Which pathology of autonomic cardiac regulation is mediated by sympathetic innervation?

Increased Ca+ influx with sympathetic stimulation that raises the heart rate.

Sympathetic activation boosts K+ efflux and increases the inotropic effect.

Sympathetic activation decreases dromotrophy by lowering conduction speed.

Increased Na+ influx with sympathetic stimulation reduces pacemaker firing.’

Answer and Explanation

The Correct Answer is A

Choice A: Increased Ca+ influx with sympathetic stimulation that raises the heart rate is a manifestation of sympathetic innervation. Sympathetic activation leads to the release of norepinephrine, which enhances the influx of calcium ions (Ca+) into cardiac muscle cells, resulting in increased contractility and heart rate.

Choice B: Sympathetic activation does increase the inotropic effect (contractility) of the heart, but it is primarily mediated by the increased influx of calcium ions (Ca+).

Choice C: Sympathetic activation does not decrease dromotrophy (conduction speed). Instead, it can increase the conduction speed through the cardiac conduction system.

Choice D: Increased Na+ influx with sympathetic stimulation does not reduce pacemaker firing; instead, it contributes to the enhanced excitability and automaticity of cardiac cells.

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Correct Answer is ["A","B","C"]

Explanation

Choice A: Redness at the intravenous site may indicate infection or phlebitis, which are complications of TPN.

Choice B: Generalized nonpitting edema may indicate fluid overload, which can occur due to the high osmolarity of TPN.

Choice C: Frequent productive cough may indicate pulmonary edema or aspiration, which are also potential complications of TPN.

Choice D: Hypoactive bowel sounds in all 4 quadrants are not necessarily abnormal, as TPN bypasses the gastrointestinal tract.

Choice E: Urinary output greater than 30 mL per hour is within the normal range and indicates adequate renal function.

A. I will withhold the antacid for now, and if you get indigestion, I will bring it back. B. CKD stresses your body to over-secrete gastric juices, and antacids help neutralize them. C. Your serum phosphate levels are up, and aluminum antacids prevent absorption of phosphates in foods. D. OK, I will let your healthcare provider know that you do not need the antacid.

Correct Answer is C

Explanation

Choice A: Withholding the antacid until the client gets indigestion is not appropriate because the primary purpose of aluminum hydroxide in CKD is to bind to phosphates in foods and reduce their absorption. It is not primarily used for indigestion.

Choice B: While CKD can lead to disturbances in gastric acid secretion, aluminum antacids are primarily used in CKD to control hyperphosphatemia by binding to phosphates in the gastrointestinal tract. Their role is not primarily related to gastric acid control.

Choice C: This response provides the most appropriate rationale. Aluminum antacids are often prescribed to CKD clients to prevent the absorption of dietary phosphates, which can contribute to hyperphosphatemia in CKD.

Choice D: Simply informing the healthcare provider that the client does not want to take the antacid is not the most informative response, as it does not address the rationale behind the medication use in CKD.

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Which pathology of autonomic cardiac regulation is mediated by sympathetic innervation?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding(s) should alert the nurse that further assessment is needed? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

An adult male client with chronic kidney disease (CKD) is receiving aluminum hydroxide (Amphojel). He tells the nurse that since he does not have indigestion there is no need for him to take the antacid with his meals. Which response is best for the nurse to provide?

Correct Answer is C

Explanation

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