A nurse is caring for a client with congestive heart failure (CHF). Which of the following symptoms would indicate worsening of the condition?
The client reports increased shortness of breath.
The client has a temperature of 37°C (98.6°F).
The client has a blood pressure of 120/80 mmHg.
The client reports occasional dizziness.
The Correct Answer is A
Choice A rationale
Increased shortness of breath is a key symptom of worsening congestive heart failure (CHF). It indicates that the heart is not effectively pumping blood, leading to fluid buildup in the lungs and increased respiratory effort.
Choice B rationale
A temperature of 37°C (98.6°F) is within the normal range and does not indicate worsening CHF. Monitoring the patient’s temperature is important, but it is not a sign of CHF exacerbation.
Choice C rationale
A blood pressure of 120/80 mmHg is within the normal range and does not indicate worsening CHF. Blood pressure should be monitored, but this reading does not suggest an acute issue.
Choice D rationale
Occasional dizziness can be a symptom of many conditions, including CHF, but it is not as specific or critical as increased shortness of breath. It should be monitored, but it does not indicate an immediate worsening of CHF.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Cerebral edema is the swelling of the brain due to fluid accumulation, which can occur after excessive alcohol consumption. However, it is not related to myxedema, which is a condition associated with severe hypothyroidism.
Choice B rationale
The deposit of fatty tissue is associated with conditions like hyperaldosteronism, where there is an excess production of aldosterone. This condition does not cause the characteristic skin changes seen in myxedema.
Choice C rationale
Proliferation of tissue behind the eyes, known as exophthalmos, is common in hyperthyroidism, particularly in Graves’ disease. Myxedema, on the other hand, is related to severe hypothyroidism and involves different pathophysiological mechanisms.
Choice D rationale
Myxedema is characterized by the accumulation of mucopolysaccharides in the skin and other tissues, leading to swelling and thickening of the skin. This condition is a result of severe hypothyroidism and can lead to a myxedema crisis if left untreated.
Correct Answer is A
Explanation
Choice A rationale
Cerebral ischemia due to an embolus that originates in the left atrium is a common complication of chronic atrial fibrillation (AFib). AFib causes irregular and chaotic electrical signals in the atria, leading to poor blood flow and the formation of blood clots. These clots can travel to the brain, causing a stroke. This is the most acute and severe event associated with chronic AFib.
Choice B rationale
Development of ventricular fibrillation is a life-threatening arrhythmia that can occur in patients with severe heart disease, but it is not a common acute event in chronic AFib.
Ventricular fibrillation involves the ventricles and is characterized by rapid, erratic electrical impulses, leading to ineffective heart contractions and sudden cardiac arrest.
Choice C rationale
Ischemia of the cerebellum due to a ruptured intracranial aneurysm is not directly related to chronic AFib. While AFib increases the risk of stroke, it does not specifically cause aneurysms or cerebellar ischemia. Aneurysms are typically related to other risk factors such as hypertension and vascular abnormalities.
Choice D rationale
Prolonged capillary refill secondary to a complete lack of cardiac output is a sign of severe cardiac dysfunction or shock. While AFib can lead to heart failure and reduced cardiac output, it does not typically cause a complete lack of cardiac output. The most acute event related to AFib is the formation of emboli and subsequent stroke.
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