Meet the Client
Meet the Client: Kristin ElrodKristin Elrod, who is 58 years old and postmenopausal, is seen at the
women's health clinic for a routine checkup. She reports to the clinic because she is experiencing fatigue,
vaginal bleeding, and occasional heartburn.
Important to Know
1. Your first answer is the one that counts towards your score, but you’ll be prompted to try again if you
get the wrong answer. When you get the right answer, you’ll go to the next section.
2. If you choose to re-take a Case Study, you will no longer be able to see your previous score.
Section 1
Physical Assessment
Ms. Elrod is alert and oriented x 3. Her complexion is pale and skin is warm to the touch. She describes
her symptoms of vaginal bleeding as intermittent and moderate. Her heartburn occurs she says on a daily
basis and coincides with eating acidic foods like tomatoes. Exercise such as walking is impossible for her
because of the generalized weakness and fatigue she experiences on a daily basis. Her height is 5’ 6”.
The client is obese and weighs 200 lbs. (90.72 kg) with a body mass index (BMI) of 30. Ms. Elrod was
diagnosed with diabetes mellitus 2 years ago and takes oral antidiabetic medication. She says that her
lower left leg feels sore and tender and the nurse notices a red rash with a swollen appearance on the
anterior portion of the leg. Ms. Elrod states her pain level is more like discomfort, but rates it as 4 out of
10. The nurse's initial assessment identifies the client at high risk for coronary artery disease (CAD) and
notifies the healthcare provider (HCP). A lab screening and diagnostic tests are prescribed by the HCP so
the nurse schedules the client for a complete coronary artery disease screening.
Home Medications
Metformin 500 mg, po BID
Lisinopril 20 mg, po BID
Sudafed 12 hour relief 1 tab every morning
Vital Signs
Blood Pressure 175/85 mmHg
Pulse 95 beats/min
Temperature 99° F (37.2° C)
Respirations 20 breaths/min
O2
Sat 95%
Pain level 4/10
Blood Glucose 246
Section 2
Risk Factors
Which information in Kristin's history indicates an increased risk for coronary artery disease (CAD)?
Select all that apply
Frequent episodes of hypoglycemia.
, Hypoglycemia does not increase the risk for CAD. A history of diabetes mellitus is a contributing risk
factor.
Family history of hyperlipidemia.
Genetic predisposition is a significant factor in the development of CAD.
Frequent consumption of a high fat diet.
Unhealthy habits, such as consuming fatty foods, are contributing risk factors to CAD.
Participation in a bowling league.
Physical inactivity is a major modifiable risk factor for CAD, but participation in athletic events is not a risk
factor.
Smoking two packs of cigarettes per day.
Other risk factors identified by the nurse include obesity and reported job stress.
Which intervention should the nurse consider when assisting Kristin in achieving her goal to quit smoking.
Identify 4 feelings associated with smoking.
Asking the client to identify her feelings associated with smoking is a step toward cognitive behavioral
change, and it is a client-specific goal.
Discuss smoking cessation before the end of the shift.
This is a nursing goal, not a client-centered goal.
Provide education concerning the health risks associated with long-term cigarette use.
While this is an important concept, this is a nursing goal, not a client goal.
Insist that she give up cigarettes within 1 week.
This goal may not be realistic, and it potentially sets up the client for failure.
Section 3
Therapeutic Communication: Noncompliance
Kristin has numerous risk factors for CAD and she takes the clinic's online learning course on reducing
the risk for heart disease. At the conclusion of the course, Kristin tells the nurse, "I don't need more of
these classes because God will take care of my heart."
What is the best response by the nurse?
"I believe that God helps those who help themselves."
Therapeutic communication should be free of the nurse's personal values. This blocks further
communication.
"You will have a heart attack if you don't change your lifestyle."
This statement is overly threatening and confrontational, and it does not promote further communication.
"Do you feel that you do not need to be involved in your health care?"
Clarification of the client's statement is a useful therapeutic technique that encourages further
communication.
"You must accept that you have a responsibility to care for yourself."
This statement is confrontational and does not promote further communication.
Submit
After further discussion, Kristin agrees to go to her scheduled lab appointment, and she considers making
some modifications in her lifestyle.
