The patient with restrictive cardiomyopathy asks the nurse what could have caused this disorder. Which response by the nurse is most accurate?

"All patients with this disorder have a genetic defect which causes it."

"There are many theories about its development but amyloidosis in your history is a probable cause."

"You probably had a silent heart attack which caused this disorder."

"Your long-standing hypertension caused this disorder."

Answer and Explanation

The Correct Answer is B

A. "All patients with this disorder have a genetic defect which causes it.": Restrictive cardiomyopathy is not primarily a genetic disorder. While there may be rare familial forms, most cases are acquired, often secondary to systemic diseases, making this statement inaccurate and misleading.

B. "There are many theories about its development but amyloidosis in your history is a probable cause.": This is the most accurate response. Restrictive cardiomyopathy is commonly associated with infiltrative diseases such as amyloidosis, hemochromatosis, and sarcoidosis, which impair ventricular filling due to stiff, non-compliant myocardium.

C. "You probably had a silent heart attack which caused this disorder.": Silent myocardial infarctions can contribute to ischemic cardiomyopathy, typically leading to dilated, not restrictive, changes in the myocardium. They are not a primary cause of restrictive cardiomyopathy.

D. "Your long-standing hypertension caused this disorder.": Chronic hypertension more commonly leads to left ventricular hypertrophy and may contribute to diastolic heart failure, but it is not a typical cause of restrictive cardiomyopathy.

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Correct Answer is C

Explanation

A. A 60-year-old woman with cardiac dysrhythmias post myocardial infarction. Her HR is 39 & irregular, BP 147/65: Although her heart rate is low, carvedilol is commonly used post-MI to reduce mortality, especially in patients with dysrhythmias. However, caution is warranted, and dosage adjustments or withholding may be necessary due to bradycardia.

B. A 55-year-old woman with HTN due to renal failure from chronic pyelonephritis. HR 92. BP 145/72: This client has stable vitals, and carvedilol can be safely used to help manage hypertension. Renal impairment requires monitoring, but it is not a contraindication if renal function is closely followed.

C. A 78-year-old man with a history of hyperlipidemia & cardiac dysfunction. He is in 3rd degree heart block. HR 42. BP 92/65: Carvedilol is contraindicated in clients with 2nd or 3rd degree heart block without a functioning pacemaker. It can worsen bradycardia and conduction delays, making its use unsafe in this client without rhythm control support.

D. A 49-year-old male, BMI 36, history of type 2 diabetes & HTN. HR 105, BP 158/92: This client is hypertensive and tachycardic, both of which carvedilol can help manage. Although diabetes requires careful monitoring for hypoglycemia, there is no contraindication in this scenario.

Correct Answer is ["200"]

Explanation

Volume ordered is 1 L.

Convert the total volume to milliliters (mL)

1 L = 1000 mL.

Total volume in mL = 1 L × 1000 mL/L = 1000 mL

Total infusion time = 5 hours

Calculate the infusion rate in milliliters per hour (mL/hr).

Infusion rate (mL/hr) = Total volume (mL) / Total infusion time (hours)

= 1000 mL / 5 hours

= 200

The appropriate setting is 200 mL/hr.

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The patient with restrictive cardiomyopathy asks the nurse what could have caused this disorder. Which response by the nurse is most accurate?

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Naxlex Comprehensive Predictor Exams

The nurse would contact the prescriber for safety concerns about using carvedilol in which of the following clients?

Correct Answer is C

Explanation

A post-op client is to receive the following: D5%W/0.45% NS 1 L to infuse over 5 hours. What is the appropriate setting on an infusion pump in milliliters per hour? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["200"]

Explanation

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