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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Increased platelet count: Preeclampsia is often associated with thrombocytopenia (low platelet count), not an increase. A falling platelet count can be a warning sign of worsening disease or progression to HELLP syndrome.
B. Increased protein in urine: Proteinuria is one of the hallmark signs of preeclampsia, resulting from glomerular damage in the kidneys. A 24-hour urine protein test or dipstick is commonly used to detect elevated protein levels during pregnancy.
C. Decreased BUN: Blood urea nitrogen (BUN) may increase if renal perfusion is compromised, but a decrease is not typical in preeclampsia. Kidney involvement often leads to elevated BUN and creatinine levels.
D. Decreased serum uric acid: Preeclampsia usually causes elevated serum uric acid levels due to decreased renal clearance. A drop in uric acid would be inconsistent with this diagnosis
Correct Answer is ["A","C","D","E","F"]
Explanation
Rationale:
A. Temperature: The client's temperature decreased from 38.6°C (101.5°F) to 37.1°C (98.9°F), indicating that the febrile response to infection has resolved. This trend supports the effectiveness of the antibiotic therapy initiated on postpartum day 3.
B. Hgb: Hemoglobin dropped from 11.1 to 10 g/dL, which may reflect continued postpartum blood loss or hemodilution. This decline does not indicate improvement and may require monitoring for worsening anemia.
C. Heart rate; Heart rate improved from 110/min to 78/min, demonstrating reduced physiologic stress and better cardiovascular stability. This aligns with the drop in temperature and suggests systemic recovery from infection.
D. Fundal height; The fundus decreased from 1 cm above the umbilicus to 4 cm below, showing normal postpartum involution. A firm, midline uterus without excessive tenderness also supports clinical improvement.
E. Lochia: Lochia changed from moderate, dark brown, and foul-smelling to a small amount of brownish-red with no odor, which suggests resolving endometrial infection. This progression is typical in healthy postpartum recovery.
F. WBC count: The WBC count normalized from 33,000/mm³ to 10,000/mm³, reflecting resolution of systemic inflammation or infection. This is consistent with decreasing temperature and improved vital signs.
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