The assessment findings of a patient with myocardial infarction (MI) include jugular venous distention, weight gain, peripheral edema, and a heart rate of 108/minute. The nurse suspects what complication?

Left-sided HF

Right-sided HF

Chronic heart failure (HF)

Acute decompensated heart failure (ADHF)

Answer and Explanation

The Correct Answer is B

The assessment findings of jugular venous distention, weight gain, peripheral edema, and a heart rate of 108/minute are consistent with right-sided heart failure (HF). Right-sided HF occurs when the right ventricle of the heart is unable to pump effectively, leading to congestion in the venous circulation. This can result in jugular venous distention (JVD) due to increased pressure in the jugular veins, peripheral edema due to fluid retention, and weight gain due to fluid accumulation.

Option A (Left-sided HF) may also present with similar symptoms like jugular venous distention, weight gain, and peripheral edema. However, in left-sided HF, there would typically be signs of pulmonary congestion, such as crackles in the lungs and shortness of breath.

Option C (Chronic heart failure) is a general term used for heart failure that has been present for an extended period, and it does not specify whether it is left-sided or right-sided heart failure.

Option D (Acute decompensated heart failure - ADHF) is a form of heart failure that presents with severe symptoms and requires urgent treatment. It is more of a clinical classification rather than a specific complication related to the symptoms mentioned in the scenario.

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Correct Answer is ["A","B","D"]

Explanation

A) Potassium: CKD can lead to hyperkalemia (high potassium levels) as the kidneys lose their ability to excrete potassium effectively. Limiting potassium intake helps prevent elevated potassium levels and reduces the risk of cardiac arrhythmias.

B) Calcium: In CKD, impaired kidney function can lead to abnormalities in calcium and phosphorus metabolism, which can result in secondary hyperparathyroidism. Limiting calcium intake can help manage the imbalances in calcium and phosphorus levels.

(D) Phosphorus: Impaired kidney function in CKD leads to decreased phosphate excretion, resulting in hyperphosphatemia (high phosphorus levels). High phosphorus levels can lead to bone disease and other complications, so limiting phosphorus intake is essential.

Iron (C) is not typically limited in the diet of a client with CKD unless they have iron overload or specific conditions that warrant iron restriction.

A. First-degree atrioventricular block B. Inverted P wave C. Sinus Tachycardia D. ST-segment elevation

Correct Answer is D

Explanation

ST-segment elevation on an electrocardiogram (ECG) is a critical finding and should be reported rapidly to the health care provider. It is a hallmark ECG change seen in myocardial infarction (heart attack). When there is myocardial ischemia or injury (such as in a heart attack), the ST segment

elevates above the baseline in the affected leads of the ECG. This elevation indicates that there is an ongoing loss of oxygen and blood supply to a part of the heart muscle.

ST-segment elevation is a medical emergency because it suggests acute coronary syndrome (ACS), which can rapidly progress to a myocardial infarction if not promptly treated. Immediate intervention is needed to restore blood flow to the affected coronary artery and prevent further damage to the heart muscle.

The other options listed (A) First-degree atrioventricular block, (B) Inverted P wave, and (C) Sinus tachycardia, while significant in some situations, do not have the same urgency as ST-segment elevation in the context of chest pain. They may require medical attention, but they do not typically indicate an acute myocardial infarction or an immediate life-threatening condition. ST-segment elevation is a critical finding that requires rapid intervention to preserve heart muscle function and prevent complications.

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The assessment findings of a patient with myocardial infarction (MI) include jugular venous distention, weight gain, peripheral edema, and a heart rate of 108/minute. The nurse suspects what complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

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Correct Answer is D

Explanation

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