If Mr. Lane, with essential hypertension, complains of dizziness when changing position, your evaluation would be that Mr. Lane

Correct Answer: B

Rationale: In this scenario, the correct answer is B) should be instructed in preventing hypotensive reactions. When a patient with essential hypertension complains of dizziness upon changing position, it could indicate orthostatic hypotension, a common side effect of antihypertensive medications. Providing education on preventing hypotensive reactions, such as rising slowly from sitting or lying down, increasing fluid intake, and monitoring blood pressure regularly, can help manage this issue. Option A) is probably not taking his medications properly is incorrect because assuming non-adherence without evidence can lead to incorrect conclusions and potentially harm the patient's trust in healthcare providers. Option C) is responding as expected to the prescribed medications is incorrect because dizziness upon changing position is not an expected response to antihypertensive medications and warrants further evaluation. Option D) should be totally reevaluated is too drastic a response at this stage without first addressing potential medication-related side effects. In an educational context, understanding the relationship between essential hypertension, antihypertensive medications, and potential side effects like orthostatic hypotension is crucial for healthcare professionals. Recognizing and managing these side effects through patient education is essential in providing safe and effective care for individuals with hypertension.

Correct Answer: B

Rationale: In evaluating a client's compensation in chronic congestive heart failure, the most useful measure would be option B) Daily weight assessment. This is because in congestive heart failure, fluid retention is a common issue due to the heart's inability to effectively pump blood. Monitoring daily weight can provide valuable information on fluid status. Option A) Weekly digoxin blood level assessment is not the most useful measure for evaluating compensation in chronic congestive heart failure because while digoxin is commonly used in heart failure management, monitoring its blood levels does not directly assess the client's compensation status. Option C) Hourly urinary output is not the most useful measure as it may not accurately reflect the overall fluid balance and compensation status of the client with chronic congestive heart failure. Option D) Monthly activity level assessment is not the most useful measure as it does not provide real-time information on the client's fluid status and compensation in chronic congestive heart failure. Educationally, understanding the rationale behind selecting the appropriate measure for evaluating a client's compensation in chronic congestive heart failure is crucial for healthcare providers to make informed clinical decisions and provide optimal care for their patients. Monitoring daily weight can help in early identification of fluid retention and decompensation, leading to timely interventions and improved outcomes for individuals with congestive heart failure.

Correct Answer: D

Rationale: The correct answer is D) Pericarditis. Pericarditis is an inflammation of the pericardium, the sac-like covering around the heart. The symptom described in the question - pain worsened by inspiration and relieved by sitting up - is classic for pericarditis. This sharp, stabbing chest pain is often aggravated by lying down and deep breathing due to the movement of the inflamed pericardial layers. Option A) Myocarditis involves inflammation of the heart muscle itself and typically presents with symptoms such as chest pain, fatigue, and shortness of breath, but not specifically worsened by inspiration or relieved by sitting up. Option B) An extended infarction refers to a heart attack that has affected a large area of the heart muscle. The pain associated with a heart attack is usually not positional and may not change with breathing or body position. Option C) Cardiac cripple syndrome is not a recognized medical term and does not describe a specific cardiovascular condition. Understanding the differentiation of symptoms between various cardiovascular conditions is crucial in clinical practice for accurate diagnosis and appropriate management. Recognizing the unique presentation of pericarditis can lead to timely intervention and improved patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) His pacemaker will fire only when his own heart rate drops below 72 beats per minute. This statement is crucial in understanding the function of a synchronous pacemaker. A synchronous pacemaker is designed to pace the heart only when the patient's intrinsic heart rate falls below a set threshold (in this case, 72 beats per minute), thereby providing support when the heart's natural pacemaker is not functioning effectively. Option A is incorrect because a synchronous pacemaker is intended to work in synchrony with the patient's natural heart rate, not override it regardless of the heart's activity. Option C is incorrect as the pacemaker firing rate is set based on the patient's needs and may not always be 72 beats per minute. Option D is incorrect because a synchronous pacemaker is less likely to cause ventricular fibrillation compared to other types of pacemakers, as it is programmed to pace the heart at appropriate times. Educationally, understanding the function of different types of pacemakers is essential for healthcare providers involved in the care of patients with cardiac issues. Knowing the specific indications and mechanisms of each type of pacemaker helps in clinical decision-making, monitoring patient responses, and ensuring optimal patient outcomes.