A nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

Apical pulse rate is different than the radial pulse rate

Drop in systolic BP by 20 mm Hg when changing positions

Increase in heart rate by 20% when moving from sitting to standing

Decrease in systolic pressure by more than 10 mm Hg during inspiration

Answer and Explanation

The Correct Answer is D

A. A difference between the apical pulse rate and the radial pulse rate is more indicative of a pulse deficit, which is not specific to constrictive pericarditis.
B. A drop in systolic blood pressure by 20 mm Hg when changing positions describes orthostatic hypotension, not paradoxical blood pressure.
C. An increase in heart rate when moving from sitting to standing reflects orthostatic changes, not paradoxical blood pressure.
D. Paradoxical blood pressure refers to a decrease in systolic blood pressure of more than 10 mm Hg during inspiration, which can occur in constrictive pericarditis due to impaired filling of the heart during diastole.

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Correct Answer is B

Explanation

A. Coffee has not been shown to significantly increase the risk of gout attacks and may even have a protective effect due to its antioxidant properties.

B. Alcohol, especially beer and spirits, can trigger gout attacks by increasing the level of uric acid in the blood. Alcohol consumption should be limited or avoided to reduce the risk of gout flare-ups.

C. Milk and other low-fat dairy products are actually recommended for people with gout, as they may help lower uric acid levels.

D. Orange juice, while high in vitamin C, does contain fructose, which can increase uric acid production. However, it is not as significant a trigger as alcohol. Moderation is key.

A. Instruct the client on use of crutches. B. Perform neurovascular checks of the extremities. C. Medicate the client for pain. D. Direct the client to perform exercises of the ankle and toes.

Correct Answer is B

Explanation

A. Instructing the client on the use of crutches is important but not as immediate as assessing for complications.

B. Performing neurovascular checks of the extremities is the most important action to identify complications such as compartment syndrome or impaired circulation.

C. Medicating the client for pain is important but secondary to monitoring for immediate postoperative complications.

D. Directing the client to perform exercises of the ankle and toes helps prevent complications but is not as critical as performing neurovascular assessments.

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A nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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