(1 point). Listen.
Which of the following conditions will the nurse observe documented on the cha, the patient has a rapid collection of fluid in the pericardial sac, resulting in tamponade?
Pericardial rub.
Pericardial effusion.
Cardiomyopathy.
Constrictive pericarditis.
The Correct Answer is B
Choice A rationale:
Pericardial rub A pericardial rub is a clinical finding where a healthcare provider can hear a grating or scratching sound when listening to the heart using a stethoscope. It is a sign of inflammation of the pericardium (pericarditis) but is not necessarily associated with the rapid collection of fluid in the pericardial sac. Pericardial rub is more indicative of inflammation and not fluid accumulation.
Choice B rationale:
Pericardial effusion Pericardial effusion is the abnormal accumulation of fluid in the pericardial sac surrounding the heart. If the fluid accumulates rapidly, it can lead to cardiac tamponade, a life-threatening condition where the heart's ability to pump blood is compromised. The nurse should observe for signs and symptoms of pericardial effusion and its complications in the patient's chart when rapid fluid collection is suspected.
Choice C rationale:
Cardiomyopathy Cardiomyopathy is a condition characterized by abnormal heart muscle function. It can lead to heart failure and other cardiac issues, but it is not directly related to the rapid collection of fluid in the pericardial sac. The question specifically focuses on a condition resulting from the rapid accumulation of fluid in the pericardial sac.
Choice D rationale:
Constrictive pericarditis Constrictive pericarditis is a condition in which the pericardium becomes thickened and rigid, restricting the heart's ability to expand and fill with blood. It is a chronic condition and not typically associated with a rapid collection of fluid in the pericardial sac. Rapid fluid accumulation leading to tamponade is more indicative of pericardial effusion, which is the correct answer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Labeling hyperhomocysteinemia as a traditional risk factor is not accurate. This statement is incorrect. Hyperhomocysteinemia is not typically considered a traditional risk factor for coronary artery disease (CAD). Traditional risk factors include factors such as smoking, hypertension, high cholesterol, and diabetes.
Choice B rationale:
Labeling hyperhomocysteinemia as a major risk factor is not common. This statement is incorrect. While elevated homocysteine levels are associated with an increased risk of CAD, it is not typically considered a major risk factor. Major risk factors for CAD usually include factors like smoking, high blood pressure, and high cholesterol.
Choice C rationale:
Labeling hyperhomocysteinemia as a novel risk factor is appropriate. This statement is correct. Hyperhomocysteinemia is considered a novel or emerging risk factor for CAD. Elevated homocysteine levels have been associated with an increased risk of CAD, and it is an area of ongoing research and investigation.
Choice D rationale:
Labeling hyperhomocysteinemia as a conventional risk factor is not accurate. This statement is incorrect. Hyperhomocysteinemia is not considered a conventional risk factor for CAD. Conventional risk factors are well-established and widely recognized risk factors for a particular condition.
Correct Answer is B
Explanation
Choice A rationale:
Insulin resistance is not a typical complication of sustained hypertension. This statement is incorrect. While hypertension can lead to various complications, insulin resistance is not one of the primary complications associated with high blood pressure.
Choice B rationale:
Left ventricular hypertrophy is a common complication of sustained hypertension. This statement is correct. Prolonged high blood pressure can lead to the thickening and enlargement of the left ventricle of the heart, known as left ventricular hypertrophy. This is a well-recognized and common complication of hypertension.
Choice C rationale:
Excessive excretion of fluid by the kidneys is not a typical complication of sustained hypertension. This statement is incorrect. Hypertension often leads to kidney damage, but it is more likely to result in reduced kidney function and fluid retention rather than excessive fluid excretion.
Choice D rationale:
Hormone dysfunction is not a primary complication of sustained hypertension. This statement is incorrect. While hypertension can affect various physiological processes, it is not a direct cause of hormone dysfunction. Hormone dysfunction may be related to other conditions, but it is not a direct consequence of hypertension. .
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
