Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
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Solution
Right-sided heart failure
Weight gain, nausea, and a decrease in urine output are secondary effects of right-sided heart failure.
Option A: Angina pectoris doesn’t cause weight gain, nausea, or a decrease in urine output.
Option B: Cardiomyopathy is usually identified as a symptom of left-sided heart failure.
Option C: Left-sided heart failure causes primarily pulmonary symptoms rather than systemic ones.
Stimulation of the sympathetic nervous system produces which of the following responses?
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Solution
Tachycardia
Stimulation of the sympathetic nervous system causes tachycardia and increased contractility. The other symptoms listed are related to the parasympathetic nervous system, which is responsible for slowing the heart rate.
Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?
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Solution
Inotropic agents
Inotropic agents are administered to increase the force of the heart’s contractions, thereby increasing ventricular contractility and ultimately increasing cardiac output.
Which of the following symptoms might a client with right-sided heart failure exhibit?
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Solution
Oliguria
Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria.
In which of the following disorders would the nurse expect to assess sacral edema in a bedridden client?
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Solution
Right-sided heart failure
The most accurate area on the body to assess dependent edema in a bed-ridden client is the sacral area. Sacral, or dependent, edema is secondary to right-sided heart failure.
Which of the following symptoms is most commonly associated with left-sided heart failure?
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Solution
Crackles
Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by fluid backing up into the pulmonary system.
Option B: Arrhythmias can be associated with both right- and left-sided heart failure.
Option D: Left-sided heart failure causes hypertension secondary to an increased workload on the system.
Toxicity from which of the following medications may cause a client to see a green-yellow halo around lights?
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Solution
Digoxin
One of the most common signs of digoxin toxicity is the visual disturbance known as the “green-yellow halo sign.” The other medications aren’t associated with such an effect.
With which of the following disorders is jugular vein distention most prominent?
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Solution
Heart failure
Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart to pump.
Options A and D: JVD isn’t a symptom of abdominal aortic aneurysm or pneumothorax.
Option C: An MI, if severe enough, can progress to heart failure, however, in and of itself, an MI doesn’t cause JVD.
What is the most common complication of an MI?
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Solution
Arrhythmias
Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI.
Option A: Cardiogenic shock, another complication of an MI, is defined as the end stage of left ventricular dysfunction. This condition occurs in approximately 15% of clients with MI.
Option B: Because the pumping function of the heart is compromised by an MI, heart failure is the second most common complication.
Option D: Pericarditis most commonly results from a bacterial or viral infection but may occur after the MI.
Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?
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Solution
Beta-adrenergic blockers
Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing myocardial oxygen demand.
Option B: Calcium channel blockers reduce the workload of the heart by decreasing the heart rate.
Option C: Narcotics reduce myocardial oxygen demand, promote vasodilation, and decrease anxiety.
Option D: Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) and systemic vascular resistance (afterload).