Nokea
Mr. Olds is admitted with constrictive pericarditis. He complains of chest pain and receives morphine as ordered. Pain relief for this patient is also facilitated by
- A. Sitting forward
- B. Lying supine
- C. Taking deep breaths
- D. Coughing
Correct Answer: A
Rationale: Sitting forward reduces pressure on the heart.
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Which of the following dietary recommendations should a nurse give a client taking diuretics?
- A. Include potassium-rich foods.
- B. Include protein-rich foods.
- C. Avoid fruit and fruit juices.
- D. Avoid dairy products.
Correct Answer: A
Rationale: Diuretics can deplete potassium levels, so including potassium-rich foods helps maintain electrolyte balance.
A 2400 mg sodium diet is prescribed for the patient with chronic heart failure. The nurse recognizes that additional teaching is necessary when the patient states
- A. I should limit my milk intake to 2 cups a day
- B. I can eat fresh fruits and vegetables without worrying about sodium levels
- C. I can eat most foods as long as I do not add salt when cooking or at the table
- D. I need to read the labels on prepared foods and medicines for their sodium content
Correct Answer: C
Rationale: All foods that are high in sodium should be eliminated in a 2400 mg sodium diet, in addition to the elimination of salt during cooking.
If Dr. Baker complains of loss of appetite and nausea after starting chlorothiazide, it would be important to
- A. check her digitalis and potassium levels
- B. obtain a urine specimen
- C. get an electrocardiogram immediately
- D. reassure her that since her blood pressure is normal these symptoms are to be expected
Correct Answer: A
Rationale: Chlorothiazide can affect electrolyte balance, requiring monitoring.
Which condition is characterized by the right ventricle of the heart failing due to increased pressure in the lungs, often caused by chronic lung disease?
- A. Cor pulmonale
- B. Pulmonary embolism
- C. Aortic stenosis
- D. Hypertrophic cardiomyopathy
Correct Answer: A
Rationale: The correct answer is A: Cor pulmonale. This condition is characterized by right ventricle failure due to increased pulmonary pressure from chronic lung disease. Step 1: Chronic lung disease causes increased pressure in the lungs. Step 2: The increased pressure in the lungs leads to the right ventricle of the heart working harder to pump blood through the lungs. Step 3: Over time, this increased workload can cause right ventricular failure, known as cor pulmonale. Summary: B is incorrect as pulmonary embolism is a sudden blockage of an artery in the lungs. C is incorrect as aortic stenosis involves narrowing of the aortic valve, affecting the left ventricle. D is incorrect as hypertrophic cardiomyopathy is a genetic condition causing thickening of the heart muscle.
Which condition involves the body's immune system attacking the lungs and kidneys, causing severe respiratory and renal damage?
- A. Goodpasture syndrome
- B. Sarcoidosis
- C. Wegener's granulomatosis
- D. Interstitial lung disease
Correct Answer: A
Rationale: Step-by-step rationale for A being correct:
1. Goodpasture syndrome is an autoimmune disease where the body produces antibodies against collagen in the lungs and kidneys.
2. Antibodies attack the basement membrane of the lungs and kidneys, leading to severe respiratory and renal damage.
3. Symptoms include coughing up blood, difficulty breathing, and kidney failure.
4. Treatment involves immunosuppressive therapy and plasma exchange to remove harmful antibodies.
Summary:
- B: Sarcoidosis involves granulomas in multiple organs but typically not lung-kidney damage.
- C: Wegener's granulomatosis affects the respiratory tract and kidneys but involves inflammation, not antibodies against collagen.
- D: Interstitial lung disease is a broad term for various lung conditions but doesn't specifically involve the immune system attacking lungs and kidneys.