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 C
Explanation
Choice A rationale:
Buffers do not excrete weak acids; instead, they help regulate the pH of bodily fluids by preventing drastic changes in acidity or alkalinity.
Choice B rationale:
Buffers do not secrete hydrogen ions. In fact, buffers can either absorb or release hydrogen ions to maintain a stable pH.
Choice C rationale:
To convert strong acids to weak acids is the correct answer. Buffers are substances that can neutralize both acids and bases, helping to maintain a stable pH in a solution. They achieve this by accepting hydrogen ions from strong acids or donating hydrogen ions to strong bases, converting them into weaker acids or bases, respectively.
Choice D rationale:
Buffers do not convert ammonia to ammonium ions. This conversion is a part of the body's acid-base regulation system, but it is not the primary function of buffers.
Correct Answer is C
Explanation
Choice A rationale:
Spasm of a major coronary artery, also known as variant (Prinzmetal's) angina, typically occurs at rest and is not necessarily provoked by exertion. The patient's chest pain is exacerbated by exertion, making this choice less likely.
Choice B rationale:
Exposure of the thrombogenic surface to plaque refers to acute coronary syndromes like unstable angina or myocardial infarction. While plaque rupture and thrombosis can cause myocardial ischemia, the characteristic feature of these conditions is chest pain that may not be relieved by rest, unlike the patient described here.
Choice D rationale:
Myocardial ischemia secondary to microvascular disease, also known as cardiac syndrome X, is a condition where chest pain occurs without significant coronary artery stenosis. However, this condition usually affects women, and the pain is often unrelated to exertion. In the given case, the pain is provoked by exertion, making this choice less likely.
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