A client with a history of hypertension and diabetes mellitus presents to the clinic with complaints of fatigue, difficulty breathing, and frequent urination at night. Which risk factor is most likely contributing to the client's symptoms?

Hypertension

Diabetes mellitus

Smoking history

Family history of heart disease

Answer and Explanation

The Correct Answer is A

A) This choice is correct. Hypertension (high blood pressure) is a significant risk factor for congestive heart failure (CHF). Prolonged hypertension can lead to the heart's increased workload, causing it to weaken over time and eventually leading to CHF. The client's symptoms of fatigue, difficulty breathing, and nocturia (frequent urination at night) are common manifestations of CHF resulting from uncontrolled hypertension.

B) This choice is incorrect because diabetes mellitus, while a risk factor for cardiovascular disease, is not directly associated with the symptoms described by the client. However, diabetes can exacerbate CHF if the client's blood glucose levels are not well-controlled.

C) This choice is incorrect because smoking history is a risk factor for various cardiovascular diseases, but it is not specifically linked to the symptoms reported by the client in this case.

D) This choice is incorrect because a family history of heart disease may increase the client's risk of developing CHF, but it does not directly contribute to the current symptoms the client is experiencing.

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Correct Answer is A

Explanation

A) This choice is correct. ACE inhibitors are used to lower blood pressure and reduce the workload on the heart. The client should monitor their blood pressure regularly and report any significant changes to their healthcare provider. Adjustments to the medication dosage should only be made under the guidance of the healthcare provider.

B) This choice is incorrect because while ACE inhibitors can increase potassium levels, avoiding foods high in potassium is not necessary unless specifically directed by the healthcare provider. The client should follow a balanced diet and inform the healthcare provider of any changes in their dietary habits.

C) This choice is incorrect because ACE inhibitors should not be taken with grapefruit juice. Grapefruit juice can interfere with the metabolism of the medication, leading to increased levels and potential side effects.

D) This choice is incorrect because limiting fluid intake is not specific to the administration of ACE inhibitors. Fluid intake may need to be adjusted based on the client's overall fluid balance and congestive heart failure status, but it is not a direct instruction related to the medication.

A. Orthopnea B. Paroxysmal nocturnal dyspnea C. Peripheral edema D. Tachypnea

Correct Answer is B

Explanation

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.

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A client with a history of hypertension and diabetes mellitus presents to the clinic with complaints of fatigue, difficulty breathing, and frequent urination at night. Which risk factor is most likely contributing to the client's symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a client with congestive heart failure who is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should instruct the client to:

Correct Answer is A

Explanation

A client with congestive heart failure reports waking up at night with sudden breathlessness and feeling the need to sit upright to breathe comfortably. The nurse should document this symptom as:

Correct Answer is B

Explanation

A nurse is providing discharge teaching to a client diagnosed with congestive heart failure. Which instruction is essential for the client to prevent exacerbation of symptoms?

A client with suspected congestive heart failure undergoes an echocardiogram. The nurse should expect which parameter to be measured during the echocardiogram to assess the client's heart function?

A client with congestive heart failure presents with a dry, persistent cough. The nurse should recognize this symptom as:

A nurse is caring for a client with congestive heart failure who is prescribed a beta-blocker. The nurse should instruct the client to:

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 client with congestive heart failure is prescribed digoxin. The nurse should monitor the client for which common side effect of this medication?

A client with congestive heart failure is prescribed a daily dose of furosemide. The nurse should monitor the client for which potential adverse effect of this medication?

A client with congestive heart failure presents with swollen ankles, legs, and abdomen. The nurse should document these findings as: