A nurse is providing teaching to a client who has heart failure and a decreased cardiac output. Which of the following information should the nurse include in the teaching?

Restrict daily exercise

Encourage 3 large meals per day.

Limit dietary salt intake

Obtain weight once per week.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Restrict daily exercise: Clients with heart failure benefit from regular, moderate activity as tolerated to improve cardiac efficiency and prevent deconditioning. Restricting all exercise can worsen functional status and is not recommended unless specifically limited by the healthcare provider.

B. Encourage 3 large meals per day: Large meals can increase cardiac workload and exacerbate heart failure symptoms due to increased blood flow demands during digestion. Smaller, more frequent meals are preferable to reduce strain on the heart.

C. Limit dietary salt intake: Reducing sodium intake helps prevent fluid retention and edema, which can exacerbate heart failure and increase cardiac workload. Teaching clients to limit salt is a key intervention to manage decreased cardiac output and maintain stable fluid balance.

D. Obtain weight once per week: Daily weight monitoring is recommended for clients with heart failure to detect fluid retention early. Weekly weights may delay recognition of sudden fluid accumulation, increasing the risk of decompensation.

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Free Nursing Study Resources

Correct Answer is ["A","B","D","E","G"]

Explanation

Rationale for correct choices

• The statement "Why don't you just leave me? I am of no use" reflects hopelessness, a high‑risk indicator for self‑harm in older adults. Expressions of worthlessness or being a burden require immediate follow‑up because they signal severe depression or suicidal ideation. The priority is ensuring safety and initiating urgent mental health evaluation.

• The report of cognitive decline accompanied by worsening memory, disordered thought process, and impaired self‑care indicates a significant functional deterioration. These symptoms can reflect rapidly progressing depression, delirium, or early dementia. Any acute decline in cognition or functional ability in an older adult warrants prompt assessment to identify reversible causes.

• Loss of appetite with an 8‑lb weight loss in one month suggests clinically significant unintentional weight loss. Combined with decreased interest in eating, this is a red flag for major depressive disorder, frailty progression, or underlying illness. Sudden nutritional decline increases morbidity risk and requires timely intervention.

• Poor eye contact, monotone speech, and flat facial expression are key affective indicators of depression. These signs, when combined with statements of worthlessness, suggest severe depressive symptoms that require urgent assessment and intervention to prevent further decline.

Rationale for incorrect choices

• Sleeping 7 hours per night with 1–2 awakenings to urinate can be normal for older adults. This finding does not indicate acute risk and is not a priority compared with weight loss, cognitive decline, or suicidal statements. It can be evaluated during routine assessment rather than requiring urgent follow‑up.

• Heart rate 68/min is within normal limits for an older adult and does not signal instability or deterioration. It does not require immediate intervention and can be monitored routinely while priority concerns related to mood, cognition, and safety are addressed.

A. 61-year-old male B. Has smoked 1 pack of cigarettes per day for 40 years. C. History of hyperlipidemia. D. Walks at least a mile three times a week. E. Reports drinking two to three beers each evening F. Client reports he follows the Dietary Approaches to Stop Hypertension (DASH) diet. G. Biological father has a history of hyperlipidemia and hypertension. H. Biological mother has history of renal failure requiring dialysis. I. BMI 30.5

Correct Answer is ["A","B","C","E","G","H","I"]

Explanation

Rationale for correct choices

• 61-year-old male: Advanced age and male sex increase the risk of cardiovascular complications such as coronary artery disease, heart failure, and stroke. Aging contributes to arterial stiffness, reduced cardiac reserve, and higher likelihood of comorbidities, all of which elevate the risk profile for this client.

• Has smoked 1 pack of cigarettes per day for 40 years: Chronic smoking is a major modifiable risk factor for atherosclerosis, myocardial infarction, stroke, and peripheral arterial disease. Long-term tobacco use promotes endothelial damage, increases LDL cholesterol, and impairs oxygen delivery, significantly increasing cardiovascular risk.

• History of hyperlipidemia: Elevated cholesterol and triglycerides predispose the client to plaque formation in arteries, contributing to atherosclerosis and cardiovascular disease. Hyperlipidemia is a key risk factor for complications such as myocardial infarction and stroke, especially when combined with other comorbidities.

• Reports drinking two to three beers each evening: Excessive alcohol consumption contributes to hypertension, cardiomyopathy, and arrhythmias. Chronic alcohol intake can also exacerbate hyperlipidemia and increase the risk of liver disease, compounding cardiovascular and systemic complications.

• BMI 30.5: A BMI above 30 classifies the client as obese, which increases the risk for hypertension, type 2 diabetes, heart disease, and stroke. Obesity contributes to metabolic syndrome and further stresses the cardiovascular system, making the client more prone to complications.

• Family history: Biological father with hyperlipidemia and hypertension, Biological mother with renal failure: A strong family history of cardiovascular and renal disease increases the client’s genetic susceptibility to these conditions. Inherited risk factors, when combined with lifestyle factors, significantly elevate the likelihood of developing complications such as heart failure, chronic kidney disease, or stroke.

Rationale for incorrect choices

• Walks at least a mile three times a week: Regular physical activity is protective, not a risk factor, for cardiovascular and metabolic complications. Exercise helps improve lipid profile, blood pressure, and overall cardiovascular health, mitigating some of the client’s other risk factors.

• Client reports he follows the DASH diet: Adhering to the DASH diet is a positive lifestyle behavior that reduces blood pressure, supports heart health, and lowers the risk of stroke or heart disease. It is not a risk factor; rather, it is a mitigating factor against cardiovascular complications.

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System	Findings
General	Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me."
Physical	Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Heart rate 68/min
Affect	Client says, "Why don't you just leave me? I am of no use."

A nurse is providing teaching to a client who has heart failure and a decreased cardiac output. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","D","E","G"]

Explanation

Correct Answer is ["A","B","C","E","G","H","I"]

Explanation

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