A nurse is assessing a client with suspected congestive heart failure. Which symptom is the classic hallmark of left-sided heart failure?
Ascites
Dependent edema
Crackles in the lungs
Jugular vein distention
The Correct Answer is C
A) This choice is incorrect because ascites (abdominal swelling due to fluid accumulation) is a sign of right-sided heart failure, not left-sided heart failure.
B) This choice is incorrect because dependent edema (swelling in the legs and ankles) is also a sign of right-sided heart failure, not left-sided heart failure.
C) This choice is correct. Crackles in the lungs, also known as rales, are the classic hallmark of left-sided heart failure. They occur when fluid accumulates in the lungs, leading to abnormal lung sounds on auscultation.
D) This choice is incorrect because jugular vein distention is associated with right-sided heart failure, not left-sided heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) This choice is incorrect because bradycardia (slow heart rate) is not a common adverse effect of furosemide, a loop diuretic.
B) This choice is correct. Furosemide is a loop diuretic that can lead to increased potassium excretion in the urine, potentially causing hypokalemia (low potassium levels). The nurse should closely monitor the client's potassium levels and provide potassium supplementation if necessary.
C) This choice is incorrect because hypertension (high blood pressure) is not typically associated with loop diuretics like furosemide. In fact, furosemide is used to treat hypertension and congestive heart failure by promoting the excretion of excess fluid and reducing blood pressure.
D) This choice is incorrect because hyperglycemia (high blood glucose levels) is not a common adverse effect of furosemide. In fact, furosemide can sometimes cause transient hypoglycemia.
Correct Answer is C
Explanation
A) This choice is incorrect because an electrocardiogram (ECG) is a valuable diagnostic tool for assessing the heart's electrical activity and rhythm, but it is not the gold standard for diagnosing CHF. It can provide information about possible cardiac hypertrophy or rhythm disturbances associated with heart failure.
B) This choice is incorrect because a chest X-ray is helpful in evaluating heart size and the presence of pulmonary congestion, but it is not the gold standard for diagnosing CHF.
C) This choice is correct. An echocardiogram is the gold standard for diagnosing CHF. It uses ultrasound waves to assess the heart's structure and function, including ejection fraction and valve function, providing critical information to confirm the diagnosis of heart failure.
D) This choice is incorrect because a brain natriuretic peptide (BNP) level is a blood test that can aid in the diagnosis of CHF. Elevated BNP levels indicate heart strain, but it is not the gold standard for diagnosing CHF.
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