Section 4
Client Teaching: Hyperlipidemia
Meet the Client: Kristin ElrodKristin Elrod, who is 58 years old and postmenopausal, is seen at the
women's health clinic for a routine checkup. She reports to the clinic because she is experiencing fatigue,
vaginal bleeding, and occasional heartburn.
Important to Know
1. Your first answer is the one that counts towards your score, but you’ll be prompted to try again if you
get the wrong answer. When you get the right answer, you’ll go to the next section.
2. If you choose to re-take a Case Study, you will no longer be able to see your previous score.
Section 1
Physical Assessment
Ms. Elrod is alert and oriented x 3. Her complexion is pale and skin is warm to the touch. She describes
her symptoms of vaginal bleeding as intermittent and moderate. Her heartburn occurs she says on a daily
basis and coincides with eating acidic foods like tomatoes. Exercise such as walking is impossible for her
because of the generalized weakness and fatigue she experiences on a daily basis. Her height is 5’ 6”.
The client is obese and weighs 200 lbs. (90.72 kg) with a body mass index (BMI) of 30. Ms. Elrod was
diagnosed with diabetes mellitus 2 years ago and takes oral antidiabetic medication. She says that her
lower left leg feels sore and tender and the nurse notices a red rash with a swollen appearance on the
anterior portion of the leg. Ms. Elrod states her pain level is more like discomfort, but rates it as 4 out of
10. The nurse's initial assessment identifies the client at high risk for coronary artery disease (CAD) and
notifies the healthcare provider (HCP). A lab screening and diagnostic tests are prescribed by the HCP so
the nurse schedules the client for a complete coronary artery disease screening.
Home Medications
Metformin 500 mg, po BID
Lisinopril 20 mg, po BID
Sudafed 12 hour relief 1 tab every morning
Vital Signs
Blood Pressure 175/85 mmHg
Pulse 95 beats/min
Temperature 99° F (37.2° C)
Respirations 20 breaths/min
O2
Sat 95%
Pain level 4/10
Blood Glucose 246
Section 2
Risk Factors
Which information in Kristin's history indicates an increased risk for coronary artery disease (CAD)?
Select all that apply
Frequent episodes of hypoglycemia.
, Hypoglycemia does not increase the risk for CAD. A history of diabetes mellitus is a contributing risk
factor.
Family history of hyperlipidemia.
Genetic predisposition is a significant factor in the development of CAD.
Frequent consumption of a high fat diet.
Unhealthy habits, such as consuming fatty foods, are contributing risk factors to CAD.
Participation in a bowling league.
Physical inactivity is a major modifiable risk factor for CAD, but participation in athletic events is not a risk
factor.
Smoking two packs of cigarettes per day.
Other risk factors identified by the nurse include obesity and reported job stress.
Which intervention should the nurse consider when assisting Kristin in achieving her goal to quit smoking.
Identify 4 feelings associated with smoking.
Asking the client to identify her feelings associated with smoking is a step toward cognitive behavioral
change, and it is a client-specific goal.
Discuss smoking cessation before the end of the shift.
This is a nursing goal, not a client-centered goal.
Provide education concerning the health risks associated with long-term cigarette use.
While this is an important concept, this is a nursing goal, not a client goal.
Insist that she give up cigarettes within 1 week.
This goal may not be realistic, and it potentially sets up the client for failure.
Section 3
Therapeutic Communication: Noncompliance
Kristin has numerous risk factors for CAD and she takes the clinic's online learning course on reducing
the risk for heart disease. At the conclusion of the course, Kristin tells the nurse, "I don't need more of
these classes because God will take care of my heart."
What is the best response by the nurse?
"I believe that God helps those who help themselves."
Therapeutic communication should be free of the nurse's personal values. This blocks further
communication.
"You will have a heart attack if you don't change your lifestyle."
This statement is overly threatening and confrontational, and it does not promote further communication.
"Do you feel that you do not need to be involved in your health care?"
Clarification of the client's statement is a useful therapeutic technique that encourages further
communication.
"You must accept that you have a responsibility to care for yourself."
This statement is confrontational and does not promote further communication.
Submit
After further discussion, Kristin agrees to go to her scheduled lab appointment, and she considers making
some modifications in her lifestyle.
Section 4
Client Teaching: Hyperlipidemia
