A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

Decreased urinary output

Cool extremities

Peripheral edema

Crackles in the lung fields

Answer and Explanation

The Correct Answer is C

A. Decreased urinary output: Decreased urinary output can occur in heart failure due to reduced kidney perfusion, but it is more commonly associated with left-sided heart failure as it leads to fluid congestion in the lungs and a decreased ability of the kidneys to function effectively.

B. Cool extremities: Cool extremities can occur in heart failure, but they are more commonly seen in left-sided heart failure due to poor circulation from the left ventricle. Right-sided heart failure primarily affects the systemic circulation.

C. Peripheral edema: Peripheral edema is a hallmark sign of right-sided heart failure. The right side of the heart is unable to pump blood efficiently to the lungs, causing blood to back up into the veins and resulting in fluid retention in the lower extremities and other parts of the body.

D. Crackles in the lung fields: Crackles in the lung fields are a characteristic finding in left-sided heart failure, as fluid backs up into the lungs. This is not typically a finding associated with right-sided heart failure, which affects the systemic circulation.

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Free Nursing Study Resources

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

Explanation

A. "You will take medication for this condition for several months!": Hypothyroidism typically requires lifelong thyroid hormone replacement therapy, not just for several months. The client should be informed that they will need to take the medication for the long term.

B. "This condition can cause you to gain weight.": Weight gain is a common symptom of hypothyroidism due to a slowed metabolism. The nurse should include this in the teaching to help the client understand how the condition may affect their weight.

C. "We will perform laboratory tests to monitor the effect of your medication.": Regular monitoring of thyroid function tests (such as TSH and T4 levels) is essential to ensure that the medication is effective and that the dosage is appropriate.

D. "You might notice that you perspire more with this condition.": Hypothyroidism typically causes cold intolerance and reduced perspiration, not increased perspiration. This statement is incorrect and should not be included in the teaching.

E. "You will need to eat a high-fiber diet to prevent complications of this condition.": Hypothyroidism can lead to constipation due to a slowed metabolism. A high-fiber diet is recommended to help prevent constipation and promote regular bowel movements.

A. Serous drainage noted in the collection chamber B. Tidaling in the water seal chamber with respirations C. Diminished breath sounds in the lung bases D. Movement of the trachea toward the unaffected side

Correct Answer is B

Explanation

A. Serous drainage noted in the collection chamber: The type of drainage typically seen with a pneumothorax is not serous; it is usually minimal or absent. If there is significant drainage, it could indicate bleeding or another issue that should be monitored.

B. Tidaling in the water seal chamber with respirations: Tidaling, or the movement of the water level in the water seal chamber with respirations, is a normal finding. It indicates that the chest tube is correctly placed, and the lung is expanding and contracting.

C. Diminished breath sounds in the lung bases: Diminished breath sounds are expected in the area where the pneumothorax occurred, but it does not specifically indicate the placement of the chest tube.

D. Movement of the trachea toward the unaffected side: Tracheal deviation toward the unaffected side is a sign of tension pneumothorax, which is a medical emergency. It should not be expected following the placement of a chest tube for a pneumothorax, as the goal of the chest tube is to resolve the pneumothorax and prevent complications.

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A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply.)

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

Explanation

A nurse is caring for a client following the placement of a chest tube drainage system for a pneumothorax. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

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