A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Hypovolemia

Hypotension

Left ventricular failure

Cardiogenic shock

Answer and Explanation

The Correct Answer is C

Rationale:
A. Hypovolemia: Hypovolemia causes a decrease in PAWP due to reduced circulating blood volume and inadequate venous return to the heart. A low PAWP reflects decreased left ventricular preload, not an elevated value.

B. Hypotension: Hypotension alone does not directly increase PAWP. In fact, low blood pressure often accompanies decreased cardiac filling pressures. Elevated PAWP typically occurs with fluid overload or impaired ventricular function rather than simple hypotension.

C. Left ventricular failure: An elevated PAWP indicates increased left-sided heart pressures due to ineffective left ventricular pumping. Blood backs up into the pulmonary circulation, leading to pulmonary congestion and edema.

D. Cardiogenic shock: In cardiogenic shock, PAWP can be elevated due to impaired contractility, but it is accompanied by low cardiac output and hypotension. While related, the elevated PAWP in cardiogenic shock results from the underlying left ventricular failure, which is the primary cause of the pressure increase.

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Correct Answer is B

Explanation

Rationale:
A. Tell the client they can continue to drink cranberry juice while taking warfarin: Cranberry juice can potentiate the effects of warfarin, increasing the risk of bleeding. Clients should be cautioned to avoid interactions that affect anticoagulation.

B. Consult the pharmacist about potential interactions between the client's regular medications and warfarin: Warfarin has numerous drug and food interactions that can significantly alter its effectiveness. Consulting a pharmacist ensures safe management of concurrent medications and reduces the risk of adverse effects.

C. Recommend the client take warfarin at the same time as other medications: While consistent dosing is important, the priority is verifying potential interactions with other medications rather than simply synchronizing administration times.

D. Advise the client that over-the-counter medications remain safe to consume as needed: Many OTC medications, such as NSAIDs, can increase bleeding risk when taken with warfarin. Clients should always check with their provider or pharmacist before using OTC products.

A. The person holding financial power of attorney will make health care decisions based on the client's advance directives. B. The client has the right to refuse medical treatment, even if health care providers recommend it. C. If the client's advance directives are in writing and notarized, the client cannot change it in the future. D. The client's eldest adult child has the right to change advance directives in an end-of-life situation.

Correct Answer is B

Explanation

Rationale:
A. A financial power of attorney manages financial affairs, not medical decisions. Health care decisions are instead guided by a health care proxy or durable power of attorney for health care, as outlined in the client’s advance directives.

B. The Patient Self-Determination Act upholds the client’s autonomy by allowing them to accept or refuse medical or life-sustaining treatment. This includes the right to decline care, even if such refusal may lead to death, ensuring that personal values and wishes guide end-of-life care.

C. Advance directives can be revised or revoked by the client at any time, regardless of notarization, as long as the client remains mentally competent. The document reflects current wishes and is not legally binding indefinitely.

D. Family members cannot alter a legally valid advance directive. The document represents the client’s own decisions, and only the client can modify or revoke it while competent to do so.

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A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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