Nokea
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.
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The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?
- A. Notify the healthcare provider immediately.
- B. Continue the medication and monitor lung function.
- C. Discontinue the medication and start oxygen therapy.
- D. Reduce the dose and monitor respiratory status.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Pulmonary fibrosis is a serious side effect of amiodarone.
2. Immediate notification of the healthcare provider is necessary to address this potentially life-threatening complication.
3. The healthcare provider will need to evaluate the client's condition, consider alternative treatments, and adjust the care plan accordingly.
Summary of incorrect choices:
B. Continuing the medication without intervention can worsen the pulmonary fibrosis.
C. Discontinuing the medication is necessary, but oxygen therapy alone may not address the underlying issue.
D. Reducing the dose may not be sufficient to manage the pulmonary fibrosis and delaying provider notification can lead to further complications.
What is a condition characterized by episodes of severe, acute shortness of breath, often occurring at night?
- A. Paroxysmal nocturnal dyspnea
- B. Sleep apnea
- C. Orthopnea
- D. Dyspnea
Correct Answer: A
Rationale: The correct answer is A: Paroxysmal nocturnal dyspnea. This condition is characterized by sudden, severe shortness of breath at night. It can be caused by heart failure or other cardiac conditions. Sleep apnea (B) is a disorder where breathing repeatedly stops and starts during sleep, not specifically related to acute shortness of breath. Orthopnea (C) is difficulty breathing while lying flat and is not specific to nighttime episodes. Dyspnea (D) is a general term for difficulty breathing and does not specifically refer to acute episodes at night.
What is a condition where the heart's electrical impulses are delayed or blocked, leading to a slower or irregular heartbeat?
- A. Heart block
- B. Tachycardia
- C. Bradycardia
- D. Arrhythmia
Correct Answer: A
Rationale: The correct answer is A: Heart block. Heart block is a condition where the electrical impulses in the heart are delayed or blocked, leading to a slower or irregular heartbeat. This can result in symptoms like dizziness, fatigue, and fainting. Tachycardia (B) is a condition of a fast heart rate, not a delayed or blocked impulse. Bradycardia (C) is a slow heart rate, but it doesn't necessarily involve delayed or blocked impulses. Arrhythmia (D) is a broad term for any irregular heartbeat pattern, not specifically related to delayed or blocked impulses.
What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?
- A. Hypertrophic cardiomyopathy
- B. Dilated cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Myocarditis
Correct Answer: A
Rationale: The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle becomes thickened, affecting the heart's ability to pump blood efficiently. This is due to genetic mutations causing the muscle cells to grow abnormally. This leads to poor relaxation and filling of the heart, impairing its pumping function.
B: Dilated cardiomyopathy involves the heart muscle becoming weak and stretched, leading to reduced pumping ability.
C: Restrictive cardiomyopathy involves the heart muscle becoming stiff and rigid, impairing its ability to fill with blood properly.
D: Myocarditis is inflammation of the heart muscle, typically caused by infections or autoimmune conditions, leading to temporary reduction in heart function.
Hence, the correct answer is A as it specifically describes the scenario of a thickened heart muscle without an obvious cause impacting the heart's pumping ability.
A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse's priority action?
- A. Hold the spironolactone and notify the healthcare provider.
- B. Administer a potassium supplement.
- C. Continue the spironolactone as ordered.
- D. Increase the dose of spironolactone.
Correct Answer: A
Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia. With a potassium level of 6.0 mEq/L, the client is at risk for serious cardiac complications. Holding the medication and notifying the healthcare provider is the priority to prevent further increase in potassium levels. Administering a potassium supplement (B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (C) or increasing the dose (D) would also worsen the situation.