A 60-Year-Old Man Comes to the Office for Follow Up

question 230

Multiple Choice

A 60-year-old man comes to the office for follow up appointment, he feels shortenss of breath while walking his dog around the block. He states that he is experiencing a dyspnea while sleeping therefor he uses 3 pillows or sleep on the recliner.   The patient had an acute myocardial infarction 2 years ago and has been nonadherent with his medications.  Temperature is 36.9 C (98 F) , blood pressure is 125/74 mm Hg, pulse is 92/min, and respirations are 21/min.  Physical examination shows bibasilar lung crackles, jugular venous distension, and bilateral pitting edema in the lower extremities.  Chest x-ray reveals cardiomegaly and pulmonary venous congestion.  Which of the following factors is most likely contributing to this patient's symptoms?

• A)Decreased arteriolar resistance
• B)Decreased plasma renin activity
• C)Decreased ventricular end-diastolic pressure
• D)Increased plasma brain natriuretic peptide concentration
• E)Increased sympathetic nervous system activity

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Definitions:

Language Acquisition

The process by which humans learn to perceive, recognize, and produce language, typically occurring in early childhood.

Echoing

The repetition or mimicking of words or sounds, often used as a learning tool or as a symptom of certain disorders.

Expanding

The act or process of increasing in size, volume, quantity, or scope.

Infant Language Development

The process by which babies and young children acquire the ability to understand and produce language.