Which diagnostic test will be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure?

Serum troponin

Arterial blood gasses

12-lead electrocardiogram

B-type natriuretic peptide

Answer and Explanation

The Correct Answer is D

B-type natriuretic peptide (BNP) is a diagnostic blood test that can be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure.

BNP is a hormone produced by the heart in response to increased pressure and volume in the heart, especially in cases of heart failure. When the heart is under stress, such as in heart failure, it releases BNP into the bloodstream. Elevated levels of BNP are strongly indicative of heart failure, and the test is particularly helpful in differentiating heart failure from other conditions that may present with similar symptoms, such as pulmonary disorders.

When a patient presents with acute shortness of breath, the BNP test can provide valuable information to help guide the diagnosis and treatment. If the BNP level is elevated, it suggests that heart failure is likely the cause of the symptoms, and appropriate interventions can be initiated promptly.

While other diagnostic tests like serum troponin (A) are important for assessing heart damage in conditions like myocardial infarction (heart attack), they may not be as specific for heart failure.

Arterial blood gases (B) are helpful in evaluating gas exchange and acid-base balance, especially in patients with respiratory distress, but they are not specific for diagnosing heart failure.

A 12-lead electrocardiogram (ECG) (C) can provide valuable information about the heart's electrical activity and any signs of acute myocardial infarction or other cardiac abnormalities, but it is not the primary test for diagnosing heart failure. An ECG can support the diagnosis if specific changes suggestive of heart failure are present, but the BNP test provides more direct evidence for heart failure diagnosis.

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Correct Answer is A

Explanation

Diuretics are the primary class of drugs used to treat volume overload in patients with acute decompensated heart failure (ADHF). These medications help to increase urine output, reducing the overall fluid volume in the body and relieving congestion in the lungs and other tissues.

The goal of using diuretics in ADHF is to alleviate symptoms such as shortness of breath, edema (swelling), and fluid retention by promoting the elimination of excess fluid. The most commonly used diuretics in this setting are loop diuretics (e.g., furosemide, bumetanide), which have a potent diuretic effect and can rapidly reduce fluid overload.

While narcotics, vasodilators, and positive inotropes may have roles in specific cases of ADHF, they are not the primary drugs used to treat volume overload. Narcotics may be used for pain management, vasodilators to reduce afterload (the resistance the heart has to pump against), and positive inotropes to increase the heart's contractility in certain situations. However, the first-line treatment for volume overload in ADHF is diuretic therapy.

A. IV morphine sulfate 4 mg B. Oral acetaminophen (Tylenol) 650 mg C. Oral ibuprofen (Motrin) 600 mg D. Fentanyl 1 mg IV

Correct Answer is C

Explanation

Pericarditis is inflammation of the pericardium, the sac-like membrane surrounding the heart. It can cause chest pain, which is often worsened by deep breathing or coughing. The goal of treatment for pericarditis is to reduce inflammation and relieve pain.

In this case, the client's pain level is reported as 6 out of 10. As per the PRN (as-needed) medication options given:

C) Oral ibuprofen (Motrin) 600 mg: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and can help reduce inflammation and relieve pain in cases of pericarditis. It is an appropriate choice for this client's pain level of 6 out of 10.

A) IV morphine sulfate 4 mg: IV morphine is a potent opioid analgesic and may be appropriate for severe pain. However, in this case, the client's pain level is moderate (6 out of 10), and it is not the first-line medication for pericarditis pain.

B) Oral acetaminophen (Tylenol) 650 mg: Acetaminophen is a mild analgesic and antipyretic that can be effective for mild to moderate pain. However, in this situation, the client's pain is moderate (6 out of 10), and acetaminophen alone may not provide adequate relief for pericarditis pain.

D) Fentanyl 1 mg IV: Fentanyl is another potent opioid analgesic. However, similar to morphine, it may be more appropriate for severe pain, not moderate pain like in this scenario.

Based on the client's pain level and the goal of reducing inflammation, the most appropriate PRN medication for the nurse to give is oral ibuprofen (Motrin) 600 mg.

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Which diagnostic test will be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure?

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Naxlex Comprehensive Predictor Exams

The nurse recalls that which type of drug therapy is used to treat volume overload in patients with acute decompensated heart failure (ADHF)?

Correct Answer is A

Explanation

A client recovering from heart surgery develops pericarditis and reports level 6 (0 to 10 scale) chest pain with deep breathing. Which prescribed PRN medication will be the most appropriate for the nurse to give?

Correct Answer is C

Explanation

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