A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

Dependent edema

Frothy sputum

Nocturnal polyuria

Jugular distention

Answer and Explanation

The Correct Answer is B

Frothy sputum is a sign of left-sided heart failure, due to the pulmonary congestion and impaired gas exchange. The sputum may be pink-tinged or blood-streaked, indicating pulmonary edema.

a. Dependent edema is more likely to be seen in clients who have right-sided heart failure, due to the increased venous pressure and ﬂuid retention. The edema is usually symmetrical and aﬀects the lower extremities, abdomen, and sometimes the face.

c. Nocturnal polyuria is not a specific finding of left-sided heart failure, but it may occur in clients who have renal impairment, diabetes mellitus, or diuretic therapy.

d. Jugular distention is another sign of right-sided heart failure, due to the increased central venous pressure and backward ﬂow of blood into the superior vena cava. It is visible as a bulging of the neck veins, especially when the client is in a semi-Fowler's position.

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Correct Answer is B

Explanation

An exercise stress test is a diagnostic procedure that measures the heart's response to physical activity. The client is instructed to walk on a treadmill or pedal a stationary bike while their heart rate, blood pressure, and electrocardiogram are monitored. The test can help detect coronary artery disease, arrhythmias, or other cardiac problems.

The client should follow certain guidelines before the test, such as:

Avoiding caﬀeine, nicotine, alcohol, and stimulants for at least 4 hours before the test, as they can aﬀect the heart rate and blood pressure.
Fasting for at least 2 hours before the test, as eating can aﬀect the blood ﬂow to the heart.
Getting adequate rest and sleep the night before the test, as fatigue can aﬀect the performance and results of the test.
Wearing comfortable clothing and shoes that are suitable for exercise.
Informing the provider of any medications they are taking, as some medications may need to be withheld or adjusted before the test, such as beta blockers, calcium channel blockers, nitrates, or antiarrhythmics. These medications can aﬀect the heart rate and blood pressure and interfere with the interpretation of the test results.

Therefore, the comment made by the client that indicates a need for further teaching is "I'll take my heart medications the morning of my test." The client should consult with their provider about whether they should take their heart medications or not before the test. The other comments made by the client are appropriate and indicate that they understand the pre-test instructions.

A. "I should use naproxen to manage discomfort." B. "I plan to slow down if I am tired the day after exercising." C. "I will read food labels and limit my sodium to 4 grams per day." D. "I will take my diuretic before sleep and drink ﬂuids during the day."

Correct Answer is B

Explanation

Planning to slow down if tired the day after exercising is a statement that indicates the client understands the importance of pacing activities and avoiding overexertion, which can worsen heart failure symptoms.

a. "I should use naproxen to manage discomfort." is not correct, as naproxen is a nonsteroidal anti-inﬂammatory drug (NSAID) that can cause ﬂuid retention, increase blood pressure, and worsen heart failure. The client should avoid NSAIDs and use other analgesics, such as acetaminophen, unless contraindicated.

c. "I will read food labels and limit my sodium to 4 grams per day." is not appropriate, as 4 grams of sodium per day is too high for a client who has congestive heart failure. The client should limit sodium intake to 2 grams or less per day, as sodium can cause ﬂuid retention and increase the workload of the heart.

d. "I will take my diuretic before sleep and drink ﬂuids during the day." is not advisable, as taking a diuretic before sleep can cause nocturia and disrupt the sleep cycle, which can aﬀect the quality of life and cardiac function. The

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A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following comments made by the client should indicate to the nurse that the client requires further teaching?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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