The nurse calculates the body mass index (BMI) for an adult client who is obese. Which additional assessment finding places the client at high risk for cardiac disease?

Choice A reason: While high serum insulin levels can be indicative of insulin resistance and metabolic syndrome, they are not as directly related to cardiac risk as large waist circumference.

Choice B reason: Hyperpigmentation on neck skin folds, also known as acanthosis nigricans, can indicate insulin resistance and metabolic syndrome but is not as strong a predictor of cardiac disease as central obesity.

Choice C reason: Poor muscle tone is not a direct indicator of cardiac disease risk. It can be associated with overall health and fitness but is not as specific a risk factor for cardiac disease.

Choice D reason: Large waist circumference with central fat, also known as abdominal obesity, is a well-known risk factor for cardiovascular disease. Central fat is associated with increased risk of heart disease, hypertension, and diabetes, making it a significant indicator to monitor.

Choice A reason: Lifting weights every other day might not be harmful, but it is not specifically relevant to managing chronic venous insufficiency. The statement does not indicate an understanding of the specific care needed for this condition.

Choice B reason: Avoiding sitting and crossing the legs is an important measure to prevent worsening of chronic venous insufficiency. Crossing legs can impede blood flow and worsen symptoms. This statement reflects an understanding of how to manage the condition.

Choice C reason: Standing for prolonged periods, even if there is no pain, can exacerbate venous insufficiency. This statement shows a misunderstanding of the importance of movement and elevation of the legs to promote blood flow.

Choice D reason: Walking is generally encouraged to promote circulation in clients with venous insufficiency. The statement about needing someone else to walk the dog may indicate a misunderstanding of the benefits of regular, gentle exercise.