The nurse is monitoring the results of laboratory tests for a client suspected of having heart failure.
Which of the following tests would provide key diagnostic information for the nurse?

Choice A rationale

Lower extremity edema is often associated with right-sided heart failure rather than left ventricular failure. Right-sided failure leads to systemic venous congestion, causing fluid accumulation in peripheral tissues like the legs. Left ventricular failure predominantly affects pulmonary circulation, making edema of the lower extremities a less expected finding.

Choice B rationale

Pulmonary crackles are a hallmark finding in left ventricular failure due to fluid accumulation in the alveoli. This occurs because reduced cardiac output causes blood to back up into pulmonary veins and capillaries, increasing hydrostatic pressure and leading to pulmonary congestion. Crackles indicate the presence of interstitial or alveolar fluid, a direct result of left-sided dysfunction.

Choice C rationale

Ascites results from portal hypertension and systemic venous congestion, typically seen in right-sided heart failure or advanced liver disease. Left ventricular failure impacts the pulmonary system rather than the abdominal cavity, making ascites an unlikely finding during assessment for this condition.

Choice D rationale

Jugular vein distention is indicative of systemic venous congestion caused by right-sided heart failure. In left ventricular failure, pulmonary congestion dominates, and jugular vein distention is not a primary finding. Assessments should focus on symptoms directly linked to pulmonary effects such as crackles or dyspnea.

Choice A rationale

Magnesium levels and bilateral lower extremity ultrasounds are not specific for assessing target organ damage in hypertension. While magnesium may influence cardiovascular health, it is not a primary indicator of organ damage. Ultrasounds evaluate arterial or venous abnormalities, not hypertension’s systemic effects.

Choice B rationale

Urinalysis, blood chemistry, and a 12-lead electrocardiogram assess renal, metabolic, and cardiac effects of hypertension. Proteinuria in urinalysis indicates kidney damage. Electrolyte imbalances or creatinine elevations suggest renal impairment. An ECG reveals left ventricular hypertrophy or ischemia. These tests comprehensively evaluate hypertension-related complications.

Choice C rationale

A complete blood count evaluates blood cell counts but does not directly assess target organ damage from hypertension. An electroencephalogram assesses brain activity, not hypertension-induced injury. These tests are inappropriate for this diagnostic goal.

Choice D rationale

Troponin, calcium, and partial thromboplastin time evaluate myocardial infarction, bone health, and coagulation, respectively. They do not provide information about hypertension’s systemic organ effects. Accurate test selection ensures appropriate diagnostic focus.