Nokea
Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)?
- A. Polycythemia and clubbing
- B. Anemia and barrel chest
- C. Increased white blood cells and low platelets
- D. Elevated erythrocyte sedimentation rate and peripheral edema
Correct Answer: A
Rationale: Hypoxemia stimulates erythropoiesis, causing polycythemia, which along with chronic hypoxemia can lead to digital clubbing.
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A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?
- A. Administration of IV furosemide (Lasix)
- B. Initiation of an external pacemaker
- C. Assistance with endotracheal intubation
- D. Placement of central venous access
Correct Answer: B
Rationale: An 80% blockage of the RCA can lead to bradycardia or heart block. An external pacemaker may be needed to maintain adequate heart rate and cardiac output.
Complement C3 levels are decreased in:
- A. Systemic lupus erythematoses
- B. Henoch-Schoenlein purpura
- C. Haemolytic uraemic syndrome
- D. Type II membrano-proliferative glomerulonephritis
Correct Answer: A
Rationale: Decreased C3 levels are characteristic of systemic lupus erythematosus due to immune complex deposition and complement consumption.
An older male client with long-standing lung disease is admitted to the medical unit for treatment of pulmonary infection. In assessing for signs of increasing hypoxia, which action should the nurse include? (select all that apply)
- A. Monitor dryness of mucous membranes
- B. Check for changes in mentation
- C. Observe color of skin and nailbeds
- D. Note appearance of jugular veins
Correct Answer: B
Rationale: Changes in mentation, skin color, and breathing patterns are key indicators of hypoxia in clients with lung disease.
Which of the following antibodies has least association with neonatal lupus?
- A. Anti-Ro (SSA)
- B. Anti-La (SSB)
- C. Anti-RNP
- D. Anti-CCP
Correct Answer: D
Rationale: Anti-CCP antibodies have the least association with neonatal lupus compared to the other antibodies listed.
Which of the following is a vasodilator?
- A. Thromboxane A2
- B. Endothelin
- C. Prostaglandin E2
- D. Urotensin II
Correct Answer: C
Rationale: Prostaglandin E2 is a vasodilator.