Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?

Enlarged liver and peripheral edema.

Crackles in the lungs.

Dry hacking cough.

Altered mentation with pinpoint pupils.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Enlarged liver (hepatomegaly) and peripheral edema are common clinical manifestations of right heart failure (RHF). RHF leads to congestion of systemic circulation, causing fluid accumulation in the liver and peripheral tissues.
Choice B rationale
Crackles in the lungs are more commonly associated with left-sided heart failure, where fluid backs up into the pulmonary circulation, leading to pulmonary edema.
Choice C rationale
A dry hacking cough is not a typical symptom of right heart failure. It is more commonly associated with respiratory conditions such as asthma or bronchitis.
Choice D rationale
Altered mentation with pinpoint pupils is not a characteristic of right heart failure. These symptoms are more indicative of neurological conditions or opioid overdose.

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Correct Answer is B

Explanation

Choice A rationale
Hypercalcemia is characterized by increased calcium levels in the blood, often due to increased absorption of calcium from the gut. However, in chronic kidney disease (CKD), the kidneys’ ability to activate vitamin D is impaired, leading to decreased calcium absorption from the gut, not increased. Therefore, hypercalcemia is not a typical sign of CKD1.
Choice B rationale
A positive Chvostek’s sign is indicative of hypocalcemia, which is a common symptom in CKD. The kidneys’ reduced ability to activate vitamin D leads to decreased calcium absorption from the gut, resulting in low calcium levels in the blood. This hypocalcemia can cause neuromuscular irritability, leading to a positive Chvostek’s sign.
Choice C rationale
Tetany is a condition characterized by muscle cramps and spasms, often due to hypocalcemia. In CKD, hypocalcemia occurs due to the kidneys’ inability to activate vitamin D, leading to decreased calcium absorption from the gut. This hypocalcemia can cause hyperexcitability of nerves and muscles, resulting in tetany.
Choice D rationale
Hyperphosphatemia is characterized by high phosphate levels in the blood. In CKD, the kidneys’ ability to excrete phosphate is impaired, leading to its accumulation in the blood. However, this is not directly related to the inability to absorb phosphate from the gut but rather the kidneys’ reduced excretion capacity.

A. Acute respiratory distress syndrome (ARDS). B. Chronic obstructive pulmonary disease (COPD). C. Pulmonary edema. D. Pneumonia.

Correct Answer is D

Explanation

Choice A rationale
Acute respiratory distress syndrome (ARDS) is characterized by severe hypoxemia and respiratory distress, often requiring mechanical ventilation. It is not typically associated with a mild fever and increased respiratory rate.
Choice B rationale
Chronic obstructive pulmonary disease (COPD) is a chronic condition characterized by airflow limitation and respiratory symptoms, but not typically associated with a mild fever.
Choice C rationale
Pulmonary edema involves fluid accumulation in the lungs, leading to respiratory distress and hypoxemia, but not typically associated with a mild fever.
Choice D rationale
Pneumonia is an infection of the lungs causing fever (37.5°C), increased respiratory rate (28 breaths per minute), and other respiratory symptoms. It is the most likely condition given the symptoms.

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Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with chronic kidney disease usually has a decrease in the ability to activate vitamin D, likely resulting in signs and symptoms (S&S) such as:

Correct Answer is B

Explanation

A nurse is caring for a client with a temperature of 37.5°C (99.5°F) and a respiratory rate of 28 breaths per minute. Which condition is the client most likely experiencing?

Correct Answer is D

Explanation

A nurse is caring for a client with acute pancreatitis. Which laboratory result would the nurse expect to find elevated?

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A nurse is caring for a client with a body temperature of 38°C (100.4°F). Which of the following interventions should the nurse prioritize?

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