The nurse is reviewing the patient’s recent symptoms and lab results. Which of the following symptoms or findings suggest worsening heart failure? (Select all that apply)
Oxygen saturation of 92% on room air
Bilateral pulmonary congestion on chest x-ray
Recent 5-lb weight gain
BUN of 28 mg/dL
Potassium of 4.9 mEq/L
Correct Answer : B,C
Choice A reason: Oxygen saturation of 92% is low-normal (95-100%), not specific to worsening heart failure acutely. It may reflect chronic lung issues or mild hypoxia, but alone, it’s not a definitive sign of decompensation.
Choice B reason: Bilateral pulmonary congestion on x-ray shows fluid in alveoli from left heart failure, impairing gas exchange. It’s a classic sign of worsening, as rising pressure backs fluid into lungs, causing dyspnea.
Choice C reason: A 5-lb weight gain over days indicates fluid retention, a hallmark of worsening heart failure. It reflects sodium and water buildup from reduced cardiac output, directly correlating with symptom exacerbation.
Choice D reason: BUN of 28 mg/dL (normal 7-20 mg/dL) suggests mild renal stress, possibly from diuretics. It’s not specific to worsening heart failure without symptoms like dyspnea, as it may reflect dehydration instead.
Choice E reason: Potassium of 4.9 mEq/L is normal (3.5-5.0 mEq/L), not indicating worsening heart failure. It may rise with ACE inhibitors, but this value alone doesn’t signal acute decompensation or symptom progression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Streptomycin treats TB, but persistent AFB after 2 months suggests resistance or non-adherence. Requesting it now skips assessing compliance, which is critical first, as adding drugs prematurely may worsen resistance.
Choice B reason: Injectable antibiotics (e.g., amikacin) address resistant TB, but without confirming adherence, this is premature. Non-compliance is common; discussing this assumes resistance without evidence, delaying root cause investigation.
Choice C reason: Teaching about drug-resistant TB is relevant if resistance is confirmed, not assumed. Positive AFB may reflect non-adherence, so education is secondary to verifying medication use, which drives next steps.
Choice D reason: Asking about adherence checks if the patient took drugs as directed, a common reason for persistent AFB. Non-compliance delays sputum conversion, making this the first action to guide further treatment decisions.
Correct Answer is ["B","C"]
Explanation
Choice A reason: Oxygen saturation of 92% is low-normal (95-100%), not specific to worsening heart failure acutely. It may reflect chronic lung issues or mild hypoxia, but alone, it’s not a definitive sign of decompensation.
Choice B reason: Bilateral pulmonary congestion on x-ray shows fluid in alveoli from left heart failure, impairing gas exchange. It’s a classic sign of worsening, as rising pressure backs fluid into lungs, causing dyspnea.
Choice C reason: A 5-lb weight gain over days indicates fluid retention, a hallmark of worsening heart failure. It reflects sodium and water buildup from reduced cardiac output, directly correlating with symptom exacerbation.
Choice D reason: BUN of 28 mg/dL (normal 7-20 mg/dL) suggests mild renal stress, possibly from diuretics. It’s not specific to worsening heart failure without symptoms like dyspnea, as it may reflect dehydration instead.
Choice E reason: Potassium of 4.9 mEq/L is normal (3.5-5.0 mEq/L), not indicating worsening heart failure. It may rise with ACE inhibitors, but this value alone doesn’t signal acute decompensation or symptom progression.
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