Which of the following clients is at a high risk for developing ...

[iveyjurea]

Which of the following clients is at a high risk for developing dilated cardiomyopathy?
 
  A)
  A 17-year-old with a diving injury resulting in paraplegia
  B)
  A 4-year-old child born with cerebral palsy and confined to a wheelchair
  C)
  A 44-year-old noncompliant female who forgets to take her hypertensive medications
  D)
  A 78-year-old patient with Alzheimer disease who received a third-degree burn following an oven fire

Question 2

A 77-year-old male client with a diagnosis of stomach cancer has been found to have metastases in his liver. The client and his family are surprised at this turn of events, stating that they do not see how he could have developed cancer in his liver.
 
  Which of the following facts would underlie the reply that the care team provides?
  A)
  The parenchymal tissue of the liver is particularly susceptible to secondary malignancies.
  B)
  The portal circulatory system brings venous blood from the GI tract into the liver.
  C)
  Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchorage dependence.
  D)
  The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a lack of contact inhibition.

[fwbard]

Answer to Question 1

Ans:
C

Feedback:

In hypertension, the increased workload required to pump blood against an elevated arterial pressure in the aorta results in a progressive increase in LV muscle mass and need for coronary blood flow. The pressure overload causes hypertrophied cells to have greater width and length. Paraplegia, cerebral palsy, and Alzheimer disease do not increase the workload of the cardiac muscle per se.

Answer to Question 2

Ans:
B

Feedback:

Portal circulation brings venous blood into the portal vein of the liver, facilitating hematologic spread. The parenchyma of the liver possesses no particular susceptibility to cancer, and hepatic tissue does not share traits of cancerous cells such as low contact inhibition or a lack of anchorage dependence.