A physician orders an electrocardiogram (ECG) for a patient diagnosed with congestive heart failure. The medical record indicates the patient is currently taking digitalis. What effect would you expect digitalis to have on the patient's ECG?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Lengthened PR interval. Digitalis, commonly prescribed for congestive heart failure, affects the electrical conduction system of the heart. It primarily works by increasing the strength of the heart's contractions. One of the known effects of digitalis on the ECG is prolongation of the PR interval, which reflects delayed conduction through the AV node. This can lead to heart block or arrhythmias. Option A) Sinus tachycardia is unlikely with digitalis use as it tends to slow down the heart rate by increasing vagal tone. Option C) Lengthened QT interval is not a typical effect of digitalis. Drugs like antiarrhythmics are more commonly associated with QT prolongation. Option D) Elevated ST segment is not a direct effect of digitalis. ST segment changes are more indicative of myocardial ischemia or injury. Educationally, understanding the effects of medications on ECG readings is crucial for healthcare providers. It helps in interpreting ECG results accurately, identifying potential adverse effects, and providing appropriate patient care. This knowledge ensures patient safety and effective treatment management for individuals with cardiac conditions.

Correct Answer: C

Rationale: In this scenario, the correct classification of the patient's blood pressure reading of 138/88 mm Hg would be "Hypertension stage 1 (C)." This classification is based on the current guidelines for blood pressure levels set by medical organizations such as the American Heart Association. The classification of blood pressure readings is crucial in determining the risk of cardiovascular diseases and guiding appropriate interventions. Hypertension stage 1 is defined as a systolic blood pressure ranging from 130-139 mm Hg or a diastolic blood pressure ranging from 80-89 mm Hg. Therefore, the patient's blood pressure of 138/88 mm Hg falls within this range, indicating the presence of hypertension stage 1. The other options can be ruled out as follows: - Option A (Normal): This option is incorrect because the blood pressure reading provided exceeds the normal range for blood pressure, which is typically defined as less than 120/80 mm Hg. - Option B (Elevated): While the blood pressure reading is higher than normal, it does not fall within the range specified for elevated blood pressure, which is typically systolic 120-129 mm Hg and diastolic less than 80 mm Hg. - Option D (Hypertension stage 2): This option is incorrect as hypertension stage 2 is characterized by higher blood pressure readings than those presented in the scenario, typically systolic 140 mm Hg or higher and diastolic 90 mm Hg or higher. Understanding how to accurately classify blood pressure readings is essential for healthcare professionals like physical therapists as it allows for early detection of hypertension and appropriate referral or intervention. Monitoring and managing blood pressure levels can significantly impact a patient's cardiovascular health and overall well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Pleural effusion. Tactile fremitus is a palpable vibration transmitted through the bronchopulmonary system during breathing. Decreased tactile fremitus over a specific lung area suggests a change in the normal transmission of vibrations, which can be caused by the presence of fluid or air in the underlying lung tissue or pleural space. Pleural effusion is the most likely cause of decreased tactile fremitus in the left lower lung field as it involves the accumulation of fluid in the pleural space, which dampens the transmission of vibrations. The incorrect options can be explained as follows: A) Pneumonia typically presents with increased tactile fremitus due to consolidation of lung tissue. C) Asthma is a condition characterized by reversible airway obstruction and does not directly affect tactile fremitus. D) Pulmonary embolism would not typically result in changes in tactile fremitus but may present with other respiratory signs and symptoms. From an educational standpoint, understanding the significance of tactile fremitus in respiratory assessments is crucial for nurses to accurately assess and monitor patients' respiratory status. This knowledge helps in identifying potential underlying respiratory conditions and guiding appropriate interventions.

Correct Answer: B

Rationale: In understanding the components of a health history assessment, it is crucial to differentiate between the various elements involved. The correct answer, option B) Thorax and lungs, is not typically a component of the health history. Instead, it falls under the physical examination portion of a patient assessment. This distinction is important because the health history focuses on gathering information related to the patient's past and current health status, including aspects like past medical history, family history, social history, medications, allergies, and the present illness. Option A) Review of systems is an integral part of the health history as it involves a systematic inquiry into different body systems to identify any symptoms or issues the patient may be experiencing. Option C) Present illness is also a crucial component as it helps in understanding the current health concerns and context of the patient's visit. Option D) Personal and social items are essential for understanding the patient's lifestyle, social support, and potential factors influencing their health. From an educational perspective, it is important for healthcare professionals to grasp the distinctions between different components of a patient assessment to gather comprehensive and accurate information for effective care planning. Understanding these distinctions ensures that healthcare providers can conduct a thorough assessment, make informed clinical decisions, and provide optimal patient care.

Correct Answer: B

Rationale: In the context of vital signs assessment, it is crucial to differentiate between signs and symptoms. A sign is an objective indicator of a patient's condition that can be observed or measured by a healthcare provider, whereas a symptom is a subjective indication of a patient's condition that is reported by the patient. In this question, the correct answer is B) A temperature of 102°F because it is an objective measurement that can be quantified using a thermometer. This is a classic example of a vital sign as it provides valuable information about the patient's health status. Regarding why the other options are incorrect: A) A sore throat is a subjective symptom that the patient reports feeling. It cannot be directly observed or measured by a healthcare provider without relying on the patient's description. C) A headache is also a subjective symptom that the patient reports experiencing. Like a sore throat, it is not an objective indicator that can be measured or observed. D) Nausea is another subjective symptom that the patient reports feeling. It is not an observable or measurable sign that can be used to assess a patient's condition objectively. Understanding the distinction between signs and symptoms is fundamental in healthcare assessment as it guides healthcare providers in making accurate diagnoses and determining appropriate treatment plans. By recognizing the significance of objective signs like body temperature in this context, healthcare professionals can better evaluate and monitor patients' health status effectively.