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
Explanation
Choice A rationale:
The base does interact with acids in the acid-base balance. Bases, by definition, are substances that can accept hydrogen ions (protons) and neutralize acids. In the context of acid-base balance, bases help regulate the pH of body fluids by counteracting the effects of acids.
Choice B rationale:
The role of the base in the acid-base balance is to promote the excretion of acid. Bicarbonate ions (HCO3-) are a vital component of the body's buffering system, helping to neutralize excess acid. The kidneys play a crucial role in excreting acids from the body, maintaining the acid-base balance.
Choice C rationale:
The base does not activate the system of acid-base balance; instead, it is part of the body's natural buffering system. The acid-base balance is regulated by the lungs and kidneys, which work together to maintain the pH of body fluids within a narrow range (7.35-7.45)
Choice D rationale:
Bases do not increase the action of hydrogen ions. In fact, bases neutralize hydrogen ions, which are acidic. By accepting these ions, bases help to decrease the acidity of a solution, playing a key role in maintaining the body's acid-base balance.
Correct Answer is C
Explanation
Choice A rationale:
Metabolic acidosis is characterized by low blood pH and low bicarbonate ion levels. The patient's bicarbonate ion level (24 mEq/L) is within the normal range, and the low pH (7.32) and elevated PaCO2 (56 mm Hg) indicate respiratory acidosis, not metabolic acidosis.
Choice B rationale:
Metabolic alkalosis is characterized by high blood pH and high bicarbonate ion levels. The patient's pH is low (7.32), and the bicarbonate ion level (24 mEq/L) is within the normal range, indicating respiratory acidosis rather than metabolic alkalosis.
Choice C rationale:
Respiratory acidosis is characterized by low blood pH and high PaCO2 levels. In this case, the patient has a low pH (7.32) and elevated PaCO2 (56 mm Hg), indicating respiratory acidosis. The bicarbonate ion level (24 mEq/L) is a compensatory response. Respiratory alkalosis would present with high pH and low PaCO2 levels.
Choice D rationale:
Respiratory alkalosis is characterized by high blood pH and low PaCO2 levels. The patient's PaCO2 level is elevated (56 mm Hg), indicating respiratory acidosis, not alkalosis. The low pH (7.32) further supports the diagnosis of respiratory acidosis.
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