A client with a history of hypertension and diabetes mellitus presents to the clinic with complaints of fatigue, difficulty breathing, and frequent urination at night. Which risk factor is most likely contributing to the client's symptoms?

Hypertension

Diabetes mellitus

Smoking history

Family history of heart disease

Answer and Explanation

The Correct Answer is A

A) This choice is correct. Hypertension (high blood pressure) is a significant risk factor for congestive heart failure (CHF). Prolonged hypertension can lead to the heart's increased workload, causing it to weaken over time and eventually leading to CHF. The client's symptoms of fatigue, difficulty breathing, and nocturia (frequent urination at night) are common manifestations of CHF resulting from uncontrolled hypertension.

B) This choice is incorrect because diabetes mellitus, while a risk factor for cardiovascular disease, is not directly associated with the symptoms described by the client. However, diabetes can exacerbate CHF if the client's blood glucose levels are not well-controlled.

C) This choice is incorrect because smoking history is a risk factor for various cardiovascular diseases, but it is not specifically linked to the symptoms reported by the client in this case.

D) This choice is incorrect because a family history of heart disease may increase the client's risk of developing CHF, but it does not directly contribute to the current symptoms the client is experiencing.

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Correct Answer is C

Explanation

A) This choice is incorrect because ACE inhibitors should not be taken with grapefruit juice. Grapefruit juice can interfere with the metabolism of the medication, leading to increased levels and potential side effects.

B) This choice is incorrect because the client should not adjust the dose of the ACE inhibitor without consulting their healthcare provider. Blood pressure should be monitored, but any dosage adjustments should be made by the healthcare provider based on the client's response to the medication.

C) This choice is correct. ACE inhibitors can cause a side effect of a persistent dry cough, and in some cases, difficulty breathing. The client should promptly report these symptoms to their healthcare provider for evaluation and possible adjustment of the medication regimen.

D) This choice is incorrect because while ACE inhibitors can increase potassium levels, avoiding foods high in potassium is not necessary unless specifically directed by the healthcare provider. The client should follow a balanced diet and inform the healthcare provider of any changes in their dietary habits.

A. Take the medication with food to reduce stomach upset. B. Avoid using erectile dysfunction medications while on nitrate therapy. C. Avoid grapefruit juice while on nitrate therapy. D. Increase the dose if chest pain is not relieved within 15 minutes.

Correct Answer is B

Explanation

A) This choice is incorrect because taking the nitrate medication with food is not necessary. Nitrate medications are usually taken sublingually or by mouth and are not associated with significant stomach upset.

B) This choice is correct. Nitrate medications, such as nitroglycerin, can cause a dangerous drop in blood pressure when used concurrently with erectile dysfunction medications, specifically phosphodiesterase type 5 inhibitors (PDE5 inhibitors) like sildenafil (Viagra) or tadalafil (Cialis). Clients should be warned against using these medications together to prevent hypotension and potential cardiovascular complications.

C) This choice is incorrect because grapefruit juice is not typically associated with nitrate medications. Grapefruit juice can interact with certain medications, but it is not a known interaction with nitrates.

D) This choice is incorrect because increasing the nitrate dose without healthcare provider guidance can be dangerous. Clients should be instructed to take nitrate medications as prescribed and seek immediate medical attention if chest pain is not relieved within a specific timeframe, as directed by their healthcare provider.

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A client with a history of hypertension and diabetes mellitus presents to the clinic with complaints of fatigue, difficulty breathing, and frequent urination at night. Which risk factor is most likely contributing to the client's symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client with congestive heart failure. The client is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which instruction is essential for the client to follow?

Correct Answer is C

Explanation

A client with congestive heart failure is prescribed a nitrate medication. The nurse should instruct the client to:

Correct Answer is B

Explanation

A client with congestive heart failure is prescribed spironolactone, a potassium-sparing diuretic. The nurse should instruct the client to:

A nurse is providing education to a client with congestive heart failure who is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should instruct the client to:

A client with congestive heart failure is prescribed a loop diuretic. The nurse should closely monitor the client for which electrolyte imbalance associated with this medication?

A nurse is caring for a client with congestive heart failure who reports sudden weight gain, shortness of breath, and swelling in the ankles. What is the nurse's priority action?

A client with a history of hypertension and diabetes mellitus presents to the clinic with complaints of fatigue, difficulty breathing, and frequent urination at night. Which risk factor is most likely contributing to the client's symptoms?

A client with congestive heart failure is prescribed a beta-blocker. The nurse should closely monitor the client for which potential adverse effect of this medication?

A client with suspected congestive heart failure undergoes a chest X-ray. The nurse should anticipate which finding that may be indicative of CHF?

A nurse is assessing a client with congestive heart failure. Which finding indicates possible fluid accumulation in the lungs, a common symptom of CHF?