A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Hacking cough

Abdominal distension

Dependent edema

Jugular venous distention

Answer and Explanation

The Correct Answer is A

A. Hacking cough: This is the correct answer. Left-sided heart failure can lead to pulmonary congestion, resulting in a cough that is often described as "hacking" or "persistent." This cough may be worse at night when the client is lying down.

B. Abdominal distension: Abdominal distension is more commonly associated with right-sided heart failure, as fluid accumulates in the abdomen (ascites). In left-sided heart failure, fluid accumulates in the lungs, leading to pulmonary symptoms.

C. Dependent edema: Dependent edema is also more commonly associated with right-sided heart failure. In left-sided heart failure, fluid tends to accumulate in the lungs, causing pulmonary congestion and related symptoms.

D. Jugular venous distention: Jugular venous distention is often seen in right-sided heart failure due to impaired blood flow from the right atrium into the right ventricle. This finding is less likely to be prominent in left-sided heart failure.

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Correct Answer is B

Explanation

A. Providing immediate rest for the client: Rest is important, but in the context of an acute asthma exacerbation, addressing the underlying respiratory distress is the priority.

B. Administering a nebulized beta-adrenergic agonist: This is the correct answer. Beta-adrenergic agonists, such as albuterol, are bronchodilators that help relieve bronchoconstriction and improve airflow. Administering a nebulized beta-adrenergic agonist is a key intervention during an acute asthma exacerbation to alleviate symptoms and improve respiratory function.

C. Positioning the client in high-Fowler's: While positioning can assist with respiratory effort, administering a bronchodilator is a more direct and immediate intervention to relieve airway obstruction.

D. Initiating oxygen therapy: While oxygen therapy may be necessary, addressing bronchoconstriction with a beta-adrenergic agonist is the primary intervention during an acute asthma exacerbation.

A. Cellular hypoxia B. Prolonged bleeding C. Impaired immunity D. Fluid retention

Correct Answer is A

Explanation

A. Cellular hypoxia: Hemoglobin carries oxygen to the body's tissues. A low hemoglobin level, as well as a low hematocrit, indicates a reduced oxygen-carrying capacity of the blood, putting the client at risk for cellular hypoxia. Symptoms may include fatigue, weakness, and shortness of breath.

B. Prolonged bleeding: Hemoglobin and hematocrit levels are not directly indicative of a risk of prolonged bleeding. Prolonged bleeding is more related to platelet function and clotting factors.

C. Impaired immunity: Hemoglobin and hematocrit levels are not directly indicative of impaired immunity. Immune function is more closely associated with white blood cell count and function.

D. Fluid retention: Hemoglobin and hematocrit levels are not directly associated with fluid retention. Fluid retention is more related to factors such as sodium balance and kidney function.

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A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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