A nurse is monitoring a client who has heart failure related to mitral stenosis. The client reports shortness of breath on exertion. Which of the following conditions should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A: Increased pulmonary congestion. In mitral stenosis, the narrowing of the mitral valve leads to reduced blood flow from the left atrium to the left ventricle, causing increased pressure in the left atrium and pulmonary veins. This results in pulmonary congestion, leading to symptoms like shortness of breath on exertion. Explanation for incorrect choices: B: Decreased cardiac output - While heart failure can lead to decreased cardiac output, in mitral stenosis, the primary issue is increased pressure in the left atrium, not necessarily decreased cardiac output. C: Peripheral edema - Peripheral edema is more commonly associated with right-sided heart failure rather than mitral stenosis, which primarily affects the left side of the heart. D: Hypotension - Hypotension is not typically expected in mitral stenosis, as the main issue is increased pressure in the left atrium rather than decreased systemic blood pressure.

Correct Answer: A

Rationale: The correct answer is A: Hypertension is a common adverse effect of this medication. Epoetin alfa is a medication that stimulates red blood cell production, which can lead to an increase in blood pressure. The nurse should educate the client about monitoring blood pressure regularly and reporting any signs of hypertension. Choice B is incorrect because weight loss is not a common effect of epoetin alfa. Choice C is incorrect as hair growth does not increase with this medication. Choice D is incorrect as urine output is not typically affected by epoetin alfa. The key is to focus on the medication's potential adverse effects and educate the client accordingly.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Diclofenac is a NSAID commonly used for pain relief and inflammation. 2. NSAIDs inhibit the enzyme cyclooxygenase, reducing inflammation. 3. Celecoxib is a selective NSAID, but not the only true NSAID. 4. Methotrexate is an immunosuppressant used for autoimmune diseases. 5. Leflunomide is a disease-modifying antirheumatic drug (DMARD), not an NSAID. Summary: Diclofenac is the correct answer as it is a traditional NSAID that inhibits cyclooxygenase. Celecoxib is a selective NSAID, while Methotrexate and Leflunomide are not categorized as NSAIDs but serve different purposes in treatment.

Correct Answer: A

Rationale: The correct answer is A: Leflunomide, as it is an immunomodulator that acts by inhibiting pyrimidine synthesis, thereby suppressing the immune response in autoimmune diseases like rheumatoid arthritis. Methotrexate (B) is an immunosuppressant that inhibits DNA synthesis. Hydroxychloroquine (C) is an antimalarial drug with immunomodulatory effects but is not primarily used for this purpose. Adalimumab (D) is a biologic agent that targets tumor necrosis factor-alpha and is classified as a TNF inhibitor, not an immunomodulator.

Correct Answer: D

Rationale: The correct answer is D: Retinal damage. Xanthine oxidase inhibitors like allopurinol can lead to retinal damage, causing vision problems. This is due to the drug's potential to accumulate in the retina. Bone marrow suppression, nausea, and vomiting are not common side effects of xanthine oxidase inhibitors, making them incorrect choices.