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 D
Explanation
A. A murmur and splinter hemorrhages are expected findings in infective endocarditis and do not indicate an immediate life-threatening condition.
B. Sharp chest pain with inspiration in rheumatic fever may indicate pericarditis, which needs monitoring but is not immediately unstable.
C. Bilateral crackles suggest fluid overload in dilated cardiomyopathy, requiring attention, but not as urgent as hypotension in acute valve failure.
D. Acute aortic regurgitation with hypotension (BP 86/54 mm Hg) indicates a possible hemodynamic collapse and cardiogenic shock, making this client the highest priority for immediate assessment and intervention.
Correct Answer is C
Explanation
A. A blood pressure of 84/50 mm Hg is more consistent with the progressive stage of shock, where compensation is failing.
B. Petechiae may be seen in disseminated intravascular coagulation (DIC), a complication of severe shock, typically not in the compensatory stage.
C. Confusion is an early sign of impaired cerebral perfusion, which can occur in the compensatory stage of shock. It reflects the body’s efforts to maintain perfusion to vital organs despite declining cardiac output.
D. Anuria (no urine output) is a late finding, typically seen in the irreversible stage of shock, indicating complete renal failure.
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