A nurse is reviewing the diagnostic tests for a client suspected of having congestive heart failure. Which test is considered the gold standard for diagnosing CHF?

A) This choice is incorrect because orthopnea is a different symptom where the client experiences difficulty breathing while lying flat and finds relief by sitting upright or standing.

B) This choice is correct. Paroxysmal nocturnal dyspnea is characterized by sudden breathlessness that awakens the client from sleep, usually 1-2 hours after falling asleep. The client may feel the need to sit upright or dangle the legs to breathe comfortably.

C) This choice is incorrect because peripheral edema refers to swelling in the legs, ankles, and feet, which is a common symptom of congestive heart failure but does not match the client's reported symptom.

D) This choice is incorrect because tachypnea is rapid breathing and is not specifically related to the client's nighttime symptom of sudden breathlessness.

A) This choice is incorrect because hypertension is not a common side effect of digoxin. Digoxin is used to treat heart failure and can help control blood pressure in some cases.

B) This choice is incorrect because hyperkalemia (elevated potassium levels) is not a common side effect of digoxin. In fact, digoxin can sometimes cause hypokalemia (low potassium levels) as a side effect.

C) This choice is correct. Bradycardia (slow heart rate) is a common side effect of digoxin. Digoxin works by increasing the force of the heart's contractions and can slow down the heart rate. Clients taking digoxin should have their heart rate monitored regularly, and the healthcare provider should be notified if the heart rate is below the prescribed parameters.

D) This choice is incorrect because respiratory alkalosis is not a common side effect of digoxin. Digoxin does not directly affect the respiratory system.

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