Nokea
The nurse cares for a client with suspected congestive heart failure (CHF). Which of the following laboratory tests would the nurse expect the primary health care provider (PHCP) to prescribe to confirm the diagnosis?
- A. Basic metabolic panel (BMP)
- B. B-type natriuretic peptide (BNP)
- C. Complete Metabolic Profile (CMP)
- D. C-Reactive Protein (CRP)
Correct Answer: B
Rationale: BNP is a specific marker for heart failure, elevated due to ventricular strain.
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The nurse is assessing a client with clinical manifestations of right ventricular heart failure (HF). Which of the following statements by the client would be consistent with this diagnosis?
- A. I notice that my feet are always swollen.
- B. I can't seem to get rid of this wet cough.
- C. I develop shortness of breath after I walk a few feet.
- D. My legs start to burn if I walk long distances.
Correct Answer: A
Rationale: Right ventricular heart failure causes systemic venous congestion, leading to peripheral edema, such as swollen feet.
Which of the following findings would the nurse expect to observe in a client with peripheral arterial disease (PAD)? Select all that apply.
- A. Decreased peripheral pulses
- B. Pain with ambulation
- C. Reddish-brown ankle discoloration
- D. Bilateral dependent edema
- E. Protruding veins in the leg
Correct Answer: A,B,C
Rationale: Decreased pulses result from arterial obstruction. Pain with ambulation (claudication) is a hallmark of PAD. C: Correct - Reddish-brown discoloration indicates chronic arterial insufficiency. D: Incorrect - Edema is more typical of venous issues. E: Incorrect - Protruding veins suggest venous disease, not arterial.
Which of the following information should the nurse include when teaching a client about congestive heart failure (CHF)? Select all that apply.
- A. Foods such as canned vegetables and luncheon meat should be avoided.
- B. Weigh yourself daily and notify the physician if the weight gain is more than ten pounds in a week.
- C. You may continue to take ibuprofen for your aches and pains.
- D. Annual immunizations such as the influenza vaccine are recommended.
- E. If you feel sick, you will need to check your urine for ketones.
Correct Answer: A,D
Rationale: High-sodium foods like canned vegetables and luncheon meat should be avoided to prevent fluid retention. B: Incorrect - Weight gain >2-3 lbs in a week is concerning, not 10 lbs. C: Incorrect - Ibuprofen can worsen heart failure. D: Correct - Influenza vaccine reduces infection risk, which can exacerbate heart failure. E: Incorrect - Checking urine for ketones is relevant for diabetes, not CHF.
The nurse reviews the client's continuous telemetry monitor and observes the following. As the nurse reviews the client's current medications, which prescribed medication is most likely causing this tracing? See the image below.
- A. losartan
- B. nitroglycerin transdermal patch
- C. enalapril
- D. verapamil
Correct Answer: D
Rationale: Verapamil, a calcium channel blocker, can cause bradycardia or heart block, potentially leading to abnormal ECG tracings.
The nurse is caring for a client who has just been diagnosed with acute pericarditis. Which of the following medications should the nurse anticipate the primary health care provider (PHCP) will prescribe?
- A. isoniazid
- B. colchicine
- C. allopurinol
- D. warfarin
Correct Answer: B
Rationale: Colchicine is used to reduce inflammation in acute pericarditis, often combined with NSAIDs.