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The nurse is caring for a client who was diagnosed with left-sided heart failure and states, "I do not understand why I have so much trouble breathing if I have heart failure.”. Which of the following responses should the nurse make?

"I am going to notify the healthcare provider because you should not have trouble breathing with left-sided heart failure.”.

"The right side of your heart fails first and causes a back-up of blood in the left side of the heart and then the lungs.”.

"When the left side of your heart does not pump enough blood out, it gets backed up in your lungs and causes shortness of breath.”.

"Typically, clients with left-sided heart failure have difficulty breathing with exertion, but not when resting.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Trouble breathing is a hallmark symptom of left-sided heart failure. Suggesting that it should not occur would be inaccurate. The failure of the left ventricle leads to blood accumulation in the pulmonary vessels, creating pulmonary congestion and shortness of breath. Prompt provider notification may be necessary but does not address the underlying pathophysiology. Pulmonary symptoms are expected in this type of heart failure.

Choice B rationale

While left-sided heart failure can eventually lead to right-sided heart failure, the initial problem is with left ventricular dysfunction. This causes reduced forward blood flow and pulmonary congestion due to backflow of blood into the lungs. Right-sided heart failure is not the primary event leading to pulmonary symptoms in left-sided heart failure.

Choice C rationale

The left ventricle's inability to pump effectively results in blood backing up into the pulmonary circulation, causing pulmonary congestion and symptoms like shortness of breath. This is consistent with the hemodynamics of left-sided heart failure. Pulmonary capillary pressure increases, leading to fluid leakage and impaired gas exchange, explaining the client's breathing difficulty.

Choice D rationale

Although difficulty breathing with exertion (dyspnea on exertion) is common, resting symptoms, including orthopnea and paroxysmal nocturnal dyspnea, can also occur in left-sided heart failure due to fluid redistribution. Limiting symptoms to exertion inaccurately portrays the clinical presentation and disregards other significant pulmonary signs.

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Correct Answer is A

Explanation

Choice A rationale

Medications, such as phosphodiesterase type-5 inhibitors (e.g., sildenafil), are typically the next line of treatment for erectile dysfunction (ED) after lifestyle modifications fail. These agents enhance blood flow to the penile tissues during sexual stimulation by inhibiting the breakdown of cyclic guanosine monophosphate, facilitating erectile function.

Choice B rationale

Negative-pressure devices, also known as vacuum erection devices, are considered third-line treatments and are typically used in clients for whom oral medications are contraindicated or have failed. These devices work by mechanically increasing blood flow to the penis but are less effective than pharmacological interventions.

Choice C rationale

Penile injections, such as alprostadil, are invasive and used as a later option when oral medications and devices are unsuccessful or contraindicated. These injections directly relax the smooth muscle to increase penile blood flow, but they are generally not first-line treatments.

Choice D rationale

Penis transplants are experimental and not recognized as a standard treatment for erectile dysfunction. This option is far from practical or feasible and is considered unsuitable for most clients, especially given the complexity of the condition.

Correct Answer is ["12"]

Explanation

Step 1 is to convert 176 pounds to kilograms. (176 ÷ 2.2) = 80 kg.

Step 2 is to calculate the drug dose. (10 mcg × 80 kg) ÷ 1000 = 0.8 mg/minute.

Step 3 is to find the hourly dose. (0.8 mg × 60 minutes) = 48 mg/hour.

Step 4 is to calculate mL/hour. (48 mg ÷ (1000 mg ÷ 250 mL)) = 12 mL/hour. The final calculated answer is 12 mL/hour.

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The nurse is caring for a client who was diagnosed with left-sided heart failure and states, "I do not understand why I have so much trouble breathing if I have heart failure.”. Which of the following responses should the nurse make?

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Naxlex Comprehensive Predictor Exams

The nurse is following up with a male client diagnosed 3 months ago with erectile dysfunction who attempted lifestyle modifications as the first line of treatment.The client reports having continued symptoms.The nurse should discuss which of the following types of treatment with the client next?

Correct Answer is A

Explanation

Correct Answer is ["12"]

Explanation

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