The nurse is assessing a client with decompensated heart failure. Which finding would indicate that the client is manifesting right-sided heart failure?

Decreased peripheral pulses

S3 heart murmur

Distended neck veins

Orthopnea

Answer and Explanation

The Correct Answer is C

A. Decreased peripheral pulses. Decreased pulses may be related to poor perfusion but are not a hallmark sign of right-sided heart failure.

B. S3 heart murmur. An S3 heart murmur is associated with left-sided heart failure due to fluid overload in the lungs.

C. Distended neck veins: Right-sided heart failure leads to the backup of blood in the systemic circulation, which often causes jugular vein distention (JVD), peripheral edema, and hepatomegaly.

D. Orthopnea. Orthopnea is a symptom of left-sided heart failure, where fluid builds up in the lungs, making it difficult to breathe when lying flat.

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Correct Answer is ["A","B","C","E"]

Explanation

A. Bring the crash cart to the bedside: Essential for advanced cardiac life support (ACLS), including defibrillation and medications.

B. Start cardiopulmonary resuscitation: High-quality CPR is critical to maintain circulation until defibrillation can occur.

C. Defibrillate the client: Defibrillation is the definitive treatment for ventricular fibrillation to restore a normal rhythm.

D. Administer adenosine (Adenocard) to assist in determining the rhythm: Adenosine is used for diagnosing or treating certain supraventricular tachycardias, not ventricular fibrillation.

E. Consider the "Hs and Ts": Identifying reversible causes of cardiac arrest (e.g., hypoxia, hypothermia, toxins) is part of the ACLS protocol.

A. Administration of prescribed Atropine B. A prescription for transcutaneous pacing. C. An extra dose of digoxin will be prescribed D. The next dose of digoxin will be held

Correct Answer is D

Explanation

A. Administration of prescribed Atropine. Atropine is typically used for bradycardia related to second-degree heart block Mobitz 2 or complete block, but Mobitz 1 usually resolves on its own and does not require atropine unless symptoms develop.

B. A prescription for transcutaneous pacing. Transcutaneous pacing is typically used for more severe types of heart block, such as Mobitz 2 or third-degree block, not Mobitz 1.

C. An extra dose of digoxin will be prescribed. Giving additional digoxin would be contraindicated due to its effects on AV conduction.

D. The next dose of digoxin will be held: Second-degree heart block Mobitz 1 (also known as Wenckebach) can be worsened by digoxin, which has a vagomimetic effect that can slow conduction through the AV node. Therefore, the next dose of digoxin should be held to avoid further exacerbating the block.

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The nurse is assessing a client with decompensated heart failure. Which finding would indicate that the client is manifesting right-sided heart failure?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is D

Explanation

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