While obtaining a client’s health history related to smoking cigarettes, the nurse plans to determine the client’s smoking pack years. What information should the nurse obtain for this calculation? Select all that apply.
Packs of cigarettes smoked per day.
Number of attempts to quit smoking.
Client’s current age.
Age when the client started smoking.
Number of years the client smoked.
Correct Answer : A,D,E
Choice A rationale
Packs of cigarettes smoked per day is essential information for calculating smoking pack years.
Choice B rationale
The number of attempts to quit smoking is not required for calculating smoking pack years.
Choice C rationale
The client’s current age is not required for calculating smoking pack years.
Choice D rationale
The age when the client started smoking is necessary to determine the total number of years smoked.
Choice E rationale
The number of years the client smoked is essential for calculating smoking pack years.
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Correct Answer is D
Explanation
Choice A rationale
A BMI of 32 kg/m² is not considered an appropriate weight for height. According to the American Heart Association, a BMI between 18.5 and 24.9 kg/m² is considered normal weight. A BMI of 32 kg/m² falls into the obese category, which indicates excess body fat and potential health risks.
Choice B rationale
While a BMI of 32 kg/m² is classified as obese, it is not categorized as extreme obesity. Extreme obesity is typically defined as a BMI of 40 kg/m² or higher. Therefore, this choice is incorrect.
Choice C rationale
A BMI of 32 kg/m² does not indicate undernutrition or malnutrition. Undernutrition is associated with a BMI of less than 18.5 kg/m². This choice is incorrect as the BMI in question indicates obesity, not undernutrition.
Choice D rationale
A BMI of 32 kg/m² is classified as obese. Obesity is a serious threat to well-being as it increases the risk of various health conditions, including heart disease, diabetes, hypertension, and certain cancers. Therefore, this choice is correct.
Correct Answer is B
Explanation
Choice A rationale
A 75-year-old with a pneumothorax and a chest tube may have a displaced PMI due to the pneumothorax, but it is not necessarily difficult to locate. The chest tube may also cause some displacement, but it is not the primary factor affecting PMI location.
Choice B rationale
A 54-year-old who is 5 feet (152.4 cm) tall and weighs 300 pounds (136.1 kg) is likely to have difficulty locating the PMI due to the increased adipose tissue. Obesity can make it challenging to palpate the PMI as the excess tissue can obscure the heart’s apex.
Choice C rationale
A 2-year-old who is demonstrating diaphragmatic breathing may have a PMI that is slightly higher and more medial than in adults, but it is generally not difficult to locate.
Choice D rationale
A 45-year-old long-distance runner with a body mass index (BMI) of 18 kg/m² is likely to have a more prominent PMI due to a leaner body composition and a potentially enlarged heart from athletic conditioning.