The nurse is assessing a male client for symptoms of benign prostatic hyperplasia (BPH). The nurse should ask the client about which of the following?

Choice A rationale

Serum electrolyte analysis provides insights into fluid and electrolyte balance but does not specifically diagnose heart failure. Electrolyte changes may occur secondary to heart failure but are not definitive markers for the condition.

Choice B rationale

Complete blood count evaluates for anemia or infection, which may contribute to symptomatology but is not diagnostic for heart failure. Heart failure diagnosis focuses on cardiac-specific markers rather than hematologic parameters.

Choice C rationale

Blood urea nitrogen assesses renal function and reflects perfusion status but lacks specificity for heart failure. Although renal dysfunction may occur in advanced heart failure, BNP measurement is more definitive for cardiac assessment.

Choice D rationale

Brain natriuretic peptide (BNP) is a key diagnostic marker for heart failure. Elevated BNP levels occur due to ventricular stretch and strain associated with fluid overload, a hallmark of heart failure. Normal BNP levels are typically <100 pg/mL, with elevated levels strongly suggesting cardiac dysfunction. .

Choice A rationale

Lower extremity edema is often associated with right-sided heart failure rather than left ventricular failure. Right-sided failure leads to systemic venous congestion, causing fluid accumulation in peripheral tissues like the legs. Left ventricular failure predominantly affects pulmonary circulation, making edema of the lower extremities a less expected finding.

Choice B rationale

Pulmonary crackles are a hallmark finding in left ventricular failure due to fluid accumulation in the alveoli. This occurs because reduced cardiac output causes blood to back up into pulmonary veins and capillaries, increasing hydrostatic pressure and leading to pulmonary congestion. Crackles indicate the presence of interstitial or alveolar fluid, a direct result of left-sided dysfunction.

Choice C rationale

Ascites results from portal hypertension and systemic venous congestion, typically seen in right-sided heart failure or advanced liver disease. Left ventricular failure impacts the pulmonary system rather than the abdominal cavity, making ascites an unlikely finding during assessment for this condition.

Choice D rationale

Jugular vein distention is indicative of systemic venous congestion caused by right-sided heart failure. In left ventricular failure, pulmonary congestion dominates, and jugular vein distention is not a primary finding. Assessments should focus on symptoms directly linked to pulmonary effects such as crackles or dyspnea.