A nurse in a provider's office is collecting data from a client who reports dyspnea and fatigue.
The nurse determines that the client also has tachycardia and edema. Which of the following disorders should the nurse suspect?
Asthma
Heart failure
Aortic valve regurgitation
Aortic stenosis
The Correct Answer is B
a. Asthma: While asthma can cause dyspnea and fatigue, it is not typically associated with tachycardia and edema.
b. Heart failure: Heart failure is characterized by symptoms such as dyspnea, fatigue,
tachycardia, and edema. Tachycardia may be a compensatory response to maintain cardiac output, and edema can result from fluid retention.
c. Aortic valve regurgitation: Aortic valve regurgitation may cause symptoms such as dyspnea and fatigue, but it is not typically associated with tachycardia and edema.
d. Aortic stenosis: Aortic stenosis may lead to symptoms such as dyspnea, but tachycardia and edema are not typical features of aortic stenosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
a. Low BP and low pulse rate: In hypovolemic shock, there is a decrease in blood volume,
leading to low blood pressure. However, the body compensates by increasing the heart rate to maintain perfusion to vital organs.
b. Low BP and high pulse rate: This is indicative of hypovolemic shock. The low blood pressure results from decreased blood volume, while the high pulse rate is a compensatory mechanism to maintain cardiac output.
c. High BP and low pulse rate: This combination is not typical of hypovolemic shock. High blood pressure is not expected in the presence of decreased blood volume.
d. High BP and high pulse rate: While a high pulse rate is expected in hypovolemic shock, high blood pressure is not a characteristic finding.
Correct Answer is D
Explanation
a. Encourage the client to take small bites: While encouraging small bites is important, the priority for a client with dysphagia is to ensure they are in an upright position to prevent aspiration.
b. Place food in the unaffected side of the mouth: Placing food in the unaffected side of the mouth may not prevent aspiration and does not address the priority of positioning.
c. Offer mouth care before meals: While oral hygiene is important, it is not the priority when addressing the risk of aspiration during feeding.
d. Place the client in the upright position: The upright position helps prevent aspiration during swallowing, which is crucial for clients with dysphagia.
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