The nursing instructor is discussing heart failure during post-conference. Which statement by the student confirms their understanding of a contributing factor to a patient's increased risk for developing heart failure?

"Young people do not have to worry about heart failure, just older people."

"Progressive kidney failure contributes to the development and severity of heart failure."

"The elderly patient used cocaine as a teenager and complains of occasional anxiety."

"The patient takes 20mg of losartan every day and their potassium level is 3.8 mEq/L."

Answer and Explanation

The Correct Answer is B

Choice A reason: The statement that young people do not have to worry about heart failure, just older people, is incorrect. While heart failure is more common in older adults, it can occur at any age, particularly in individuals with underlying health conditions or risk factors.

Choice B reason: Progressive kidney failure contributes to the development and severity of heart failure. Kidney function and heart function are closely related. When the kidneys are not working properly, they can contribute to fluid retention, increased blood pressure, and additional strain on the heart, leading to heart failure.

Choice C reason: The elderly patient using cocaine as a teenager and complaining of occasional anxiety is less relevant to the immediate risk factors for developing heart failure. While past cocaine use can have long-term cardiovascular effects, occasional anxiety is not a significant contributing factor to heart failure.

Choice D reason: The patient taking 20mg of losartan every day and having a potassium level of 3.8 mEq/L is relevant to managing their heart condition but does not directly address the development of heart failure. Losartan is a medication used to manage blood pressure and heart failure, and the potassium level is within the normal range.

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Correct Answer is D

Explanation

Choice A reason: Always using a low flow device such as a nasal cannula or simple face mask is not necessarily appropriate for all patients. The choice of device should be based on the patient's oxygen needs and clinical status.

Choice B reason: Correcting the PaO2 to a normal level as quickly as possible using mechanical ventilation is not appropriate in most cases. Rapid correction of oxygen levels can lead to complications such as oxygen toxicity. Mechanical ventilation is used in severe cases but is not the first line of treatment for most patients.

Choice C reason: Using continuous positive airway pressure (CPAP) to maintain PaCO2 greater than 50 mmHg is incorrect. CPAP is used to maintain open airways and improve oxygenation but is not used to target specific PaCO2 levels.

Choice D reason: Increasing the PaO2 to an acceptable level at the lowest oxygen concentration possible is the most appropriate guideline. This approach aims to correct hypoxemia without causing oxygen toxicity. The goal is to achieve adequate oxygenation while minimizing the risk of adverse effects from high oxygen concentrations.

A. Potassium supplements can cause irregular heart rhythm and must be avoided. B. Instruct the patient to take diuretics at bedtime to promote diuresis during the night. C. Notify the physician if weight increases by three pounds in one week. D. Administer diuretics in the morning and notify physician of decreased urine output.

Correct Answer is C

Explanation

Choice A reason: Potassium supplements can actually be important for patients on diuretic therapy, especially if they are taking loop diuretics like furosemide, which can cause potassium loss. However, it is important to monitor potassium levels and follow the physician's guidance on supplement use.

Choice B reason: Instructing the patient to take diuretics at bedtime is not recommended. Diuretics should be taken in the morning to avoid frequent urination during the night, which can disrupt sleep.

Choice C reason: Notifying the physician if weight increases by three pounds in one week is a key instruction for patients with heart failure. Rapid weight gain can indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and adjustment of treatment.

Choice D reason: Administering diuretics in the morning and notifying the physician of decreased urine output is important, but the focus on notifying the physician about significant weight gain provides a more specific and actionable guideline for managing heart failure.

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The nursing instructor is discussing heart failure during post-conference. Which statement by the student confirms their understanding of a contributing factor to a patient's increased risk for developing heart failure?

Nursing Test Bank

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