A nurse is caring for a client. Identify risk factors for stroke from client's medical record. (Select all that apply.)

Identifying modifiable and non-modifiable stroke risk factors from the client's medical record is essential for comprehensive stroke care. Diabetes mellitus is a well-established stroke risk factor because chronic hyperglycemia damages blood vessels and promotes atherosclerosis, increasing both ischemic and hemorrhagic stroke risk. Hyperlipidemia contributes to atherosclerotic plaque formation in cerebral and carotid arteries, directly increasing ischemic stroke risk — this client is already prescribed pravastatin to manage this condition. Hypertension is the single most important modifiable risk factor for stroke; a blood pressure of 185/105 mmHg on arrival confirms this is an active concern, as sustained high pressure damages arterial walls and promotes thrombus formation. An elevated BMI (32, indicating obesity) is a recognized independent stroke risk factor because it is associated with hypertension, dyslipidemia, insulin resistance, and a pro-inflammatory state. Hypothyroidism, while associated with some cardiovascular effects such as dyslipidemia, is not classified as a direct or well-established independent risk factor for stroke in the same way as the others. The client takes levothyroxine to manage this condition, and hypothyroidism itself does not independently appear on the major stroke risk factor lists used clinically. Therefore, the correct selections are diabetes mellitus, hyperlipidemia, hypertension, and elevated BMI.