A patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in the lungs. The nurse understands that these symptoms are the result of

Poor medication compliance

Increased force of ventricular contraction

Decreased force of ventricular contraction

Lack of exercise

Answer and Explanation

The Correct Answer is C

Choice A reason: Poor medication compliance may worsen heart failure but isn’t directly linked to crackles and shortness of breath. These symptoms result from fluid overload due to reduced cardiac output, not solely non-adherence. This choice is less specific to the physiological cause described.

Choice B reason: Increased ventricular contraction force, as with inotropes like digoxin, improves cardiac output, reducing fluid backup. Crackles and shortness of breath indicate fluid overload from poor heart function, not enhanced contraction, making this choice incorrect for the symptoms’ cause.

Choice C reason: Decreased ventricular contraction force in heart failure reduces cardiac output, causing blood to back up into the lungs, leading to pulmonary edema. This manifests as crackles and shortness of breath due to fluid accumulation, making this the correct physiological explanation for the symptoms.

Choice D reason: Lack of exercise may contribute to overall heart failure progression but doesn’t directly cause crackles and shortness of breath. These symptoms stem from acute fluid overload due to impaired cardiac pumping, not deconditioning, making this choice incorrect for the immediate cause.

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Correct Answer is C

Explanation

Choice A reason: Inhaled glucocorticoids, like budesonide, reduce airway inflammation over time but don’t act quickly enough to abort acute asthma attacks. Short-acting beta-agonists (e.g., albuterol) are used for acute relief, as glucocorticoids lack immediate bronchodilatory effects, making this choice incorrect for chronic asthma management.

Choice B reason: Using inhaled glucocorticoids only in emergencies is ineffective for chronic asthma. These drugs prevent inflammation and exacerbations through consistent use, not acute intervention. Emergency use is reserved for rescue inhalers like albuterol, making this choice inappropriate for long-term asthma control.

Choice C reason: Inhaled glucocorticoids require daily use to maintain anti-inflammatory effects, reducing airway hyperresponsiveness and preventing asthma exacerbations. Consistent dosing ensures steady suppression of chronic inflammation, improving lung function and reducing symptoms, making this the correct choice for managing chronic asthma effectively.

Choice D reason: A 2-week on/off schedule disrupts the consistent anti-inflammatory action of inhaled glucocorticoids needed for chronic asthma control. Intermittent use reduces efficacy, allowing inflammation to rebound, increasing exacerbation risk. Daily use is standard to maintain therapeutic benefits, making this choice incorrect.

A. In the morning and at 4:00 PM B. Approximately 15 to 30 minutes before each meal C. After meals and at bedtime D. Once daily at bedtime

Correct Answer is D

Explanation

Choice A reason: Insulin glargine is a long-acting insulin given once daily, not twice daily. Morning and 4:00 PM dosing is typical for intermediate-acting insulins, so this incorrect for glargine’s schedule.

Choice B reason: Rapid-acting insulins are given before meals, not glargine, which provides basal coverage. Glargine is dosed once daily, so this is incorrect.

Choice C reason: Post-meal or after meals and bedtime dosing does not suit glargine’s 24-hour action. It’s given once daily, typically at bedtime, so this is incorrect for the administration timing.

Choice D reason: Insulin glargine is administered once daily, often at bedtime, to provide steady basal insulin coverage for 24 hours. This aligns with its pharmacokinetics, making it the correct choice.

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A patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in the lungs. The nurse understands that these symptoms are the result of

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

Correct Answer is C

Explanation

Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

Correct Answer is D

Explanation

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