The nurse identifies that the goal of decreasing the cardiac workload for a client receiving atenolol 25 mg PO BID for unstable angina is met when the client has:
An increase in urine output.
Less dyspnea with activity.
A blood pressure of 120/80 mmHg.
A heart rate of 65 per minute.
The Correct Answer is D
Choice a reason:
An increase in urine output can be a sign of improved kidney function or the effect of medications, but it is not a direct indicator of reduced cardiac workload. Atenolol, a beta-blocker, primarily reduces the heart rate and myocardial oxygen demand, not urine output.
Choice b reason:
Less dyspnea with activity suggests improved cardiovascular efficiency, but it is not a specific measure of cardiac workload. Dyspnea can be influenced by respiratory conditions and is not solely determined by cardiac function.
Choice c reason:
A blood pressure of 120/80 mmHg is considered optimal for most adults and indicates good control of hypertension. However, it does not specifically reflect the cardiac workload, which is more directly affected by heart rate and myocardial oxygen demand.
Choice d reason:
A heart rate of 65 per minute is a clear indicator that atenolol is effective in reducing cardiac workload. Atenolol decreases the heart rate, which in turn reduces myocardial oxygen demand and the overall workload on the heart. This is particularly important for patients with unstable angina, where reducing the heart's workload can prevent angina attacks and potential myocardial infarction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
A respiratory rate of 24/min is slightly elevated, which can be expected in a client with pneumonia due to the body's attempt to increase oxygen intake and carbon dioxide elimination. However, this rate does not directly indicate ineffective airway clearance.
Choice B reason:
A weak, nonproductive cough is a key indicator of ineffective airway clearance. In pneumonia, the presence of secretions in the airways is common, and an effective cough is necessary to clear these secretions. A weak cough that does not produce sputum suggests that the client is unable to clear their airways effectively, which can lead to impaired gas exchange and worsening of symptoms.
Choice C reason:
Pulse oximetry (SpO2) of 90% indicates that the client's oxygen saturation is below the normal range, which is typically between 95-100% for healthy individuals. While this finding is concerning and warrants intervention, it is a result of ineffective airway clearance rather than a direct indicator of it.
Choice D reason:
Shortness of breath with activity is common in clients with pneumonia and can result from various factors, including impaired gas exchange, decreased lung compliance, and increased work of breathing. While it may be associated with ineffective airway clearance, it is not as specific as a weak, nonproductive cough for indicating this particular problem.
Correct Answer is C
Explanation
Choice A Reason
The continuous nature of the mucosa refers to the uninterrupted lining of the urinary tract, which provides a barrier against pathogens. However, this characteristic is not a significant factor in the increased susceptibility of women to cystitis. Both men and women have a continuous mucosal lining, and it does not account for the gender difference in infection rates.
Choice B Reason
High estrogen levels can influence the tissues of the urinary tract and may affect susceptibility to infections. However, the role of estrogen in the development of cystitis is not as direct or significant as anatomical differences. Estrogen levels vary throughout a woman's life and do not consistently correlate with cystitis risk.
Choice C Reason
Urethral proximity to the rectum is the most significant anatomical factor contributing to a woman's increased susceptibility to cystitis¹⁴. Women have a shorter urethra than men, and its close proximity to the anus allows bacteria from the bowel area to more easily enter the urinary tract and cause infections.
Choice D Reason
Inadequate fluid intake can lead to less frequent urination, which is a risk factor for cystitis because it reduces the natural flushing of bacteria from the urinary tract. However, this is a modifiable risk factor and does not inherently explain the higher incidence of cystitis in women compared to men.
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