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Which goal is a primary objective for a patient who has chronic heart failure (HF)?
- A. Maximizing cardiac output.
- B. Maintaining ideal body weight.
- C. Performing daily aerobic exercises.
- D. Maintaining a steady pulse oximetry reading.
Correct Answer: A
Rationale: Maximizing cardiac output is a primary goal for patients with chronic heart failure (HF) because it helps improve tissue perfusion and oxygen delivery to meet the body's demands. It is a crucial aspect of managing heart failure and preventing further complications.
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The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
- A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
- B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
- C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
- D. Sodium level of 144 mEq/L, potassium level of 3.7 PROTOCOL mEq/L.
Correct Answer: C
Rationale: Normal sodium (135 mEq/L) and potassium (3.6 mEq/L) levels support changing to a lower potassium IV (20 mEq KCl/L) to prevent hyperkalemia while maintaining hydration.
A patient with chronic obstructive pulmonary disease (COPD) has the following arterial blood gas (ABG) results: a blood pH of 7.29, a partial pressure of carbon dioxide (PaCO2) level of 49 mm Hg, and a bicarbonate ion (HCO3) level of 25 mEq/L. Which condition would the nurse have in mind when developing the patient's plan of care?
- A. Metabolic acidosis.
- B. Metabolic alkalosis.
- C. Respiratory acidosis.
- D. Respiratory alkalosis.
Correct Answer: C
Rationale: Respiratory acidosis is indicated by low pH (7.29) and high PaCO2 (49 mm Hg), common in COPD due to impaired CO2 elimination.
Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The data in option D (pH = 7.52, PaCO2 = 24 mm Hg) indicates respiratory alkalosis.
The blood pressure (BP) of a 71-year-old patient admitted with pneumonia is 160/70 mm Hg. Which age-related change contributes to this finding?
- A. Stenosis of the heart valves.
- B. Decreased adrenergic sensitivity.
- C. Increased parasympathetic activity.
- D. Loss of elasticity in arterial vessels.
Correct Answer: D
Rationale: Loss of elasticity in arterial vessels due to aging causes increased systolic blood pressure, as seen in the 160/70 mm Hg reading.
Which finding will the nurse expect in a patient who is hospitalized with stage I Hodgkin lymphoma?
- A. Skeletal pain.
- B. Enlarged lymph nodes.
- C. T-cell blasts in the lymph node.
- D. Lymphoblasts in the cerebrospinal fluid.
Correct Answer: B
Rationale: Enlarged lymph nodes are a characteristic feature of stage I Hodgkin lymphoma, where the disease is localized to one group of lymph nodes.