A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult client who has been experiencing fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?

Pleurisy

Cardiomyopathy

Valve dysfunction

Heart failure

Answer and Explanation

The Correct Answer is D

A. Pleurisy:

Pleurisy is inflammation of the pleura, which is the lining surrounding the lungs. It can cause sharp chest pain that worsens with breathing. While pleurisy can be associated with conditions such as infections, pneumonia, or pulmonary embolism, it is not typically directly diagnosed or investigated using the brain (B-type) natriuretic peptide (BNP) test. The symptoms of pleurisy may include chest pain, especially with deep breathing, coughing, or sneezing.

B. Cardiomyopathy:

Cardiomyopathy refers to diseases of the heart muscle, which can lead to impaired heart function. Cardiomyopathy can cause symptoms such as fatigue, shortness of breath, chest pain, and fluid retention. While elevated BNP levels can be observed in some cases of cardiomyopathy, the BNP test is not specific to cardiomyopathy alone. It is often used to assess and diagnose heart failure, a condition that can result from various cardiac abnormalities, including cardiomyopathy.

C. Valve Dysfunction:

Valve dysfunction refers to abnormalities or malfunctions of the heart valves, such as stenosis (narrowing) or regurgitation (leakage). Valve dysfunction can lead to symptoms such as shortness of breath, chest pain, palpitations, and fatigue. While valve dysfunction can contribute to heart failure by causing pressure and volume overload on the heart chambers, the BNP test is primarily used to assess heart failure itself rather than specifically identifying valve dysfunction.

D. Heart Failure:

Heart failure is a condition in which the heart is unable to pump blood effectively to meet the body's needs. It can cause symptoms such as fatigue, shortness of breath, fluid retention (edema), and exercise intolerance. Elevated BNP levels are commonly observed in patients with heart failure, especially in cases of acute exacerbations or decompensated heart failure. The BNP test is used to assess and diagnose heart failure, as higher BNP levels indicate increased cardiac stress and volume overload.

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Correct Answer is A

Explanation

A. The symptoms indicate an acute coronary episode and should be treated as such:

The client's symptoms, including sudden midsternal chest pain unrelieved with rest and a history of coronary artery disease (CAD), strongly suggest an acute coronary event, such as a myocardial infarction (heart attack). Pale, cool skin can also be indicative of decreased perfusion due to cardiac compromise. Given these critical signs and symptoms, the nurse should interpret this as a potential cardiac emergency and initiate immediate interventions aimed at managing and stabilizing the client's condition.

B. The symptoms indicate angina and should be treated as such:

While angina can present with symptoms such as chest pain, it is typically relieved with rest or nitroglycerin. In contrast, the client in this scenario has midsternal chest pain that is not relieved with rest, which is more indicative of an acute coronary event like a myocardial infarction. Therefore, interpreting the symptoms as angina and treating them as such may not be appropriate given the severity and persistence of the chest pain.

C. Treatment should be determined pending the results of an exercise stress test:

Waiting for the results of an exercise stress test is not appropriate in this scenario, as the client's presentation suggests an acute cardiac event that requires immediate intervention. Exercise stress tests are typically used for diagnostic purposes to assess cardiovascular function under controlled conditions but are not suitable for managing acute coronary episodes or emergencies.

D. The symptoms indicate a pulmonary etiology rather than a cardiac etiology:

While some symptoms, such as shortness of breath or chest pain, can overlap between cardiac and pulmonary conditions, the client's presentation with sudden midsternal chest pain unrelieved with rest, pale cool skin, and a history of CAD strongly suggests a cardiac etiology, specifically an acute coronary event. It is essential to prioritize cardiac assessment and intervention based on the client's symptoms and medical history.

A. "The decreased HOL level will increase the amount of cholesterol moved away from the artery walls." B. "Increased LDL and decreased HDL increase my risk of coronary artery disease." C. "Increased LDL has the potential to decrease my risk of heart disease." D. "The increased LDL will decrease the amount of cholesterol deposited on the artery walls."

Correct Answer is B

Explanation

A. "The decreased HDL level will increase the amount of cholesterol moved away from the artery walls":

This statement is incorrect. High-density lipoprotein (HDL) is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream and transport it to the liver for processing. A decreased HDL level is associated with an increased risk of cardiovascular disease, not with moving cholesterol away from artery walls.

B. "Increased LDL and decreased HDL increase my risk of coronary artery disease":

This statement is correct. Low-density lipoprotein (LDL) is often referred to as "bad" cholesterol because elevated LDL levels contribute to the buildup of plaque in the arteries, increasing the risk of coronary artery disease (CAD). Conversely, decreased HDL levels are associated with reduced cholesterol removal from the bloodstream, further increasing the risk of CAD.

C. "Increased LDL has the potential to decrease my risk of heart disease":

This statement is incorrect. Elevated LDL levels are a major risk factor for heart disease and are associated with an increased risk of atherosclerosis and cardiovascular events.

D. "The increased LDL will decrease the amount of cholesterol deposited on the artery walls":

This statement is incorrect. Increased LDL levels contribute to the deposition of cholesterol on artery walls, leading to the formation of plaque and narrowing of the arteries, which is detrimental to heart health.

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A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult client who has been experiencing fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data?

Correct Answer is A

Explanation

The nurse is conducting client teaching about cholesterol levels. When discussing the client's elevated LDL and lowered HDL levels, the client shows an understanding of the significance of these levels by stating what?

Correct Answer is B

Explanation

The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?

The nurse has given education for a client who is going to have an exercise stress test. The nurse knows the client understands the teaching when they say what?

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