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Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?

A.

Enlarged liver and peripheral edema.

B.

Crackles in the lungs.

C.

Dry hacking cough.

D.

Altered mentation with pinpoint pupils.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Enlarged liver (hepatomegaly) and peripheral edema are common clinical manifestations of right heart failure (RHF). RHF leads to congestion of systemic circulation, causing fluid accumulation in the liver and peripheral tissues.

 

Choice B rationale

 

Crackles in the lungs are more commonly associated with left-sided heart failure, where fluid backs up into the pulmonary circulation, leading to pulmonary edema.

 

Choice C rationale

 

A dry hacking cough is not a typical symptom of right heart failure. It is more commonly associated with respiratory conditions such as asthma or bronchitis.

 

Choice D rationale

 

Altered mentation with pinpoint pupils is not a characteristic of right heart failure. These symptoms are more indicative of neurological conditions or opioid overdose.
 


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Administering supplemental oxygen is the priority intervention for a client with COPD who has an oxygen saturation of 88% on room air. This low oxygen saturation indicates hypoxemia, which requires immediate correction to prevent further respiratory distress.

Choice B rationale

Encouraging the client to use an incentive spirometer is important for lung expansion and preventing atelectasis, but it is not the priority intervention in this scenario. The immediate concern is to correct the hypoxemia.

Choice C rationale

Administering a bronchodilator as prescribed is important for managing COPD symptoms, but the priority intervention is to correct the hypoxemia by administering supplemental oxygen.

Choice D rationale

Positioning the client in high Fowler’s position can help improve breathing, but the priority intervention is to correct the hypoxemia by administering supplemental oxygen.

Correct Answer is B

Explanation

Choice A rationale

Administering vitamin B12 to increase RBC size is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. The goal is to restore normal RBC maturation, not to increase RBC size.

Choice B rationale

Administering vitamin B12 to restore normal RBC maturation is the appropriate action. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. Administering vitamin B12 will help restore normal RBC maturation and correct the anemia.

Choice C rationale

Administering medication to decrease RBC size is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. The goal is to restore normal RBC maturation, not to decrease RBC size.

Choice D rationale

Administering iron to increase the formation of hemoglobin molecules is not appropriate in this scenario. The elevated MCV indicates macrocytic anemia, which is often due to vitamin B12 deficiency. Iron supplementation is typically used for microcytic anemia, not macrocytic anemia.

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