Nokea
The client on furosemide (Lasix) is complaining of muscle cramps. What electrolyte imbalance should the nurse suspect?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypocalcemia
- D. Hypokalemia
Correct Answer: D
Rationale: The correct answer is D: Hypokalemia. Furosemide is a loop diuretic that causes potassium excretion, leading to low potassium levels and muscle cramps. Hypokalemia is associated with muscle weakness and cramps due to altered muscle function. Hyperkalemia (A) is high potassium levels, not typically associated with furosemide. Hyponatremia (B) is low sodium levels, not directly related to furosemide use. Hypocalcemia (C) is low calcium levels, which can cause muscle cramps but is not the most likely electrolyte imbalance with furosemide.
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Which of the following is a type of heart attack that occurs when the blood supply to part of the heart muscle is severely reduced or stopped?
- A. Myocardial infarction
- B. Angina
- C. Stroke
- D. Congestive heart failure
Correct Answer: A
Rationale: The correct answer is A: Myocardial infarction. A myocardial infarction, commonly known as a heart attack, happens when the blood flow to a part of the heart muscle is blocked, leading to damage or death of the tissue due to lack of oxygen. Angina (B) is chest pain due to reduced blood flow to the heart but does not cause permanent damage like a heart attack. Stroke (C) is a brain-related condition caused by interrupted blood flow to the brain. Congestive heart failure (D) is when the heart cannot pump blood effectively, leading to fluid buildup in the body.
The diagnostic test that is most useful in differentiating the dyspnea related to pulmonary effects of heart failure from the dyspnea of pulmonary disease is
- A. Exercise stress testing
- B. A cardiac catheterization
- C. B-type natriuretic peptide (bNP) levels
- D. Serum blood urea nitrogen (BUN) levels
Correct Answer: C
Rationale: bNP is released from the ventricles in response to ventricular stretch and is a good marker for heart failure. If the bNP is elevated, shortness of breath is due to heart failure.
What are the pressure-sensitive structures located in the aortic and carotid bodies called?
- A. Baroreceptors
- B. Chemoreceptors
- C. Nociceptors
- D. Mechanoreceptors
Correct Answer: A
Rationale: The correct answer is A: Baroreceptors. Baroreceptors are pressure-sensitive structures that detect changes in blood pressure in the aortic and carotid bodies. They help regulate blood pressure by sending signals to the brain to adjust heart rate and blood vessel dilation. Chemoreceptors (B) detect changes in chemical composition, not pressure. Nociceptors (C) detect pain stimuli. Mechanoreceptors (D) detect mechanical stimuli, not specifically pressure changes. Therefore, the correct answer is A as baroreceptors specifically respond to changes in blood pressure.
The client is on a calcium channel blocker. What is the expected effect on the heart?
- A. Increased heart rate
- B. Decreased heart rate
- C. Increased blood pressure
- D. Decreased blood pressure
Correct Answer: D
Rationale: The correct answer is D: Decreased blood pressure. Calcium channel blockers inhibit the entry of calcium into cardiac muscle cells, leading to relaxation of blood vessels and decreased cardiac contractility. This results in vasodilation and decreased cardiac output, ultimately lowering blood pressure. Choice A is incorrect as calcium channel blockers typically lead to decreased heart rate due to reduced contractility. Choice B is incorrect as calcium channel blockers do not increase heart rate. Choice C is incorrect as the vasodilatory effect of calcium channel blockers typically leads to decreased blood pressure, not increased.
What accurately describes the pathophysiology of CAD?
- A. Partial or total occlusion of the coronary artery occurs during the stage of raised fibrous plaque
- B. Endothelial alteration may be caused by chemical irritants such as hyperlipidemia or by tobacco use
- C. Collateral circulation in the coronary circulation is more likely to be present in the young patient with CAD
- D. The leading theory of atherogenesis proposes that infection and fatty dietary intake are the basic underlying causes of atherosclerosis
Correct Answer: B
Rationale: Endothelial damage initiates plaque formation.