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The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?
- A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.
- B. A 43-year-old male with a family history of CAD and cholesterol level of 158.
- C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).
- D. A 65-year-old female who is obese with an LDL of 188.
Correct Answer: D
Rationale: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.
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What is the priority nursing action for a client with a suspected neurological deficit?
- A. Perform a full neurological assessment.
- B. Administer pain medication.
- C. Monitor vital signs.
- D. Notify the physician.
Correct Answer: C
Rationale: Monitoring vital signs is the priority to ensure stability and detect acute changes in a client with a suspected neurological deficit.
The nurse is admitting a client with glaucoma. The client brings prescribed eye drops from home and insists on using them in the hospital. The nurse should:
- A. Allow the client to keep the eye drops at the bedside and use as prescribed on the bottle.
- B. Place the eye drops in the medication drawer and administer as labeled on the bottle.
- C. Explain to the client that the physician will write an order for the eye drops to be used at the hospital.
- D. Ask the client's wife to assist the client in administering the eye drops while the client is in the hospital.
Correct Answer: C
Rationale: The nurse should explain that the physician needs to write an order for the eye drops to ensure they are appropriate and safe for hospital use, maintaining medication safety protocols.
Ergotamine tartrate (Gynergen) is prescribed for a client's migraine headaches. The client's report of which of the following indicates effectiveness?
- A. Prevention of the migraine.
- B. Reduced severity of the developing migraine.
- C. Relief from the sleeplessness experienced in the past after a migraine.
- D. Relief from the vision problems experienced in the past after a migraine.
Correct Answer: B
Rationale: Ergotamine reduces the severity of developing migraines by constricting cranial blood vessels. It is not primarily preventive or used for post-migraine sleeplessness or vision issues.
The client is admitted with left lower leg pain, a positive Homans' sign, and a temperature of 100.4°F (38°C). The nurse should assess the client further for signs of:
- A. Aortic aneurysm
- B. Deep vein thrombosis (DVT) in the left leg
- C. I.V. drug abuse
- D. Intermittent claudication
Correct Answer: B
Rationale: Left leg pain, positive Homans' sign (pain on dorsiflexion), and low-grade fever suggest deep vein thrombosis (DVT). Further assessment for swelling, redness, or warmth confirms this. Aortic aneurysm, I.V. drug abuse, and claudication present differently.
The nurse receives the preoperative blood work report for a client who is scheduled to undergo surgery. Which of the following laboratory findings should be reported to the surgeon?
- A. Red blood cells, 4.5 million/mm³.
- B. Creatinine, 2.6 mg/dL.
- C. Hemoglobin, 12.2 g/dL.
- D. Blood urea nitrogen, 15 mg/dL.
Correct Answer: B
Rationale: A creatinine level of 2.6 mg/dL indicates renal impairment, which can affect anesthesia and surgical outcomes. This must be reported to the surgeon. The other values are within normal ranges.