The nurse is assessing a newly admitted client diagnosed with left ventricular failure.
Which of the following findings should the nurse expect during the assessment?

Edema of the lower extremities.

Pulmonary crackles auscultated.

Ascites.

Jugular vein distention.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Edema of the lower extremities suggests right-sided heart failure, not left ventricular failure. Fluid backs up into systemic circulation in right-sided failure, while left-sided failure primarily affects pulmonary circulation. Differentiating between these conditions is essential for targeted management.

Choice B rationale

Pulmonary crackles result from fluid accumulation in alveoli due to left ventricular failure, where decreased cardiac output causes blood to back up into pulmonary vasculature. Crackles indicate pulmonary congestion or edema. Prompt identification aids in early intervention. Normal respiratory assessment excludes crackles.

Choice C rationale

Ascites is more indicative of chronic right-sided heart failure or liver disease, not acute left ventricular failure. Ascites results from systemic venous congestion, which is less common in isolated left-sided heart failure. Differentiating causes helps refine diagnostic focus.

Choice D rationale

Jugular vein distention is associated with elevated central venous pressure, typical of right-sided heart failure or combined heart failure. It does not specifically characterize left ventricular failure. Accurate recognition of findings ensures precise diagnosis and management.

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Correct Answer is A

Explanation

Choice A rationale

Venison stew and ice cream are high in animal protein and calcium. Excess dietary calcium and animal protein can increase the urinary excretion of oxalate, contributing to kidney stone formation. Hyperoxaluria leads to the precipitation of calcium oxalate crystals in the renal tubules, exacerbating stone development.

Choice B rationale

Poached salmon and green beans are suitable because salmon is low in oxalate content, and green beans are unlikely to contribute significantly to oxalate excretion. Low-oxalate foods help reduce the recurrence risk of kidney stone formation and support overall renal health.

Choice C rationale

Spinach salad and rhubarb pie are rich in oxalate. Spinach contains 970 mg per 100 g, and rhubarb contributes significantly to dietary oxalate, promoting hyperoxaluria and increasing kidney stone risks. These foods should be avoided by individuals prone to oxalate stones.

Choice D rationale

Sautéed mushrooms and fried rice are acceptable choices, as mushrooms have negligible oxalate content and fried rice does not contribute significantly to oxalate excretion. Both options support balanced nutrition while minimizing renal stone risks.

A. The client is obese and has been exercising for 20 minutes per day twice each week. B. The client has reduced sodium intake from 5 grams per day to 3.5 grams per day. C. The client drinks 1 to 2 glasses of wine with dinner a few nights per week. D. The client has reduced smoking cigarettes from 2 packs per day to 1.5 packs per day.

Correct Answer is A

Explanation

Choice A rationale

Obesity and minimal exercise contribute significantly to hypertension due to increased vascular resistance and poor cardiac health. Recommendations for hypertension management include regular physical activity at least 30 minutes daily, five times per week. Current exercise efforts are insufficient, indicating a need for intervention to optimize blood pressure reduction.

Choice B rationale

Sodium intake reduction to 3.5 grams daily is an improvement but still exceeds the recommended limit of 2.3 grams. Excess sodium contributes to hypertension by increasing fluid retention and vascular resistance, though this change alone does not prioritize follow-up over sedentary behavior, which has a larger impact.

Choice C rationale

Alcohol consumption can elevate blood pressure by affecting vascular tone and increasing sympathetic nervous system activity. While 1-2 glasses per day may be within moderation, prioritizing increased physical activity would have a greater benefit on hypertension management than reducing alcohol intake alone.

Choice D rationale

Reducing cigarette smoking from 2 packs to 1.5 packs per day lowers nicotine exposure but still significantly contributes to hypertension through vasoconstriction and arterial damage. Exercise intervention is more impactful for cardiovascular health and blood pressure management in this context.

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The nurse is assessing a newly admitted client diagnosed with left ventricular failure.Which of the following findings should the nurse expect during the assessment?

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The nurse is assessing a newly admitted client diagnosed with left ventricular failure.
Which of the following findings should the nurse expect during the assessment?