The nurse is reviewing the laboratory data of a client diagnosed with coronary artery disease. Which set of laboratory results indicates a need for client teaching regarding dietary modifications?
Cholesterol 200 mg/dL; HDL 35 mg/dL; triglycerides 190 mg/dL
Cholesterol 120 mg/dL; HDL 50 mg/dL; triglycerides 140 mg/dL
Cholesterol 180 mg/dL; HDL 40 mg/dL; triglycerides 220 mg/dL
Cholesterol 165 mg/dL; HDL 54 mg/dL; triglycerides 160 mg/dL
The Correct Answer is C
Choice A reason: This option is not correct because the cholesterol level is within the normal range of less than 200 mg/dL¹, the HDL level is slightly low but not too far from the recommended level of over 40 mg/dL for men and over 50 mg/dL for women¹, and the triglyceride level is also within the normal range of less than 150 mg/dL¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice B reason: This option is not correct because the cholesterol level is low, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice C reason: This option is correct because the cholesterol level is high, the HDL level is low, and the triglyceride level is high. These are all unfavorable results that reflect a high risk of coronary artery disease¹. High cholesterol and triglycerides can lead to plaque buildup in the arteries, which can cause atherosclerosis and reduce blood flow to the heart². Low HDL can also increase the risk of heart disease because it does not help remove LDL (bad cholesterol) from the arteries². Therefore, this set of laboratory results indicates a need for dietary modifications, such as reducing saturated and trans fats, increasing fiber, and limiting alcohol³.
Choice D reason: This option is not correct because the cholesterol level is normal, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not a correct statement. Meat and eggs mostly contain saturated fats, which are fats that have no double bonds between the carbon atoms. Saturated fats are solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should limit the intake of saturated fats to less than 10% of the total calories per day.
Choice B reason: This is not a correct statement. Coconut oil is a saturated fat, which is a fat that has no double bonds between the carbon atoms. Coconut oil is solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should avoid or limit the use of coconut oil and other sources of saturated fats.
Choice C reason: This is the correct statement. Olive oil is a monounsaturated fat, which is a fat that has one double bond between the carbon atoms. Monounsaturated fats are liquid at room temperature and can lower the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should use olive oil and other sources of monounsaturated fats instead of saturated fats.
Choice D reason: This is not a correct statement. Butter is high in saturated fats, which are fats that have no double bonds between the carbon atoms. Saturated fats are solid at room temperature and can raise the level of low-density lipoprotein (LDL) cholesterol in the blood. LDL cholesterol is also known as the "bad" cholesterol because it can deposit on the walls of the arteries and cause atherosclerosis, which is the narrowing and hardening of the arteries. The client should avoid or limit the intake of butter and other sources of saturated fats.
Correct Answer is D
Explanation
Choice A reason: Preparing for endotracheal intubation and ventilatory support is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with respiratory failure or impending airway obstruction, which are not the case for this client.
Choice B reason: Providing continuous sedation for pain relief is not the action that the nurse should take for a client with thyroid storm. This intervention may worsen the client's condition by suppressing the respiratory drive and lowering the blood pressure. The nurse should administer antithyroid medications, beta blockers, and corticosteroids as prescribed to reduce the thyroid hormone levels and the associated symptoms.
Choice C reason: Initiating cardiac monitoring and assessing for reflex bradycardia is not the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with hyperkalemia or digoxin toxicity, which are not the case for this client. The nurse should monitor the client's heart rate and rhythm, but not expect a reflex bradycardia, which is a paradoxical slowing of the heart rate in response to a rapid rise in blood pressure.
Choice D reason: Maintaining IV fluid infusion and assessing adequacy of hydration is the action that the nurse should take for a client with thyroid storm. This intervention is indicated for clients with thyroid storm, as they are at risk of dehydration and electrolyte imbalance due to increased metabolic rate, fever, sweating, vomiting, and diarrhea. The nurse should administer isotonic fluids, such as normal saline, and monitor the client's fluid intake and output, urine specific gravity, and serum electrolytes.
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