The nurse, who is caring for a client diagnosed with coronary artery disease, prioritizes the problem of impaired tissue perfusion in the plan of care. Which outcome would be most appropriate? The client will:

have a urinary output of greater than 30 mL per hour for 24 hours.

discuss which lifestyle modifications will be necessary to maintain health.

express no complaints of chest discomfort or shortness of breath.

have clear breath sounds bilaterally upon auscultation.

Answer and Explanation

The Correct Answer is C

Choice A reason: Having a urinary output of greater than 30 mL per hour for 24 hours is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of fluid volume excess or renal impairment, which are not the case for this client.

Choice B reason: Discussing which lifestyle modifications will be necessary to maintain health is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of knowledge deficit or risk for recurrence, which are not the priority for this client.

Choice C reason: Expressing no complaints of chest discomfort or shortness of breath is the most appropriate outcome for the problem of impaired tissue perfusion. This outcome indicates that the client's cardiac output and oxygen delivery are adequate and that the interventions are effective.

Choice D reason: Having clear breath sounds bilaterally upon auscultation is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of impaired gas exchange or pulmonary congestion, which are not the case for this client.

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Correct Answer is D

Explanation

Choice A reason: Respiratory alkalosis is not the correct answer. Respiratory alkalosis is a condition where the blood pH is high (above 7.45) due to low carbon dioxide levels (below 35 mmHg) caused by hyperventilation. The client's blood pH is low (7.2) and the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory alkalosis.

Choice B reason: Metabolic alkalosis is not the correct answer. Metabolic alkalosis is a condition where the blood pH is high (above 7.45) due to high bicarbonate levels (above 26 mEq/L) caused by excessive loss of acids or intake of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which does not indicate metabolic alkalosis.

Choice C reason: Respiratory acidosis is not the correct answer. Respiratory acidosis is a condition where the blood pH is low (below 7.35) due to high carbon dioxide levels (above 45 mmHg) caused by hypoventilation. The client's blood pH is low (7.2) but the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory acidosis.

Choice D reason: This is the correct answer. Metabolic acidosis is a condition where the blood pH is low (below 7.35) due to low bicarbonate levels (below 22 mEq/L) caused by excessive production or intake of acids or loss of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which indicates metabolic acidosis.

A. Decrease the incidence of tachycardia B. Dilate the coronary arteries C. Decrease cardiac workload D. Increase the strength of myocardial contraction

Correct Answer is A

Explanation

Choice A reason: Decreasing the incidence of tachycardia is not the main therapeutic effect of atenolol for coronary artery disease. Atenolol is a beta-blocker that lowers the heart rate, but this is not the primary goal of therapy for coronary artery disease. Coronary artery disease is caused by atherosclerosis, which is the buildup of plaque in the arteries that supply the heart. This reduces the blood flow and oxygen to the heart muscle and causes angina, or chest pain.

Choice B reason: Dilating the coronary arteries is not the therapeutic effect of atenolol for coronary artery disease. Atenolol does not directly affect the diameter of the coronary arteries. It works by blocking the beta receptors in the heart and reducing the response to adrenaline and other stress hormones. This lowers the blood pressure and the oxygen demand of the heart.

Choice C reason: This is the correct answer. Decreasing cardiac workload is the therapeutic effect of atenolol for coronary artery disease. Atenolol reduces the contractility and the excitability of the heart muscle, which lowers the force and the frequency of the heartbeats. This decreases the amount of work that the heart has to do and the amount of oxygen that it needs. This helps prevent or relieve anginal attacks and improve the quality of life of the client.

Choice D reason: Increasing the strength of myocardial contraction is not the therapeutic effect of atenolol for coronary artery disease. Atenolol does not increase the strength of myocardial contraction, but rather decreases it. Increasing the strength of myocardial contraction would increase the oxygen demand of the heart and worsen the angina. Atenolol aims to reduce the oxygen demand of the heart and improve the blood supply to the heart.

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The nurse, who is caring for a client diagnosed with coronary artery disease, prioritizes the problem of impaired tissue perfusion in the plan of care. Which outcome would be most appropriate? The client will:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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