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 a complete blood count (CBC) is a general blood test that measures different components of the blood, such as red blood cells, white blood cells, and platelets. It is not specifically used to measure heart strain or diagnose CHF.

B) This choice is incorrect because a basic metabolic panel (BMP) is a blood test that measures electrolytes, kidney function, and glucose levels. It is not specific to diagnosing CHF.

C) This choice is correct. A brain natriuretic peptide (BNP) level is a blood test specifically used to measure heart strain. Elevated BNP levels can indicate heart failure, making it a valuable diagnostic tool in assessing suspected CHF.

D) This choice is incorrect because a C-reactive protein (CRP) level is a marker of inflammation and is not specific to diagnosing CHF.

A. Alcohol abuse B. Malnutrition C. Sedentary lifestyle D. Occupational exposure to toxins

Correct Answer is A

Explanation

A) This choice is correct. Alcohol abuse can lead to dilated cardiomyopathy, a condition in which the heart becomes enlarged and weakened, contributing to congestive heart failure. Chronic alcohol consumption can cause toxic effects on the heart muscle, leading to impaired pumping function.

B) This choice is incorrect because malnutrition, while it can impact overall health, is not a direct precipitating cause of congestive heart failure. However, malnutrition can exacerbate heart failure symptoms and weaken the heart further.

C) This choice is incorrect because a sedentary lifestyle can be a risk factor for heart disease, including congestive heart failure, but it is not a direct precipitating cause of the client's condition in this scenario.

D) This choice is incorrect because occupational exposure to toxins can have health implications, but it is not directly related to the client's signs and symptoms of congestive heart failure in this case.

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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

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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