A 65-year-old patient with congestive heart failure has been on diuretic therapy for the past two weeks. During a follow-up appointment, which of the following findings would indicate that the diuretic therapy is effective?

Increase in blood pressure and heart rate

Significant weight gain over the past two weeks

Reduction in peripheral edema and improved breathing

Development of muscle cramps and weakness

Answer and Explanation

The Correct Answer is C

Rationale:
A. This would indicate possible fluid retention or worsening heart function, not effective diuretic therapy. Effective diuretics usually help reduce fluid overload, which may lower blood pressure in hypertensive patients.

B. Rapid weight gain is a sign of fluid retention, which suggests diuretic therapy is not effective or the patient’s heart failure is worsening.

C. These findings indicate that excess fluid is being successfully removed from the body. Decreased swelling in the extremities and improved respiratory status reflect effective diuresis and improved cardiac function, which is the goal of therapy.

D. While these can occur due to electrolyte imbalances caused by diuretics, they are adverse effects rather than indicators of effectiveness.

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Correct Answer is ["B","D"]

Explanation

Rationale:

A. While pneumonia can cause fever, fatigue, and chest discomfort, it is less likely to cause severe pedal edema, irregular heart rhythms, or palpitations. The presence of edema and irregular heart sounds points toward a cardiac origin rather than a primary pulmonary infection.

B. Fatigue, chest discomfort, irregular heart sounds, pedal edema, and low blood pressure are classic signs of heart failure, particularly in a young adult who may have acute or chronic cardiac dysfunction. Heart failure can also contribute to the development of arrhythmias.

C. COPD primarily presents with chronic cough, dyspnea, and sputum production. While it can strain the heart over time, COPD alone would not account for the acute irregular heart rate, edema, and chest discomfort in this patient.

D. The irregular heart rate (HR 112 bpm) and irregular heart sounds are indicative of atrial fibrillation, which is common in patients with underlying heart disease or heart failure. Atrial fibrillation can also worsen cardiac output, contributing to edema and fatigue.

E. Pulmonary embolism typically presents with acute dyspnea, pleuritic chest pain, tachypnea, and sometimes hemoptysis. Edema and irregular heart rhythms are not primary features, making this less likely than heart failure and atrial fibrillation.

A. A patient who has crackles bilaterally in the lung bases and is receiving oxygen with oxygen saturation of 95% B. A patient who is receiving IV nitroglycerin and has a blood pressure of 108/62 C. A patient who is cool and clammy, with new-onset confusion and restlessness D. A patient who reported dry cough after receiving the first dose of captopril

Correct Answer is C

Explanation

Rationale:
A. This patient shows signs of mild pulmonary congestion, but oxygen saturation is within an acceptable range and the patient is currently stable.

B. While this patient is on a vasodilator and has borderline low blood pressure, they are hemodynamically stable at this moment and not showing signs of acute deterioration.

C. This patient exhibits signs of poor perfusion and possible cardiogenic shock, which is life-threatening. These symptoms indicate an urgent priority for assessment and intervention.

D. This is a common side effect of ACE inhibitors and is non-emergent; the patient is stable and does not require immediate assessment

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A 65-year-old patient with congestive heart failure has been on diuretic therapy for the past two weeks. During a follow-up appointment, which of the following findings would indicate that the diuretic therapy is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 22-year-old patient presents with fatigue, chest discomfort, and palpitations. Vital signs show HR 112 bpm. BP 98/5, and low-grade fever. The nurse notes irregular heart sounds and severe pedal edema. Which condition should the nurse suspect? (Select All that Apply.)

Correct Answer is ["B","D"]

Explanation

After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first?

Correct Answer is C

Explanation

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