The nurse is assessing a client with decompensated heart failure. Which finding would indicate that the client is manifesting right-sided heart failure?

Decreased peripheral pulses

S3 heart murmur

Distended neck veins

Orthopnea

Answer and Explanation

The Correct Answer is C

A. Decreased peripheral pulses. Decreased pulses may be related to poor perfusion but are not a hallmark sign of right-sided heart failure.

B. S3 heart murmur. An S3 heart murmur is associated with left-sided heart failure due to fluid overload in the lungs.

C. Distended neck veins: Right-sided heart failure leads to the backup of blood in the systemic circulation, which often causes jugular vein distention (JVD), peripheral edema, and hepatomegaly.

D. Orthopnea. Orthopnea is a symptom of left-sided heart failure, where fluid builds up in the lungs, making it difficult to breathe when lying flat.

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Correct Answer is D

Explanation

A. Removing the cast correctly at the end of the treatment period. The nurse would not instruct the patient to remove the cast. This should be done by a healthcare provider at the appropriate time.

B. Using crutches efficiently. While crutch use is important, it is secondary to monitoring for impaired circulation, which can have immediate, serious consequences.

C. Exercising joints above and below the cast, as prescribed. This may be part of rehabilitation but does not have the same urgency as monitoring circulation for complications.

D. Reporting signs of impaired circulation. The nurse should emphasize the importance of monitoring for signs of impaired circulation, such as increased pain, numbness, or color changes, which could indicate complications like compartment syndrome or poor blood flow.

A. Urine glucose, high B. Urine specific gravity, 1.001 C. Urine output, 50 ml/hr D. Urine protein, high

Correct Answer is B

Explanation

A. Urine glucose, high: High urine glucose would suggest hyperglycemia, typically seen in diabetes mellitus, not diabetes insipidus.

B. Urine specific gravity, 1.001: Diabetes insipidus results in excessive urine output with a low specific gravity (dilute urine), reflecting the inability to concentrate urine.

C. Urine output, 50 ml/hr: This is a relatively low urine output, which does not indicate diabetes insipidus. Diabetes insipidus is characterized by very high urine output, often greater than 3 liters per day.

D. Urine protein, high: High urine protein could suggest kidney disease or glomerular injury, not diabetes insipidus.

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The nurse is assessing a client with decompensated heart failure. Which finding would indicate that the client is manifesting right-sided heart failure?

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