The nurse is caring for a client who is in the later stages of left-sided heart failure. Which chief complaint would the nurse expect the client to report?

Marked limitation with physical activity but comfortable at rest

Angioedema and urticaria

Increased urine output

Chest pain during sleep that is relieved with nitroglycerin

Answer and Explanation

The Correct Answer is A

A.   Clients with left-sided heart failure often experience symptoms like shortness of breath, fatigue, and fluid retention, which limit physical activity. However, they may still feel relatively comfortable when resting.
B.   These symptoms are more commonly associated with allergic reactions or side effects of medications (such as ACE inhibitors) rather than heart failure.
C.   This is not typical in the later stages of left-sided heart failure. In fact, clients may experience reduced urine output due to poor kidney perfusion.
D.   Chest pain can occur due to ischemia, but this is not a hallmark symptom of left-sided heart failure, which is more characterized by dyspnea and fatigue.

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Correct Answer is A

Explanation

A. Dopamine at low doses primarily increases renal perfusion, which can lead to improved urine output. An increase in urine output is a key indicator that the medication is effectively improving kidney function and blood flow. This is the most direct way to assess its effectiveness.
B. A decrease in blood pressure is not an expected effect of low-dose dopamine, which should actually help improve perfusion and raise blood pressure.
C. An increase in heart rate is more likely with higher doses of dopamine and is not an optimal indicator of the drug's effectiveness for acute heart failure.
D. Client alertness is important but does not directly reflect the primary effects of dopamine on renal perfusion and cardiac output in acute heart failure.

A. 119 seconds B. 98 seconds C. 37 seconds D. 69 seconds

Correct Answer is D

Explanation

A. A value of 119 seconds would indicate a therapeutic or even elevated level of heparin, as it is much higher than the normal aPTT range.
B. A value of 98 seconds is still above the normal aPTT range, suggesting that the heparin level is therapeutic, or even too high, but not sub-therapeutic.
C. This is just slightly above the normal range and might be considered a therapeutic range for someone
on heparin, but it’s not sub-therapeutic.
D. This aPTT value is above the normal range but likely not high enough to indicate therapeutic heparin levels, which should typically be between 1.5 to 2.5 times the normal aPTT. A sub-therapeutic level could be indicated with a lower value.

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The nurse is caring for a client who is in the later stages of left-sided heart failure. Which chief complaint would the nurse expect the client to report?

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Naxlex Comprehensive Predictor Exams

The client diagnosed with acute heart failure is prescribed an infusion of dopamine at a low dose. Which assessment parameter should the nurse use to best evaluate the effectiveness of this medication?

Correct Answer is A

Explanation

The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

Correct Answer is D

Explanation

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