A 67-year-old patient is admitted to the ICU following a myocardial infarction that has caused damage to the right side of the heart.
What complication is the patient most likely to experience?
Enlargement of the liver
Pulmonary congestion
Cardiac Tamponade
Peripheral edema
The Correct Answer is D
Choice A rationale
Enlargement of the liver is not a common complication following a myocardial infarction that has caused damage to the right side of the heart.
Choice B rationale
Pulmonary congestion is more commonly associated with left-sided heart failure.
Choice C rationale
Cardiac Tamponade is a serious medical condition in which blood or fluids fill the space between the sac that encases the heart and the heart muscle. This can occur as a result of a myocardial infarction, but it is not the most likely complication in this scenario.
Choice D rationale
Peripheral edema is a common complication following a myocardial infarction that has caused damage to the right side of the heart. When the right side of the heart is damaged, it can lead to a backup of blood in the body’s veins, which can cause swelling in the ankles, legs, and abdomen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Florence Nightingale is known as the founder of modern nursing. Her environmental theory emphasized the impact of the environment on a patient’s health.
Choice B rationale
Madeleine Leninger is known for her Culture Care Diversity and Universality theory, which emphasizes cultural competency in nursing practice. This theory aligns with the action of incorporating a patient’s cultural traditions, values, and beliefs into the care plan.
Choice C rationale
Dorthea Orem’s Self-Care Deficit theory focuses on the patient’s self-care needs and how nurses can assist in meeting those needs.
Choice D rationale
Jean Watson’s Theory of Human Caring emphasizes the humanistic aspects of nursing in relation to health, illness, and healing.
Correct Answer is B
Explanation
Choice A rationale
An exogenous infection occurs when a pathogen enters a patient’s body from their environment. For example, a healthcare worker can spread the infection due to poor adherence to infection control practices. This is not the case here as the infection is from the client’s own flora.
Choice B rationale
An endogenous infection is caused by the body’s normal flora. These microorganisms may act as opportunistic pathogens when the host is susceptible. In this case, the client’s systemic staphylococci infection originated from their own flora, making it an endogenous infection.
Choice C rationale
A community-acquired infection is one that was present or incubating prior to the patient being admitted to the hospital. Since the infection in this case originated from the client’s own flora and not from the community, this choice is incorrect.
Choice D rationale
A nosocomial infection, also known as a hospital-acquired infection, is an infection that is acquired in a hospital or other healthcare facility. Since the client’s infection originated from their own flora and not from the hospital environment, this choice is incorrect.
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