Which of the following predisposes a client to right-sided heart failure and is a condition in which the heart is affected secondarily by lung damage?

Correct Answer: B

Rationale: The correct answer is B: Cor pulmonale. This condition is characterized by right-sided heart failure due to lung damage, leading to increased pressure in the pulmonary circulation. Lung damage can result from chronic obstructive pulmonary disease (COPD) or other lung diseases, causing the heart to work harder to pump blood through the lungs. This increased workload can eventually lead to right-sided heart failure. A: Myocardial infarction primarily affects the left side of the heart. C: Hypertension can lead to left-sided heart failure but not specifically right-sided heart failure. D: Cardiomyopathy is a broad term for diseases of the heart muscle and does not specifically predispose to right-sided heart failure due to lung damage.

Correct Answer: C

Rationale: The correct answer is C: take aspirin 81 mg/d. Aspirin is recommended for primary prevention of coronary heart disease in high-risk individuals, including females. It helps reduce the risk of blood clot formation by inhibiting platelet aggregation. This action can prevent blockages in the arteries that supply the heart. Avoiding weight gain during pregnancy (A) is important for overall health but not a primary prevention specifically for coronary heart disease. Enrolling in a cardiac rehabilitation program (B) is more suitable for individuals who already have cardiovascular disease. Taking nitroglycerin (D) is used for acute relief of chest pain but is not a primary prevention strategy.

Correct Answer: C

Rationale: The correct answer is C: Cardiac murmurs. Cardiac valve problems can cause abnormal blood flow, leading to turbulent flow and producing murmurs. Murmurs are often auscultated using a stethoscope. Incorrect Choices: A: Arterial bruit is associated with vascular abnormalities, not specifically cardiac valve problems. B: Pulsus alternans is a pulse pattern, not a sound auscultated from the heart. D: Third heart sound (S3) is associated with heart failure or volume overload, not specifically valve problems.

Correct Answer: B

Rationale: Step 1: Prazosin is an alpha-adrenergic blocker that can cause orthostatic hypotension. Step 2: Adding prazosin to the regimen can further lower the patient's blood pressure. Step 3: Changing position slowly and avoiding prolonged standing helps prevent dizziness and falls. Step 4: Teaching the patient to change positions slowly is crucial to prevent orthostatic hypotension. Step 5: This education is essential for the patient's safety and well-being.

Correct Answer: C

Rationale: The correct answer is C: Lactic acid accumulation during anaerobic metabolism. During myocardial ischemia, there is a decrease in blood flow leading to insufficient oxygen supply to the heart muscle. This results in anaerobic metabolism, causing lactic acid accumulation. Lactic acid buildup leads to tissue acidosis, which is sensed as pain by nerve endings in the heart. Incorrect choices: A: Death of myocardial tissue - This is the result of prolonged ischemia leading to irreversible damage, not the direct cause of pain. B: Dysrhythmias caused by cellular irritability - Dysrhythmias can occur with ischemia, but they are not the primary cause of pain. D: Elevated pressure in the ventricles and pulmonary vessels - While elevated pressure can be a consequence of ischemia, it is not the direct cause of pain.