The nurse is explaining to a client diagnosed with heart failure that the client's heart muscle has thickened on the right side and is not able to fill properly.
The nurse is explaining which of the following types of heart failure?
Right and left-sided diastolic.
Right-sided systolic and diastolic.
Right-sided diastolic.
Right-sided systolic.
The Correct Answer is C
Choice A rationale
Right and left-sided diastolic failure refers to impairment in ventricular relaxation in both sides of the heart. This prevents proper ventricular filling, leading to decreased cardiac output and congestion in pulmonary and systemic circuits. However, the condition described involves only the right heart, making this option incorrect scientifically.
Choice B rationale
Right-sided systolic and diastolic failure involves impaired right ventricular contraction (systolic) and relaxation (diastolic). Since the scenario specifically focuses on diastolic dysfunction alone due to ventricular thickening, systolic dysfunction is not implicated. Thus, this choice does not align with the clinical presentation given.
Choice C rationale
Right-sided diastolic failure is characterized by thickened ventricular walls (often due to hypertrophy or restrictive cardiomyopathy) that impair ventricular relaxation. This reduces ventricular filling, leading to systemic venous congestion. The described pathology fits this condition, making it the accurate answer according to the description of right-sided heart failure.
Choice D rationale
Right-sided systolic failure occurs when the heart cannot effectively pump blood out of the right ventricle due to weakened contraction. Since the described issue involves diastolic dysfunction from thickened myocardial walls, systolic dysfunction is not a feature here, rendering this option scientifically incorrect. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Fatigue can occur in thrombocytopenia due to associated bleeding or anemia, but it is not a hallmark symptom specific to low platelet counts alone. Fatigue relates more to overall systemic effects or concurrent conditions rather than isolated thrombocytopenia. Hemorrhage and petechiae, however, are more directly correlated with reduced platelets in circulation, which compromise clotting and vascular integrity.
Choice B rationale
Hemorrhage is a major concern in thrombocytopenia due to severely reduced platelet counts. Normal platelet levels range from 150,000–450,000/mm³, and values of 18,000/mm³ indicate critical impairment in clot formation, increasing the risk of spontaneous bleeding. Hemorrhagic events in vital organs pose life-threatening consequences, making monitoring and interventions essential to minimize complications associated with uncontrolled bleeding.
Choice C rationale
Petechiae are pinpoint hemorrhages visible on the skin or mucosal surfaces, indicating capillary bleeding due to insufficient platelet-mediated clotting. Normal platelet levels maintain vascular integrity by enabling clot formation, which prevents such microvascular bleeding. Platelet counts as low as 18,000/mm³ lead to abnormal hemorrhagic manifestations, making petechiae a frequent and observable sign in severe thrombocytopenia cases.
Choice D rationale
Headache can occur with thrombocytopenia if intracranial hemorrhage develops, but it is not an expected symptom in all cases. While bleeding risks elevate overall concerns, headache depends on specific organ involvement. Petechiae and systemic hemorrhage are primary symptoms associated with low platelet levels. Headaches without evidence of bleeding do not distinctly correlate with thrombocytopenia diagnosis.
Correct Answer is B
Explanation
Choice A rationale
Delaying follow-up without immediate intervention may result in the client's blood pressure remaining uncontrolled, increasing the risk of complications like cardiovascular events. Reevaluation in one month without assessing adherence neglects the urgent need for optimizing management.
Choice B rationale
Assessing adherence to both lifestyle modifications and medication therapy is crucial as noncompliance may explain the suboptimal blood pressure control. Ensuring adherence and addressing any barriers are necessary steps in evaluating the effectiveness of treatment.
Choice C rationale
Increasing medication dosage without first assessing the client's adherence to current prescriptions or lifestyle modifications may be premature. Nonadherence to therapy could render dosage adjustments ineffective, leading to unnecessary changes to the regimen.
Choice D rationale
Adding a calcium-channel blocker without assessing adherence disregards the importance of compliance. Treatment should be optimized based on existing therapy before considering additional pharmacological interventions. .
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