While completing a nursing admission history, you obtain this information about the patient's cardiovascular risk factors: patient's mother and two siblings have had myocardial infarctions. Patient smokes and has a 20 pack/year history of cigarette use. Her work as a mail carrier involves a lot of walking. She takes metoprolol (Lopressor) for hypertension and her blood pressure has been in the range of 130/60 to 140/85. Which interventions will be most important to include in the discharge plan? (Choose all that apply.)
- A. Refer to community programs that assist in smoking cessation.
- B. Teach about the impact of family history on cardiovascular risk.
- C. Educate about the need for a change in antihypertensive therapy.
- D. Assist in reducing the stress associated with her cardiovascular risk.
Correct Answer: A
Rationale: Smoking cessation is crucial given her history and risk factors.
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Which of the following is a rare genetic disorder that affects the lungs, liver, and skin, causing the buildup of a specific protein that damages organs?
- A. Alpha-1 antitrypsin deficiency
- B. Cystic fibrosis
- C. Wegener's granulomatosis
- D. Marfan syndrome
Correct Answer: A
Rationale: Alpha-1 antitrypsin deficiency is the correct answer. This disorder affects the lungs, liver, and skin due to the buildup of a specific protein (alpha-1 antitrypsin) that damages organs. This deficiency can lead to lung and liver diseases. Cystic fibrosis primarily affects the lungs and digestive system, not the liver and skin. Wegener's granulomatosis is a condition that affects the blood vessels, lungs, and kidneys, not the liver. Marfan syndrome is a connective tissue disorder that affects the heart, blood vessels, bones, and eyes, not the lungs, liver, and skin.
What is a blood clot that forms in a vein, often in the legs, and can cause serious complications if it travels to the lungs?
- A. Deep vein thrombosis (DVT)
- B. Pulmonary embolism
- C. Varicose veins
- D. Atherosclerosis
Correct Answer: A
Rationale: The correct answer is A: Deep vein thrombosis (DVT). DVT is a blood clot that forms in a deep vein, commonly in the legs. It can lead to serious complications if the clot dislodges and travels to the lungs, causing a pulmonary embolism. Varicose veins (C) are enlarged, twisted veins near the surface of the skin, not involving deep veins. Atherosclerosis (D) is the build-up of plaque in arteries, not related to vein clot formation. Pulmonary embolism (B) is a complication of DVT, not the initial clot formation in a vein.
What is a chronic condition where the heart is unable to pump blood efficiently, leading to fluid buildup in the lungs and other parts of the body?
- A. Heart failure
- B. Cardiomyopathy
- C. Pericarditis
- D. Aortic stenosis
Correct Answer: A
Rationale: Step 1: Heart failure is a chronic condition where the heart is unable to pump blood efficiently.
Step 2: This inefficiency leads to fluid buildup in the lungs (pulmonary congestion) and other parts of the body.
Step 3: Cardiomyopathy is a broad term for diseases that affect the heart muscle but may not necessarily result in heart failure.
Step 4: Pericarditis is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart pumping efficiency.
Step 5: Aortic stenosis is a condition where the aortic valve narrows, affecting blood flow from the heart but not necessarily leading to heart failure.
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 a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?
- A. Bronchiectasis
- B. Chronic bronchitis
- C. Pneumoconiosis
- D. Asthma
Correct Answer: A
Rationale: The correct answer is A: Bronchiectasis. This condition involves permanent widening and damage to the airways, leading to mucus accumulation and recurrent infections. Chronic bronchitis (B) primarily involves inflammation of the bronchial tubes without permanent widening. Pneumoconiosis (C) is a group of lung diseases caused by inhaling mineral dust, not directly related to airway damage. Asthma (D) is characterized by reversible airway constriction and inflammation, not permanent widening like in bronchiectasis.