Nokea
Which assessment data collected from a client with chronic congestive heart failure would indicate precipitating causes?
- A. Subnormal body temp; Obesity; metabolic acidosis
- B. Peripheral hypotension, asthenia, high altitude
- C. Hyperthyroidism, bronchitis, overexertion
- D. Dry cough, orthopnea, bradycardia
Correct Answer: C
Rationale: These factors strain the heart.
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Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?
- A. Norepinephrine
- B. Epinephrine
- C. Dopamine
- D. Acetylcholine
Correct Answer: A
Rationale: The correct answer is A: Norepinephrine. Norepinephrine is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction. This neurotransmitter acts on beta-1 adrenergic receptors in the heart, leading to these effects. Epinephrine (choice B) is also released by the SNS and acts similarly to norepinephrine but is not as specific for the heart's beta-1 receptors. Dopamine (choice C) primarily acts as a precursor to norepinephrine and epinephrine and does not directly increase heart rate or force of contraction. Acetylcholine (choice D) is released by the parasympathetic nervous system and decreases heart rate and the force of contraction.
The client is on enalapril (Vasotec) for hypertension. What side effect is most commonly associated with this medication?
- A. Dry cough
- B. Hypotension
- C. Hyperkalemia
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Enalapril is an ACE inhibitor, which commonly causes a dry cough due to increased bradykinin levels. This side effect is well-documented in literature and can lead to medication non-adherence. Other choices (B) Hypotension, (C) Hyperkalemia, and (D) Headache are potential side effects of enalapril but are not as commonly associated as dry cough. Hypotension and hyperkalemia are more serious adverse effects that require monitoring, while headache is a less common side effect compared to dry cough.
What is a device that delivers a fine spray of medication into the airways?
- A. Nebulizer
- B. Inhaler
- C. Oxygen concentrator
- D. Peak flow meter
Correct Answer: A
Rationale: The correct answer is A: Nebulizer. A nebulizer is a device that delivers medication in the form of a fine spray into the airways, making it easier for the patient to inhale the medication and reach the lungs. It is commonly used for treating respiratory conditions such as asthma and COPD. Inhalers (B) deliver medication in a different format, through a measured dose of medication in aerosol form. Oxygen concentrators (C) provide supplemental oxygen and do not deliver medication. Peak flow meters (D) are used to measure the peak expiratory flow rate and are not used to deliver medication.
When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?
- A. Decreased blood pressure
- B. Increased heart rate
- C. Increased cardiac output
- D. Decreased heart rate
Correct Answer: C
Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors work by dilating blood vessels and reducing the workload on the heart. This leads to improved cardiac output, as the heart can pump more efficiently. Decreased blood pressure (choice A) is a common side effect due to vasodilation. Increased heart rate (choice B) and decreased heart rate (choice D) are not expected outcomes of ACE inhibitor use. Therefore, the most appropriate and expected outcome of administering an ACE inhibitor in heart failure is an increase in cardiac output, making choice C the correct answer.
What is the procedure where a catheter is used to open a blocked or narrowed coronary artery, often involving the placement of a stent?
- A. Angioplasty
- B. Valve replacement
- C. Stent placement
- D. Coronary artery bypass graft (CABG)
Correct Answer: A
Rationale: The correct answer is A: Angioplasty. During angioplasty, a catheter with a balloon at its tip is used to open a blocked or narrowed coronary artery. The balloon is inflated to widen the artery and improve blood flow. Often, a stent is placed during the procedure to help keep the artery open. Option B, valve replacement, is incorrect as it involves replacing a faulty heart valve, not opening a blocked coronary artery. Option C, stent placement, is close but not specific to the procedure of using a catheter and balloon. Option D, CABG, is a surgical procedure where arteries or veins are used to bypass blocked coronary arteries, not using a catheter.