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During an initial assessment, a healthcare provider notes that a client has elevated blood pressure. Which of the following findings is considered a major risk factor for coronary artery disease?
- A. Elevated HDL cholesterol
- B. Low LDL cholesterol
- C. Elevated blood pressure
- D. Low triglyceride levels
Correct Answer: C
Rationale: Elevated blood pressure is a significant risk factor for coronary artery disease because it increases the strain on the arteries, leading to potential damage and a higher risk of developing coronary artery disease. Elevated HDL cholesterol (Choice A) is actually considered beneficial as it helps reduce the risk of heart disease. Low LDL cholesterol (Choice B) is also beneficial as high levels of LDL are associated with an increased risk of coronary artery disease. Low triglyceride levels (Choice D) are not typically considered a major risk factor for coronary artery disease.
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A client with type 1 diabetes is admitted to the emergency room with abdominal pain, polyuria, and confusion. What should the nurse implement first?
- A. Administer intravenous insulin.
- B. Start an intravenous fluid bolus.
- C. Obtain a blood glucose level.
- D. Administer an antiemetic.
Correct Answer: B
Rationale: In this scenario, the nurse should first start an intravenous fluid bolus. This intervention is crucial in addressing severe dehydration associated with diabetic ketoacidosis, a life-threatening complication of type 1 diabetes. Administering intravenous insulin (Choice A) is important but should follow fluid resuscitation. Obtaining a blood glucose level (Choice C) is necessary but not as urgent as addressing the dehydration. Administering an antiemetic (Choice D) is not the priority in this situation.
A toddler presenting with a history of intermittent skin rashes, hives, abdominal pain, and vomiting that occurs after ingesting milk products arrives at the clinic accompanied by the parents. Which type of testing should the nurse educate the toddler's family about?
- A. Complete blood count
- B. Lactose tolerance test
- C. Skin allergy testing
- D. Serum immunoglobulin E
Correct Answer: D
Rationale: The correct answer is D, Serum immunoglobulin E (IgE) testing. This test can help diagnose food allergies, including milk protein allergies, in toddlers presenting with symptoms like skin rashes, hives, abdominal pain, and vomiting after consuming milk products. Skin allergy testing is used for allergies but may not be suitable for this age group due to developmental factors. Lactose intolerance, which is different from a milk allergy, is assessed through a lactose tolerance test, not IgE testing. A complete blood count (CBC) would not provide specific information related to food allergies.
An older client who had a subtotal parathyroidectomy is preparing for discharge. What finding requires immediate provider notification?
- A. Afebrile with a normal pulse.
- B. No bowel movement since surgery.
- C. No appetite for breakfast.
- D. A positive Chvostek's sign.
Correct Answer: D
Rationale: A positive Chvostek's sign indicates hypocalcemia, a complication after parathyroid surgery that requires immediate attention. This sign is manifested by facial muscle twitching when the facial nerve in front of the ear is tapped, indicating neuromuscular irritability due to low calcium levels. Afebrile with a normal pulse (Choice A) is a normal finding and does not require immediate notification. No bowel movement since surgery (Choice B) is common postoperatively due to anesthesia effects and pain medications and usually resolves within a few days; it does not require immediate notification unless accompanied by other concerning symptoms. No appetite for breakfast (Choice C) is a common postoperative finding and does not require immediate notification unless it persists and leads to dehydration or malnutrition.
A client receiving continuous ambulatory peritoneal dialysis (CAPD) has lost weight and exhibits increasing edema. What should the nurse prioritize?
- A. Evaluate the patency of the arteriovenous (AV) graft.
- B. Instruct the client to continue a fluid-restricted diet.
- C. Recommend support stockings for venous return.
- D. Monitor the client's serum albumin levels.
Correct Answer: A
Rationale: In a client receiving continuous ambulatory peritoneal dialysis (CAPD) who has lost weight and exhibits increasing edema, the nurse should prioritize evaluating the patency of the arteriovenous (AV) graft. This assessment is crucial to determine if hemodialysis can be resumed, addressing the client's presenting issues effectively. Instructing the client to continue a fluid-restricted diet (choice B) may not address the underlying issue related to the CAPD. Recommending support stockings for venous return (choice C) is not directly relevant to the situation described. Monitoring the client's serum albumin levels (choice D) may be important but does not directly address the immediate concern of weight loss and increasing edema in a CAPD client.
A client with Addison's disease becomes confused and weak. What is the nurse's first action?
- A. Administer a dose of hydrocortisone immediately.
- B. Check the client's electrolyte levels.
- C. Administer a dose of normal saline.
- D. Measure the client's blood pressure in both arms.
Correct Answer: A
Rationale: The correct answer is to administer a dose of hydrocortisone immediately. In Addison's disease, confusion and weakness can be signs of an adrenal crisis. Administering hydrocortisone promptly is crucial to prevent further deterioration. Checking electrolyte levels (Choice B) is important but not the first action in managing an acute adrenal crisis. Administering normal saline (Choice C) is not the priority in this situation. Measuring blood pressure in both arms (Choice D) is not the initial action needed to address the client's confusion and weakness in Addison's disease.