A 70-year-old woman presents with shortness of breath at res…

A 70-year-old woman presents with shortness of breath at rest over the past 3 days. She has found it difficult to walk short distances due to shortness of breath. Additionally, she is experiencing confusion, orthopnea, paroxysmal nocturnal dyspnea, and lightheadedness. She denies cough, fever, chills, diaphoresis, anxiety, chest pain, pleurisy, nausea, abdominal pain, vomiting, diarrhea, rashes, and syncope. On physical examination, the patient is short of breath, requiring numerous pauses during conversation. She is afebrile, but she is tachycardic, diaphoretic, and her extremities are cool. There is a diminished first heart sound, S3 gallop, laterally displaced PMI, bibasilar rales, and dullness to percussion and expiratory wheezing noted. An elevated JVD and 2+ pitting edema of the lower extremities is evident. What mechanism is primarily responsible for her symptoms?

Read the following passage, and then answer the questions th…

Read the following passage, and then answer the questions that follow: “If she herself had had any picture of the future, it had been of a society of animals set free from hunger and the whip, all equal, each working according to his capacity, the strong protecting the weak, as she had protected the lost brood of ducklings with her foreleg on the night of Major’s speech. Instead– she did not know why– they had come to a time when no one dared speak his mind, when fierce, growling dogs roamed everywhere, and when you had to watch your comrades torn to pieces after confessing to shocking crimes. There was no thought of rebellion or disobedience in her mind. She knew that, even as things were, they were far better off than they had been in the days of Jones.” What does the statement “she did not know why” suggest?Â