In assessing a client's major risk factors for heart disease, which of the following should the nurse include in the history?

Smoking, hypertension, obesity, diabetes, and hyperlipidemia.

Family history, stress, hypertension, and age.

Alcohol consumption, obesity, diabetes, stress, hyperlipidemia.

Personality type, hyperlipidemia, diabetes, and smoking.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Smoking, hypertension, obesity, diabetes, and hyperlipidemia are all well-established risk factors for heart disease. Smoking damages the lining of the arteries, leading to a buildup of fatty material which narrows the artery. Hypertension can cause hardening and thickening of the arteries, which can lead to a heart attack or stroke. Obesity increases the likelihood of high blood pressure, high cholesterol levels, and diabetes, all of which are risk factors for heart disease. Diabetes increases the risk of heart disease significantly, as high blood sugar levels can damage blood vessels and the nerves that control the heart. Hyperlipidemia, particularly high levels of LDL cholesterol, can lead to plaque buildup in the arteries, increasing the risk of heart attack or stroke.

Choice B Reason:

Family history is a non-modifiable risk factor for heart disease, as genetics can play a role in an individual's likelihood of developing heart conditions. Stress can contribute to heart disease risk factors such as hypertension and is associated with other unhealthy behaviors. Hypertension and age are both significant risk factors; the risk of heart disease increases with age and with sustained high blood pressure.

Choice C Reason:

Alcohol consumption in excess can lead to high blood pressure, heart failure, or stroke. Obesity, diabetes, and stress are all risk factors as previously mentioned. Hyperlipidemia is also a modifiable risk factor that can be managed through diet, exercise, and medication.

Choice D Reason:

Personality type itself is not a direct risk factor for heart disease, but certain personality traits can lead to stress, which is a risk factor. Hyperlipidemia, diabetes, and smoking are all direct risk factors for heart disease as they contribute to the development of cardiovascular conditions.

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Correct Answer is B

Explanation

Choice A Reason
Increased urine output is not a direct indicator of the effectiveness of nitroglycerin for angina pectoris. Nitroglycerin is a vasodilator used primarily to relieve chest pain by improving blood flow to the heart muscle, not to influence urine production.

Choice B Reason
Asking the client if their chest pain has been relieved is the most direct method of evaluating the effectiveness of nitroglycerin. Relief of chest pain indicates that the medication is working as intended, reducing the ischemia that causes angina.

Choice C Reason
While taking the client's blood pressure is important, especially since nitroglycerin can cause hypotension, it is not the primary method for evaluating the effectiveness of the medication in relieving angina. Blood pressure measurements are more of a safety check to monitor for adverse effects.

Choice D Reason
Ambulation and assessing for the absence of dyspnea can be part of an overall evaluation of the client's cardiovascular status, but they are not specific to evaluating the effectiveness of nitroglycerin for angina relief. Dyspnea may be a symptom of heart failure or other conditions, not specifically angina pectoris.

A. Creatinine level is 0.8 mg/dL. B. Potassium level is 4.2 mEq/L. C. White blood cell count is 9,000 mm³. D. Hemoglobin is 7.1 g/dL.

Correct Answer is D

Explanation

Choice A Reason
A creatinine level of 0.8 mg/dL falls within the normal range for adults, which is typically 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. This indicates normal kidney function and is not a cause for immediate intervention post-operatively.

Choice B Reason
A potassium level of 4.2 mEq/L is within the normal range, which is generally between 3.6 and 5.2 mEq/L. This level indicates a stable electrolyte balance and is not a cause for immediate concern following shoulder replacement surgery.

Choice C Reason
A white blood cell (WBC) count of 9,000 mm³ is within the normal range, which typically spans from 4,500 to 11,000 WBCs per mm³. This suggests there is no active infection or inflammation that requires immediate intervention.

Choice D Reason
A hemoglobin level of 7.1 g/dL is considered low, as the normal range for adult males is generally 13.8 to 17.2 g/dL and for adult females is 12.1 to 15.1 g/dL. Low hemoglobin can indicate anemia, which may be due to blood loss during surgery or other underlying conditions. This requires immediate intervention to address potential oxygenation issues and determine the cause of the anemia.

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In assessing a client's major risk factors for heart disease, which of the following should the nurse include in the history?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To evaluate the effectiveness of nitroglycerin 0.4 mg SL administered to a client diagnosed with angina pectoris, the nurse should:

Correct Answer is B

Explanation

Which data is cause for immediate intervention for a client after a right shoulder replacement?

Correct Answer is D

Explanation

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