A newly admitted patient, diagnosed with a myocardial infarction and left ventricular heart failure might exhibit which of the following physical symptoms? Choose all that apply.

Correct Answer: A

Rationale: Rationale: Jugular vein distention is a common physical symptom in patients with left ventricular heart failure due to increased central venous pressure. This is caused by the heart's inability to effectively pump blood, leading to backflow and congestion in the venous system. Hepatomegaly is less likely to be a direct physical symptom and is more indicative of chronic liver disease. Dyspnea and crackles are also common in heart failure, but they are more related to pulmonary congestion and fluid accumulation in the lungs, rather than a direct physical symptom. Therefore, the correct answer is A.

Correct Answer: A

Rationale: The correct answer is A: CVP. In right-sided heart failure, the right side of the heart is unable to effectively pump blood to the lungs, leading to increased pressure in the venous system. Central venous pressure (CVP) measures the pressure in the vena cava near the right atrium, reflecting the pressure in the right side of the heart. Elevated CVP is a key indicator of right-sided heart failure. Left-ventricular end-diastolic pressure (B) and pulmonary artery wedge pressure (PAWP) (C) are more indicative of left-sided heart failure, not right-sided. Cardiac output (D) may decrease in heart failure, but it is not specific to right-sided heart failure.

Correct Answer: B

Rationale: The correct answer is B: Dopamine. Dopamine is a vasopressor that helps increase blood pressure and cardiac output, which can counteract shock in cases of myocardial infarction. It improves blood flow to vital organs. Atropine (A) is used for bradycardia, not shock. Digoxin (C) and Adenosine (D) are not indicated for treating shock in myocardial infarction as they have different mechanisms of action.

Correct Answer: A

Rationale: The correct answer is A: Check the apical pulse for one minute. Before administering a beta blocker, it is essential to assess the client's heart rate because beta blockers can slow down the heart rate. Checking the apical pulse for one minute allows the nurse to establish a baseline heart rate and determine if the client's heart rate is within the safe parameters for administering the medication. This step ensures the client's safety and helps monitor for any potential adverse effects related to bradycardia. Choices B, C, and D are incorrect as they are not directly related to the specific action required prior to administering a beta blocker.

Correct Answer: C

Rationale: The correct answer is C: Wolff-Parkinson White syndrome. Calcium channel blockers can worsen the pre-excitation in patients with WPW syndrome, leading to rapid conduction through the accessory pathway and potentially causing ventricular fibrillation. A: Hypertension is not a contraindication for calcium channel blockers as they are commonly used to treat hypertension. B: First degree AV block is not a contraindication, as calcium channel blockers can be used cautiously in patients with conduction abnormalities. D: Glaucoma is not a contraindication to calcium channel blockers, as they are not known to exacerbate glaucoma.