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: The correct answer is A: Jugular vein distention. In patients with left ventricular heart failure, increased pressure in the heart can lead to jugular vein distention due to backflow of blood. This is a common physical symptom seen in such patients. Incorrect choices: - B: Hepatomegaly is not a typical physical symptom of left ventricular heart failure. It may be seen in conditions like liver cirrhosis. - C: Dyspnea is a common symptom in heart failure but is not specific to left ventricular heart failure. - D: Crackles are indicative of fluid accumulation in the lungs, which is more common in right-sided heart failure rather than left ventricular heart failure.

Correct Answer: A

Rationale: The correct answer is A: CVP (Central Venous Pressure). In right-sided heart failure, the right side of the heart fails to pump effectively, leading to increased pressure in the venous system. CVP reflects the pressure in the vena cava close to the right atrium, thus elevated in right-sided heart failure. B: Left-ventricular end-diastolic pressure is elevated in left-sided heart failure. C: PAWP (Pulmonary Artery Wedge Pressure) is elevated in left-sided heart failure. D: Cardiac output is typically decreased in heart failure, not elevated.

Correct Answer: D

Rationale: The correct answer is D because the patient is a white woman aged 72 with a high blood pressure of 172/100 and physically inactive. Advanced age, high blood pressure, and physical inactivity are significant risk factors for coronary artery disease (CAD). Age is a non-modifiable risk factor, and hypertension and lack of physical activity are modifiable but critical factors contributing to CAD. Choice A is incorrect because although the patient is African American, has obesity, and high blood pressure, the age is younger than the patient in choice D. Choice B is incorrect as smoking and stress are risk factors but not as significant as age, high blood pressure, and physical inactivity. Choice C is incorrect since although the patient has high cholesterol and elevated blood pressure, the age and other risk factors are less significant compared to the patient in choice D.

Correct Answer: C

Rationale: The correct answer is C because continuous ECG monitoring is crucial during pulmonary artery catheter insertion to detect any arrhythmias or changes in cardiac status promptly. This ensures the patient's safety and allows for immediate intervention if needed. Obtaining informed consent (choice A) is important but not specific to this procedure. Placing the patient in a high Fowler's position (choice B) may be necessary for comfort but is not directly related to the insertion process. Performing an Allen test (choice D) is not typically required for pulmonary artery catheter insertion.

Correct Answer: B

Rationale: The correct answer is B because a significant drop in respiratory rate from 18 to 12 breaths/minute after administering morphine sulfate can indicate respiratory depression, a serious side effect. This requires immediate attention to prevent further complications like hypoxia or respiratory arrest. Choices A, C, and D do not indicate immediate need for action as a slight decrease in blood pressure, feeling lightheaded, and mild chest pain are expected side effects of morphine administration and can be managed with appropriate interventions.