Which clinical manifestations would the nurse expect to find during their assessment of a patient with right heart failure (RHF)?
Enlarged liver and peripheral edema.
Crackles in the lungs.
Dry hacking cough.
Altered mentation with pinpoint pupils.
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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Correct Answer is D
Explanation
Choice A rationale
The left extrapyramidal tract is involved in motor control, but lesions here would not cause right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice B rationale
A lesion in the right cerebral hemisphere would cause left-sided symptoms, not right-sided. The patient’s symptoms are indicative of a lesion in the left cerebral hemisphere.
Choice C rationale
The cerebellum is involved in coordination and balance, not in causing right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice D rationale
A lesion in the left cerebral hemisphere can cause right homonymous hemianopia and inability to move the right arm. This is because the left hemisphere controls the right side of the body and processes visual information from the right visual field.
Correct Answer is D
Explanation
Choice A rationale
Cerebral edema is the swelling of the brain due to fluid accumulation, which can occur after excessive alcohol consumption. However, it is not related to myxedema, which is a condition associated with severe hypothyroidism.
Choice B rationale
The deposit of fatty tissue is associated with conditions like hyperaldosteronism, where there is an excess production of aldosterone. This condition does not cause the characteristic skin changes seen in myxedema.
Choice C rationale
Proliferation of tissue behind the eyes, known as exophthalmos, is common in hyperthyroidism, particularly in Graves’ disease. Myxedema, on the other hand, is related to severe hypothyroidism and involves different pathophysiological mechanisms.
Choice D rationale
Myxedema is characterized by the accumulation of mucopolysaccharides in the skin and other tissues, leading to swelling and thickening of the skin. This condition is a result of severe hypothyroidism and can lead to a myxedema crisis if left untreated.