Nokea
Hypertrophic obstructive cardiomyopathy
- A. Causes LV outflow tract obstruction
- B. Occurs after adenoviral infection
- C. Commonly occurs in infancy
- D. Double apical impulse
Correct Answer: A
Rationale: Hypertrophic obstructive cardiomyopathy primarily causes left ventricular outflow tract obstruction.
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A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition should the nurse include in this client’s teaching?
- A. The best way to lose weight is a high-protein, low-carbohydrate diet.
- B. You should balance weight loss with consuming the necessary nutrients.
- C. A nutritionist will provide you with information about your new diet.
- D. If you exercise more frequently, you won’t need to change your diet.
Correct Answer: B
Rationale: Balancing weight loss with proper nutrient intake is essential for clients with diabetes and high BMI to reduce the risk of coronary artery disease.
What is the most likely congenital heart lesion in a newborn with Trisomy 21?
- A. AVSD
- B. Tetralogy of Fallot
- C. Ventricular septal defect
- D. Pulmonary stenosis
Correct Answer: A
Rationale: Atrioventricular septal defect (AVSD) is highly associated with Trisomy 21 and is the most likely congenital heart lesion in these infants.
An older adult with heart failure is hospitalized during an acute exacerbation. To reduce cardiac workload, which intervention should the nurse include in the client's plan of care?
- A. Assist with ambulation in the hallway
- B. Encourage active range of motion exercises
- C. Provide a bedside commode for toileting
- D. Teach to sleep in a side-laying position
Correct Answer: C
Rationale: Providing a bedside commode reduces the need for the client to walk to the bathroom, decreasing strain on the heart.
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
- A. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
- B. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
- C. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
- D. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.
Correct Answer: A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
The jugular venous pressure (JVP) has a predictable relationship with pulmonary artery wedge pressure (PAWP). A JVP of >12 mm Hg predicted PAWP >22 mm Hg by 88% in which of the following trials?
- A. BNP
- B. ESCAPE
- C. EVEREST
- D. EMPA REG
Correct Answer: B
Rationale: The ESCAPE trial studied the effectiveness of therapies in patients with advanced heart failure and showed that elevated JVP was correlated with high pulmonary artery wedge pressures.