Choices:

• Compartment syndrome: Occurs when pressure within a closed muscle compartment compromises circulation and tissue function. The client presents with classic signs: pain out of proportion, pallor (cool foot), pulselessness (non-palpable pulses), paresthesia (numbness), and paralysis (inability to move foot/toes) which are hallmark signs of compromised perfusion.

  • Osteomyelitis: The presence of drainage from the splint site, increasing temperature, and markedly elevated WBC count (from 14,000 to 28,000/mm³) strongly suggest developing bone infection. The client’s open fracture and internal fixation increase susceptibility, especially with new signs of systemic infection and localized inflammation at the injury site.

Rationale for Incorrect Choices:

• Deep vein thrombosis (DVT): While trauma and immobility increase DVT risk, there is no evidence of unilateral leg swelling, calf tenderness, or redness. The primary concern here is neurovascular compromise, not venous thromboembolism, and the symptoms point more urgently to compartment syndrome and infection.

• Fat embolism syndrome: Fat embolism is a risk with long bone fractures, typically presenting within 24–72 hours with respiratory distress, hypoxia, confusion, and a petechial rash. This client is alert and not in respiratory distress, with normal oxygen saturations and no mental status changes, making fat embolism less likely at this stage.

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