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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
a. Neck vein distention: Neck vein distention may indicate fluid overload, but it is not a direct measure of fluid losses.
b. Body weight: Monitoring body weight before and after hemodialysis provides a direct
measure of fluid losses. Hemodialysis removes excess fluid, and changes in body weight reflect fluid balance.
c. Abdominal girth: Abdominal girth may be affected by fluid accumulation but is not a direct measure of fluid losses during hemodialysis.
d. Blood pressure: While blood pressure may be influenced by fluid status, it is not a specific measure of fluid losses during hemodialysis. Body weight is a more direct indicator of fluid removal.
Correct Answer is B
Explanation
a. "Both illnesses begin in the rectum." This statement is not accurate. Ulcerative colitis typically begins in the rectum and progresses proximally, while Crohn's disease can involve any part of the digestive tract.
b. "Both illnesses are inflammatory in nature." This is the correct statement. Both ulcerative colitis and Crohn's disease are inflammatory bowel diseases characterized by chronic
inflammation of the gastrointestinal tract.
c. "Both illnesses manifest fistula formation." Fistula formation is more commonly associated with Crohn's disease, not ulcerative colitis.
d. "Both illnesses result in malabsorption of nutrients." While malabsorption can occur in both conditions, it is generally more associated with Crohn's disease than ulcerative colitis.
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