Nokea
Two weeks ago, a 63-year-old patient with heart failure received a new prescription for carvedilol (Coreg) 3.125 mg orally. Upon evaluation in the outpatient clinic you find these symptoms. Which is of most concern?
- A. Complaints of increased fatigue and dyspnea.
- B. Weight increase of 0.5 kg in 2 weeks.
- C. Bibasilar crackles audible in the posterior chest.
- D. Sinus bradycardia, rate 50, as evidenced by ECG.
Correct Answer: D
Rationale: Bradycardia can impair cardiac output, especially in heart failure patients.
You may also like to solve these questions
Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?
- A. Acetylcholine
- B. Norepinephrine
- C. Dopamine
- D. Serotonin
Correct Answer: A
Rationale: The correct answer is A: Acetylcholine. Acetylcholine is released by the parasympathetic nervous system and acts on the heart to decrease heart rate. It binds to muscarinic receptors in the heart, leading to a decrease in heart rate through inhibition of the SA node. Norepinephrine (B) is released by the sympathetic nervous system and increases heart rate. Dopamine (C) and Serotonin (D) are not directly involved in regulating heart rate through the parasympathetic pathway.
What test measures the electrical activity of the heart to detect arrhythmias and other heart conditions?
- A. Electrocardiogram (ECG or EKG)
- B. Chest X-ray
- C. Stress test
- D. Arterial blood gas (ABG)
Correct Answer: A
Rationale: The correct answer is A: Electrocardiogram (ECG or EKG). An ECG measures the electrical activity of the heart by recording the heart's rhythm and electrical signals. It is used to detect arrhythmias and other heart conditions based on the pattern of the electrical waves. A chest X-ray (B) is used to visualize the heart and lungs, not to measure electrical activity. A stress test (C) assesses the heart's response to physical activity. Arterial blood gas (D) measures oxygen and carbon dioxide levels in the blood, not heart activity. Thus, the ECG is the most appropriate test for detecting arrhythmias and other heart conditions.
The client is prescribed warfarin. What should the client be taught about this medication?
- A. Avoid foods high in vitamin K.
- B. Take the medication with food to prevent stomach upset.
- C. Take the medication at the same time every day.
- D. Increase the dose if a dose is missed.
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is an anticoagulant that works by decreasing the blood's ability to clot. Vitamin K is essential for blood clotting, so consuming foods high in vitamin K can interfere with the medication's effectiveness. It is important for the client to maintain a consistent intake of vitamin K to ensure the medication works properly. Choices B, C, and D are incorrect because taking warfarin with food, at the same time daily, or increasing the dose if a dose is missed can result in adverse effects or reduced effectiveness of the medication.
Which surgical procedure involves opening or replacing a narrowed or blocked heart valve?
- A. Valve replacement
- B. Angioplasty
- C. Stent placement
- D. Coronary bypass surgery
Correct Answer: A
Rationale: The correct answer is A: Valve replacement. This surgical procedure involves opening or replacing a narrowed or blocked heart valve. During valve replacement, a damaged valve is removed and replaced with a new one to restore normal blood flow. Angioplasty (B) involves opening blocked arteries, stent placement (C) involves inserting a mesh tube to keep arteries open, and coronary bypass surgery (D) involves rerouting blood flow around blocked coronary arteries. These procedures are not specifically related to treating narrowed or blocked heart valves, making them incorrect choices for this question.
Which valve prevents backflow of blood into the right ventricle from the pulmonary artery?
- A. Pulmonary valve
- B. Aortic valve
- C. Tricuspid valve
- D. Mitral valve
Correct Answer: A
Rationale: The correct answer is A: Pulmonary valve. This valve prevents backflow of blood into the right ventricle from the pulmonary artery by closing when the right ventricle relaxes. The pulmonary valve ensures that blood flows in one direction, from the right ventricle to the pulmonary artery. The other choices, B: Aortic valve, C: Tricuspid valve, and D: Mitral valve, are incorrect because they are not located between the right ventricle and the pulmonary artery. The aortic valve is between the left ventricle and the aorta, the tricuspid valve is between the right atrium and ventricle, and the mitral valve is between the left atrium and ventricle.