A nurse is collecting data from a client who has right-sided heart failure. Which of the following findings should the nurse expect?
Orthopnea
Peripheral edema
Frothy sputum
Dyspnea
The Correct Answer is B
a. Orthopnea: Orthopnea is more commonly associated with left-sided heart failure, where fluid backs up into the lungs, making it difficult to breathe when lying down.
b. Peripheral edema: Right-sided heart failure can lead to systemic venous congestion, resulting in peripheral edema, often evident in the lower extremities.
c. Frothy sputum: Frothy sputum is more indicative of pulmonary edema, which is associated with left-sided heart failure.
d. Dyspnea: While dyspnea can occur with right-sided heart failure, it is more characteristic of left-sided heart failure.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
a. Battle's sign: Battle's sign is bruising over the mastoid process and is not a direct manifestation of increased intracranial pressure.
b. Nuchal rigidity: Nuchal rigidity (stiff neck) is associated with irritation of the meninges and is not a specific sign of increased intracranial pressure.
c. Lethargy: Lethargy or altered level of consciousness is a common manifestation of increased intracranial pressure. It can range from mild drowsiness to severe impairment of consciousness.
d. Polyuria: Polyuria is not a typical manifestation of increased intracranial pressure. Increased urine output may be associated with other conditions, such as diabetes or diuretic use.
Correct Answer is D
Explanation
a. Eating dinner early in the evening: Eating dinner early can actually be a positive factor in preventing heartburn by allowing more time for digestion before lying down.
b. Sleeping on a large wedge-style pillow: Elevating the upper body can help prevent acid reflux, so sleeping on a wedge-style pillow may be a helpful strategy.
c. Consuming low-fat meats: Low-fat meats are less likely to contribute to heartburn compared to high-fat meats.
d. Drinking orange juice regularly: Orange juice is acidic and can contribute to heartburn,
especially if consumed regularly. The acid content can irritate the esophagus and worsen GERD symptoms.
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