Diltiazem (Cardizem) is prescribed for a patient with newly diagnosed Prinzmetal's (variant) angina. Which action of diltiazem is accurate for the nurse to include in the teaching plan?

Correct Answer: C

Rationale: Step 1: Diltiazem is a calcium channel blocker. Step 2: Calcium channel blockers like diltiazem work by relaxing and dilating coronary arteries. Step 3: Coronary artery spasms are a characteristic feature of Prinzmetal's angina. Step 4: Therefore, the accurate action of diltiazem is to decrease coronary artery spasms. Summary: Choice A is incorrect because diltiazem does not directly reduce heart palpitations. Choice B is incorrect because diltiazem does not prevent coronary artery plaque. Choice D is incorrect because diltiazem does not increase the contractile force of the heart.

Correct Answer: D

Rationale: The correct answer is D because in metabolic alkalosis, the blood pH is elevated due to excess bicarbonate levels. Teaching the client fall prevention measures is important as alkalosis can cause muscle weakness and confusion, increasing the risk of falls. Monitoring hemoglobin and hematocrit (Choice A) is not relevant to metabolic alkalosis. Administering furosemide (Choice B) may worsen alkalosis by decreasing fluid volume. Encouraging deep breaths (Choice C) is not indicated as it can further decrease carbon dioxide levels, exacerbating alkalosis.

Correct Answer: B

Rationale: The correct answer is B: Anxiety-induced hyperventilation. The pH of 7.48 indicates alkalosis, likely due to hyperventilation (respiratory alkalosis). The PaCO2 of 28 mm Hg is below the normal range (35-45 mm Hg), supporting hyperventilation. HCO3 of 22 mEq/L is within the normal range, compensating for the respiratory alkalosis. PaO2 of 98 mm Hg is also within the normal range. Therefore, the ABG values are consistent with a respiratory alkalosis caused by hyperventilation due to anxiety. Choices A, C, and D are incorrect: A: Diarrhea and vomiting for 36 hours would likely result in metabolic acidosis due to loss of bicarbonate, which is not supported by the ABG values. C: COPD typically presents with respiratory acidosis due to retention of CO2, which is not the case here. D

Correct Answer: B

Rationale: The correct answer is B: focus on acute care needs. Hospitals today primarily cater to providing immediate and intensive medical care for patients with severe or urgent health issues. This is evident in their specialized departments such as emergency rooms, intensive care units, and surgical suites. Hospitals are equipped with advanced technologies and specialized medical professionals to address acute conditions promptly. Choice A (focus on chronic illnesses) is incorrect as hospitals mainly deal with acute conditions. Choice C (primary care centers) is incorrect as primary care centers provide routine and preventive care, whereas hospitals focus on more complex and urgent medical needs. Choice D (voluntary agencies) is incorrect as hospitals are healthcare institutions that may operate as public, private, or non-profit entities, rather than voluntary agencies.

Correct Answer: A

Rationale: The correct answer is A: decreased length of hospital stay. Increasing healthcare costs lead to hospitals aiming to reduce costs by decreasing the length of hospital stays. Shorter stays reduce overall expenses for the hospital. This is a direct result of the effect of increasing healthcare costs on hospital admissions. The other choices are incorrect because decreased number of surgeries (B) and fewer surgeries in ambulatory centers (D) are related to surgical procedures, not hospital admissions. Increased hospital admissions (C) would not typically be a result of increasing healthcare costs, as hospitals aim to minimize costs by reducing length of stays rather than increasing admissions.