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:

Orthopnea

Paroxysmal nocturnal dyspnea

Peripheral edema

Tachypnea

Answer and Explanation

The Correct Answer is B

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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Correct Answer is C

Explanation

A) This choice is incorrect because ascites (abdominal swelling due to fluid accumulation) is a sign of right-sided heart failure, not left-sided heart failure.

B) This choice is incorrect because dependent edema (swelling in the legs and ankles) is also a sign of right-sided heart failure, not left-sided heart failure.

C) This choice is correct. Crackles in the lungs, also known as rales, are the classic hallmark of left-sided heart failure. They occur when fluid accumulates in the lungs, leading to abnormal lung sounds on auscultation.

D) This choice is incorrect because jugular vein distention is associated with right-sided heart failure, not left-sided heart failure.

A. Avoid abrupt discontinuation of the medication. B. Take the medication with a high-fat meal. C. Limit fluid intake to prevent fluid overload. D. Take the medication in the evening to promote sleep.

Correct Answer is A

Explanation

A) This choice is correct. Beta-blockers should not be abruptly discontinued, as sudden discontinuation can lead to rebound effects and worsen the client's condition. Gradual tapering of the medication is necessary under the guidance of the healthcare provider.

B) This choice is incorrect because taking a beta-blocker with a high-fat meal is not necessary. Beta-blockers can be taken with or without food, but consistent administration is essential for optimal therapeutic effects.

C) This choice is incorrect because limiting fluid intake is not specific to the administration of beta-blockers. 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.

D) This choice is incorrect because the timing of beta-blocker administration varies depending on the specific beta-blocker prescribed and the client's individual response. Some beta-blockers may be taken in the morning, while others may be taken in the evening. The client should follow the prescribed schedule given by the healthcare provider.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client with suspected congestive heart failure. Which symptom is the classic hallmark of left-sided heart failure?

Correct Answer is C

Explanation

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

Correct Answer is A

Explanation

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