Heart failure with preserved ejection fraction is caused by:
- A. Ventricular hypertrophy reducing contractility of muscles
- B. Decreased perfusion of the myocardium
- C. Dilated cardiomyopathy
- D. Impaired ventricular relaxation resulting in the lack of ability of ventricles to fill with blood
Correct Answer: D
Rationale: HFpEF stiff ventricles won't relax, slashing fill-up, not pump-out. Hypertrophy aids, doesn't cause; perfusion dips hurt supply; dilated's HFrEF. Nurses target this, a chronic fill flaw.
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Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds
- D. The ratio of respiratory effort and respiratory rate
Correct Answer: A
Rationale: Spirometry sizes COPD FEV1/FVC ratio, air blasted in one second versus all-out capacity, pegs obstruction's depth, tracking decline. Residual's post-exhale, not this; 6-second's off; effort-rate's vague. Nurses lean on this, staging chronic airflow's fade.
Which is the most common organism infecting coral cuts?
- A. non-cholera vibrio
- B. mycobacterium marinum
- C. aeromonas species
- D. strep pyogenes
Correct Answer: D
Rationale: Coral cuts strep pyogenes streaks in, not vibrio, mycobacterium, aeromonas, or E. coli's swim. Nurses hit this chronic skin ripper.
Post exposure prophylaxis against Human Immunodeficiency Virus (HIV):
- A. is probably not effective when commenced 36 hours post exposure
- B. is administered intramuscularly
- C. is generally well-tolerated by patients
- D. when given, precludes the need for follow up serology
Correct Answer: C
Rationale: HIV PEP tolerable pills, not IM, works past 36 hours, needs serology, safe in pregnancy. Nurses dose this chronic shield easy.
A nurse in a hematology clinic is working with four clients who have polycythemia vera. Which client should the nurse see first?
- A. A client with a swollen and painful left great toe
- B. Client who reports dyspnea
- C. Client with a blood pressure of 180/98 mm Hg
- D. Client who reports calf tenderness and swelling
Correct Answer: B
Rationale: Polycythemia vera thickens blood, risking clots dyspnea signals possible pulmonary embolism, a life-threatening emergency needing instant assessment per ABCs. Toe pain suggests gout, common but less acute. Hypertension, a chronic issue here, waits behind respiratory distress. Calf tenderness hints at DVT, urgent but not immediately fatal like embolism. Nurses triage dyspnea first, ensuring airway and oxygenation, a critical call in this hyperviscous condition prone to thrombotic crises.
A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority?
- A. Helping clients adjust to their appearance
- B. Reassuring clients that this change is temporary
- C. Referring clients to a reputable wig shop
- D. Teaching measures to prevent scalp injury
Correct Answer: D
Rationale: Alopecia, or hair loss, is a common chemotherapy side effect due to drugs targeting rapidly dividing cells, including hair follicles. While emotional support is vital, the priority is client safety. Teaching measures to prevent scalp injury such as avoiding harsh brushing or sun exposure takes precedence because the scalp becomes vulnerable without hair's protective barrier, risking cuts, infections, or burns. Helping clients adjust to appearance and reassuring them about regrowth address psychosocial needs but don't mitigate physical risk. Referring to a wig shop is practical but secondary to safety. In oncology nursing, prioritizing physical protection aligns with the hierarchy of needs, ensuring the client avoids complications like infection, especially if immunocompromised, before addressing emotional impacts.