A nurse is caring for a patient with long history of chronic obstructive pulmonary disease (COPD) who develops cor pulmonale.
The nurse should monitor the patient for which expected finding if heart failure is present?

Choice A rationale

Hypertension is not a typical finding associated with community-acquired pneumonia. The condition more commonly presents with respiratory symptoms such as cough, fever, and difficulty breathing.

Choice B rationale

Unequal pupils are not a common finding in community-acquired pneumonia and could indicate a neurological issue or head injury, which would require further investigation.

Choice C rationale

Confusion, particularly in older adults, can be a symptom of community-acquired pneumonia. It is often due to hypoxia or systemic inflammation and is a sign of a more severe infection.

Choice D rationale

Tympany upon chest percussion is not expected in pneumonia. Pneumonia typically presents with dullness on percussion due to the consolidation of lung tissue, not the hyperresonance that causes tympany.

Choice A rationale

Lying down after meals can increase the risk of acid reflux in individuals with a hiatal hernia. Patients are often advised to remain upright after eating to minimize symptoms.

Choice B rationale

Elevating the head of the bed helps prevent gastric contents from refluxing into the esophagus, reducing symptoms of hiatal hernia and promoting better sleep.

Choice C rationale

Reducing caffeine and spicy foods can help manage symptoms, as these substances can irritate the stomach lining and exacerbate reflux in hiatal hernia patients.

Choice D rationale

Maintaining a healthy weight is important because excess weight can increase abdominal pressure and contribute to the worsening of hiatal hernia symptoms.

Choice E rationale

Drinking less fluid is not typically a recommendation for hiatal hernia. Adequate hydration is important for overall health, and reducing fluid intake may not have a significant impact on symptoms.