A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right- sided heart failure?

"My shoes fit really tight lately."

"I sleep with 2 pillows at night."

"I have trouble catching my breath."

"I wake up coughing every night."

Answer and Explanation

The Correct Answer is A

A. Tight shoes may indicate fluid retention in the lower extremities, which is a common symptom of right-sided heart failure. This condition leads to the backup of blood into the systemic circulation, causing peripheral edema.

B. Sleeping with two pillows may indicate left-sided heart failure, as the client may be experiencing orthopnea (difficulty breathing when lying flat).

C. Shortness of breath is more commonly associated with left-sided heart failure.

D. Waking up coughing every night is also a sign of left-sided heart failure, where pulmonary congestion leads to nocturnal coughing.

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Correct Answer is D

Explanation

A. Magnetic resonance imaging (MRI) may be used in some cases, but TRUS is more commonly used to guide biopsies after concerns arise from DRE or PSA findings.

B. Uroflowmetry studies measure urine flow, which is not the primary concern in evaluating an enlarged prostate related to potential cancer.

C. Cystourethroscopy is used to evaluate the bladder or urethra and is not typically needed in the assessment of an enlarged prostate.

D. Transrectal ultrasonography (TRUS) is commonly used in the evaluation of prostate abnormalities, especially when there are concerns about prostate cancer due to an abnormal DRE or elevated PSA. It helps in visualizing the prostate and guiding biopsy.

A. "They will circulate my blood on a machine during the surgery." B. "I will need to take an aspirin every day after the surgery to keep the graft open." C. "They will use an artery near my heart to go around the area that is blocked." D. "I will have small incisions in my leg where they will remove the vein."

Correct Answer is D

Explanation

A. "They will circulate my blood on a machine during the surgery.": This is correct information regarding the use of a heart-lung machine during CABG.

B. "I will need to take an aspirin every day after the surgery to keep the graft open.": Daily aspirin therapy is standard to prevent graft occlusion, indicating correct understanding.

C. "They will use an artery near my heart to go around the area that is blocked.": This accurately describes using the internal mammary artery for the bypass, showing correct knowledge.

D. "I will have small incisions in my leg where they will remove the vein.": This indicates confusion, as the internal mammary artery, not leg veins, is used in this type of CABG.

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Test Name	Results	Reference Range
WBC	12, 000	4, 000- 11, 000
Na+	149 mEq/L	135-145 mEq/L
K+	5.0 mEq/L	3.5- 5.0 mEq/L
Cl-	110 mEq/L	96-106 mEq/L
pH	7.34	7.35-7.45
PaCO2	34 mmHg	35- 45 mmHg
PaO2	78 mm Hg	80-100 mmHg
HCO3	21 mEq/L	22- 26 mEq/L

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right- sided heart failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse will anticipate that a 61-year-old client who has an enlarged prostate detected by digital rectal exam (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about

Correct Answer is D

Explanation

When evaluating the effectiveness of preoperative teaching with a client scheduled for coronary artery bypass graft (CABG) surgery using the internal mammary artery, the nurse determines that additional teaching is needed when the client says which of the following?

Correct Answer is D

Explanation

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