A child with congestive heart failure is started on Captopril because its primary effect is
slows the heart rate thus increasing diastolic filling time
increases urine output thus decreasing pulmonary congestion
decreases the afterload thus decreasing the workload on the heart
increases serum potassium thus improving cardiac performance
The Correct Answer is C
Choice A reason: Slowing the heart rate does not increase diastolic filling time. Diastolic filling time is the time during which the ventricles are relaxed and filling with blood. Slowing the heart rate would decrease the cardiac output and worsen the heart failure.
Choice B reason: Increasing urine output does decrease pulmonary congestion, but it is not the primary effect of Captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor, which blocks the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This reduces the blood pressure and the afterload on the heart. Diuretics are the drugs that increase urine output and reduce fluid overload.
Choice C reason: This is the correct choice. Decreasing the afterload means reducing the resistance that the heart has to overcome to pump blood to the body. This lowers the blood pressure and the workload on the heart, which improves the cardiac function and reduces the symptoms of heart failure.
Choice D reason: Increasing serum potassium does not improve cardiac performance. In fact, high levels of potassium can cause cardiac arrhythmias and cardiac arrest. Captopril can cause hyperkalemia (high potassium) as a side effect, which is why patients on this drug need to monitor their potassium levels and avoid potassium supplements or salt substitutes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Murmur, tachycardia, and low erythrocyte sedimentation rate are not specific signs of Kawasaki disease. They may indicate other cardiac or inflammatory conditions.
Choice B reason: Abdominal pain, vomiting, and restlessness are not typical signs of Kawasaki disease. They may suggest other gastrointestinal or neurological problems.
Choice C reason: Coarse breath sounds, abnormal ECG, and joint pain are not common signs of Kawasaki disease. They may indicate other respiratory, cardiac, or rheumatic disorders.
Choice D reason: This is the correct choice. Fever, "strawberry tongue" and peeling palms and soles are characteristic signs of Kawasaki disease, which is a rare but serious condition that causes inflammation of the blood vessels. Other signs include red eyes, swollen lips, rash, and swollen lymph nodes.
Correct Answer is A
Explanation
Choice A reason: This statement is correct, as ART is the standard treatment for HIV infection in infants and children, regardless of their age, clinical status, or CD4 count. ART can suppress the viral load, improve the immune function, prevent opportunistic infections, and prolong the survival and quality of life of the infant.
Choice B reason: This statement is incorrect, as delaying ART until the infant turns 12 months old can increase the risk of disease progression, mortality, and drug resistance. The nurse should explain to the parents that early initiation of ART is recommended for all infants with HIV, as they have a high viral load and a rapid decline of CD4 cells.
Choice C reason: This statement is incorrect, as waiting for the infant to have a clinical manifestation of AIDS before starting ART can be too late and ineffective. The nurse should inform the parents that AIDS is the most advanced stage of HIV infection, characterized by severe immunosuppression and life-threatening opportunistic infections. The nurse should emphasize the importance of early diagnosis and treatment of HIV to prevent the development of AIDS.
Choice D reason: This statement is incorrect, as the mother's HIV status is not mandatory to be tested, but voluntary and confidential. The nurse should respect the mother's right to privacy and autonomy, and offer her counseling and testing services if she agrees. The nurse should also educate the mother about the modes of transmission, prevention, and treatment of HIV.
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