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?

Hypotension

Hypovolemia

Cardiogenic shock

Left ventricular failure

Answer and Explanation

The Correct Answer is D

Rationale:

A. Hypotension: Hypotension is typically associated with decreased preload and low PAWP rather than elevated values. An elevated PAWP reflects increased pressure in the left heart, which does not occur with simple hypotension alone.

B. Hypovolemia: Hypovolemia leads to decreased circulating blood volume, reducing preload and PAWP. It is typically marked by low filling pressures, not elevated wedge pressures.

C. Cardiogenic shock: Although cardiogenic shock can be associated with elevated PAWP due to poor cardiac output and fluid backup, it is not as specific a marker as left ventricular failure, which directly affects PAWP.

D. Left ventricular failure: Elevated PAWP reflects increased pressure in the left atrium and pulmonary circulation, which is a hallmark of left-sided heart failure. This elevation occurs because the failing left ventricle cannot efficiently pump blood forward.

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Correct Answer is C

Explanation

Rationale:

A. "Your child can return to school once the fever has subsided.": The absence of fever does not indicate the child is no longer contagious. The child can still transmit the varicella-zoster virus until all lesions have crusted, even if fever has resolved.

B. "Your child can return to school after a negative titer result.": Titer testing is not used to determine contagiousness in active varicella infection. It is typically used to confirm immunity, especially after vaccination or past exposure.

C. "Your child can return to school once the lesions have crusted over.": Varicella is contagious until all lesions have crusted, which usually occurs about 5–7 days after the onset of rash. Crusting marks the end of the infectious period, making it safe for the child to return to school.

D. "Your child can return to school 24 hours after beginning antibiotics.": Varicella is a viral illness, not treated with antibiotics unless there is a secondary bacterial infection. Antibiotics do not impact the contagious period of the viral illness.

A. A client who has decreased interleukin-6 levels B. A client who has decreased urine cortisol levels C. A client who has decreased C-reactive protein levels D. A client who has decreased serotonin levels

Correct Answer is D

Explanation

Rationale:

A. A client who has decreased interleukin-6 levels: Interleukin-6 is a pro-inflammatory cytokine that may be elevated in depression, but its decrease is not an indicator for antidepressant use. It’s not routinely used to determine the need for antidepressant therapy in clinical practice.

B. A client who has decreased urine cortisol levels: Depression is more commonly associated with increased cortisol levels due to stress responses. Low cortisol may be seen in conditions like Addison's disease but does not typically guide antidepressant use.

C. A client who has decreased C-reactive protein levels: CRP is a nonspecific inflammatory marker. While elevated CRP has been observed in some individuals with depression, a decreased CRP level would not indicate the need for antidepressant therapy.

D. A client who has decreased serotonin levels: Low serotonin levels are closely linked to depression pathophysiology. Many antidepressants, such as SSRIs, target serotonin levels to relieve depressive symptoms, making this the most relevant indicator for antidepressant therapy.

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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?

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