The nurse is explaining to a client diagnosed with heart failure that the client's heart muscle has thickened on the right side and is not able to fill properly.
The nurse is explaining which of the following types of heart failure?

Right and left-sided diastolic.

Right-sided systolic and diastolic.

Right-sided diastolic.

Right-sided systolic.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Right-sided heart failure with thickened heart muscle refers specifically to the impaired filling capacity due to diastolic dysfunction. Diastolic dysfunction affects the filling phase, not the pumping phase. It may involve one side or both sides but is not explicitly described as right and left-sided diastolic in this context.

Choice B rationale

Right-sided systolic heart failure affects the pumping ability, while diastolic affects filling. Both conditions together do not explain the thickened myocardium impairing filling. A combination of systolic and diastolic failure typically includes both pumping and filling abnormalities rather than isolated thickening with poor filling.

Choice C rationale

Right-sided diastolic failure results from impaired ventricular relaxation and thickened myocardium, leading to reduced filling capacity. This type of failure involves the heart's inability to accommodate blood during diastole, consistent with the description of thickened heart muscle and poor filling on the right side.

Choice D rationale

Right-sided systolic failure involves impaired contractility and pumping of blood to the lungs, not poor filling caused by thickened muscle. Systolic dysfunction decreases the heart's output rather than affecting the filling phase described in this scenario.

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Correct Answer is B

Explanation

Choice A rationale

Fatigue can occur in thrombocytopenia due to associated bleeding or anemia, but it is not a hallmark symptom specific to low platelet counts alone. Fatigue relates more to overall systemic effects or concurrent conditions rather than isolated thrombocytopenia. Hemorrhage and petechiae, however, are more directly correlated with reduced platelets in circulation, which compromise clotting and vascular integrity.

Choice B rationale

Hemorrhage is a major concern in thrombocytopenia due to severely reduced platelet counts. Normal platelet levels range from 150,000–450,000/mm³, and values of 18,000/mm³ indicate critical impairment in clot formation, increasing the risk of spontaneous bleeding. Hemorrhagic events in vital organs pose life-threatening consequences, making monitoring and interventions essential to minimize complications associated with uncontrolled bleeding.

Choice C rationale

Petechiae are pinpoint hemorrhages visible on the skin or mucosal surfaces, indicating capillary bleeding due to insufficient platelet-mediated clotting. Normal platelet levels maintain vascular integrity by enabling clot formation, which prevents such microvascular bleeding. Platelet counts as low as 18,000/mm³ lead to abnormal hemorrhagic manifestations, making petechiae a frequent and observable sign in severe thrombocytopenia cases.

Choice D rationale

Headache can occur with thrombocytopenia if intracranial hemorrhage develops, but it is not an expected symptom in all cases. While bleeding risks elevate overall concerns, headache depends on specific organ involvement. Petechiae and systemic hemorrhage are primary symptoms associated with low platelet levels. Headaches without evidence of bleeding do not distinctly correlate with thrombocytopenia diagnosis.

A. Explain that the client should return in one month to be reevaluated. B. Assess the client's adherence to lifestyle modifications and medication therapy. C. Explain to the client that the health care provider will increase the dose of one of the medications already prescribed. D. Discuss adding a prescribed calcium-channel blocker to the client's medication regimen.

Correct Answer is B

Explanation

Choice A rationale

Waiting one month before reevaluating blood pressure may overlook potential adherence issues or medication effects. Hypertension requires timely intervention because consistently high values can lead to complications such as stroke or heart attack. The readings of 145/92 mm Hg and 150/89 mm Hg are above the normal range (<120/80 mm Hg), necessitating immediate review of possible contributing factors rather than postponing evaluation.

Choice B rationale

Adherence to lifestyle modifications and prescribed therapies directly affects blood pressure control. Factors such as diet, exercise, and medication compliance significantly influence systolic and diastolic values. Poor adherence can lead to inadequate control of hypertension, which is evident in the readings of 145/92 mm Hg and 150/89 mm Hg. Exploring adherence helps identify reasons for high readings and can guide targeted interventions.

Choice C rationale

Increasing medication dosage without first reviewing adherence overlooks potential causes of suboptimal control such as missed doses, incorrect timing, or lifestyle factors. Adjusting doses may lead to overtreatment, causing complications like hypotension. Addressing adherence first ensures interventions are appropriate and prevents unnecessary medication changes.

Choice D rationale

Adding a calcium-channel blocker involves modifying therapy without investigating adherence to current medications and lifestyle changes. Such an approach risks complicating the treatment plan unnecessarily. It is scientifically prudent to first evaluate the effectiveness of existing treatments through adherence assessments, ensuring interventions are tailored to the individual's needs.

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The nurse is explaining to a client diagnosed with heart failure that the client's heart muscle has thickened on the right side and is not able to fill properly.The nurse is explaining which of the following types of heart failure?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with thrombocytopenia whose platelet level is 18,000/mm³. Which of the following assessment findings should the nurse expect?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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The nurse is explaining to a client diagnosed with heart failure that the client's heart muscle has thickened on the right side and is not able to fill properly.
The nurse is explaining which of the following types of heart failure?