Nokea
The echocardiogram indicates a large thrombus in the left atrium of a patient admitted with heart failure. During the night, the patient complains of severe, sudden onset left foot pain. You note that no pulse is palpable in the left foot and that it is cold and pale. Which action should you take next?
- A. Lower the patient's left foot below heart level.
- B. Administer oxygen at 4 L/minute to the patient.
- C. Notify the patient's physician about the assessment data.
- D. Check the patient's vital signs and oximetry.
Correct Answer: C
Rationale: This likely indicates embolic occlusion, requiring immediate physician intervention.
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As the cardiac-vascular nurse prepares to administer an experimental cardiac drug to a patient who is participating in a research study, the patient states that they no longer want the medication. The nurse advises the patient that:
- A. participation in the study is critical to improving the quality of patient outcomes.
- B. the medication dose has been scheduled for administration.
- C. the primary investigator will speak with the patient about their decision.
- D. they have the right to refuse the medication and to withdraw from the study.
Correct Answer: D
Rationale: Patients have the right to refuse treatment or withdraw from a study at any time.
Which measure would be most useful in evaluating a client's compensation in chronic congestive heart failure?
- A. Weekly digoxin blood level assessment
- B. Daily weight assessment
- C. Hourly urinary output
- D. Monthly activity level assessment
Correct Answer: B
Rationale: Daily weight reflects fluid status.
Which condition is characterized by fluid collection in the lungs, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleurisy
- C. Pleural effusion
- D. Pneumothorax
Correct Answer: A
Rationale: Pulmonary edema is the correct answer because it is characterized by fluid accumulation in the lungs, leading to difficulty in breathing. This condition is often a result of heart failure, where the heart is unable to pump blood effectively, causing fluid to leak into the lungs. It can also be caused by lung infections or exposure to toxins.
Pleurisy (B) is inflammation of the pleura, the lining around the lungs, leading to chest pain exacerbated by breathing. Pleural effusion (C) is fluid accumulation in the pleural space around the lungs, not within the lungs themselves. Pneumothorax (D) is characterized by air accumulation in the pleural space, causing lung collapse, but not fluid collection in the lungs.
What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?
- A. Pulmonary hypertension
- B. Pulmonary fibrosis
- C. Pulmonary embolism
- D. Pulmonary edema
Correct Answer: A
Rationale: The correct answer is A: Pulmonary hypertension. Pulmonary hypertension refers to the condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries. This results in the heart having to work harder to pump blood through the lungs, causing potential damage to the heart and lungs over time.
B: Pulmonary fibrosis is a condition characterized by scarring of lung tissue, not thickening and stiffening of artery walls.
C: Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs, usually caused by a blood clot. It does not involve thickening and stiffening of artery walls.
D: Pulmonary edema is a condition where fluid builds up in the lungs, causing difficulty in breathing. It is not related to thickened and stiffened artery walls.
Which chronic respiratory condition is characterized by the narrowing and inflammation of the airways, leading to difficulty breathing?
- A. Asthma
- B. COPD
- C. Bronchitis
- D. Pneumonia
Correct Answer: A
Rationale: Step-by-step rationale:
1. Asthma is characterized by airway inflammation and narrowing, leading to difficulty breathing.
2. It is a chronic respiratory condition with symptoms like wheezing, coughing, and shortness of breath.
3. Asthma exacerbations can be triggered by various factors like allergens or exercise.
4. Treatment includes bronchodilators and anti-inflammatory medications to manage symptoms.
5. COPD, bronchitis, and pneumonia involve different pathophysiological mechanisms and are not primarily characterized by airway narrowing.
Summary:
Asthma is the correct answer due to its specific features of airway inflammation and narrowing, distinct from COPD, bronchitis, and pneumonia, which have different underlying causes and symptoms.