The nurse suspects that which condition associated with chronic heart failure is the cause of a patient's inability to sleep well due to frequent urination?
Fullness from ascites.
Hypoproteinemia.
Hypoperfusion to the brain.
Increased renal perfusion in the supine position.
The Correct Answer is D
Choice A rationale:
Fullness from ascites is a symptom associated with conditions like liver cirrhosis, not directly related to chronic heart failure. Ascites is the accumulation of fluid in the abdominal cavity, causing a feeling of fullness and abdominal discomfort.
Choice B rationale:
Hypoproteinemia, a condition characterized by low levels of proteins in the blood, can lead to fluid retention and edema. However, it is not a direct cause of frequent urination. Frequent urination in this context is more likely related to increased fluid volume in the body, which can be caused by increased renal perfusion in the supine position due to fluid redistribution from the lower extremities to the kidneys.
Choice C rationale:
Hypoperfusion to the brain can lead to neurological symptoms, but it does not directly cause frequent urination. Frequent urination is often related to the kidneys' ability to filter excess fluid and excrete it as urine.
Choice D rationale:
Increased renal perfusion in the supine position can cause frequent urination, especially at night. When a person with chronic heart failure lies down, fluid that has accumulated in the lower extremities (edema) during the day is redistributed to the kidneys due to the change in body position. This increased renal perfusion results in an increased production of urine, leading to nocturia (frequent urination at night) and disrupting the patient's ability to sleep well. This symptom is characteristic of heart failure-related fluid overload and is an important clinical sign indicating worsening heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Choice A rationale:
Palpitations are not directly related to a low hemoglobin level. They can occur due to various cardiac conditions but are not specific to anemia.
Choice B rationale:
Conjunctival pallor is a common physical finding in patients with low hemoglobin levels (anemia) Anemia leads to reduced oxygen-carrying capacity, causing paleness in mucous membranes such as the conjunctiva.
Choice C rationale:
Sternal tenderness is not a typical finding associated with low hemoglobin levels. It is more often associated with conditions affecting the sternum or adjacent structures, such as infections or inflammation.
Choice D rationale:
A heart rate of 104 beats/min can be a compensatory response to anemia. When the body senses reduced oxygen levels due to anemia, the heart rate may increase to pump more blood and oxygen to vital organs, attempting to compensate for the low hemoglobin levels.
Correct Answer is D
Explanation
Choice A rationale:
Thrombus formation is a later stage event in coronary artery disease (CAD) and occurs after the development of fatty streaks. Thrombus formation usually happens due to the rupture of atherosclerotic plaques, leading to platelet aggregation and clot formation.
Choice B rationale:
Formation of fibrous plaque in the endothelium is a progression that occurs after the initial development of fatty streaks. Fibrous plaques are formed as a response to the inflammation caused by fatty deposits. They are more stable than fatty streaks but can still lead to narrowing of the arteries.
Choice C rationale:
Reduction of blood flow through the coronary arteries is a consequence of atherosclerosis, which occurs after the initial development of fatty streaks. As the fatty deposits accumulate, they narrow the arteries, leading to reduced blood flow. However, this is not the initial change that makes patients susceptible to CAD.
Choice D rationale:
Development of fatty streaks in the smooth muscles of the endothelium is the initial change that occurs in the development of atherosclerosis, making patients susceptible to coronary artery disease. Fatty streaks are composed of lipid-laden macrophages and smooth muscle cells. Over time, these fatty streaks can progress into fibrous plaques and eventually lead to complications such as thrombus formation and reduced blood flow.
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