A client admitted with heart failure is able to initiate brushing their teeth and combing their hair but unable to finish these activities or wash their body due to dyspnea and fatigue. Upon ambulation to the bathroom, the patient also experiences dyspnea, fatigue, and chest pain. Based upon this information, what New York Heart Association Classification will be assigned to this client?
I
II
IV
III
The Correct Answer is D
A. Class I: No limitation of physical activity; ordinary activity does not cause symptoms. This client clearly experiences symptoms with ordinary activities.
B. Class II: Slight limitation of physical activity; comfortable at rest, but ordinary activity causes fatigue, dyspnea, or chest pain. This client is more limited than Class II.
C. Class IV: Unable to carry out any physical activity without discomfort; symptoms may be present even at rest. This client does not have symptoms at rest.
D. Class III: Marked limitation of physical activity; comfortable at rest, but less-than-ordinary activity (e.g., brushing teeth, walking to the bathroom) causes fatigue, dyspnea, or chest pain. This best fits the client's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Fluid overload is associated with elevated CVP, not low CVP.
B. Left ventricular failure may eventually cause elevated pulmonary pressures and increased CVP, but a low CVP does not indicate left-sided failure.
C. Hypovolemia (low circulating blood volume) leads to a decreased central venous pressure (CVP) because there is less venous return to the heart. This is the most accurate interpretation of a low CVP reading.
D. An intracardiac shunt may affect circulation dynamics but is not a typical cause of isolated low CVP.
Correct Answer is A
Explanation
A. PVCs during suctioning may indicate hypoxia or irritation; the priority is to stop suctioning and ventilate the patient with 100% oxygen to prevent worsening arrhythmias.
B. Medications may be needed later, but immediate action is oxygenation and stopping suctioning.
C. Adjusting suction pressure is important but secondary to ensuring patient oxygenation.
D. Documentation is necessary but not the priority when PVCs are noted.
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