The nurse is teaching a client with heart failure how to avoid complications and future hospitalizations. Which of the following statements by the client requires additional teaching?

I will weigh myself daily and notify the healthcare provider if I gain 3 pounds in one day.

I will notify the healthcare provider if I am becoming increasingly short of breath at rest.

I will include lower sodium intake in my daily diet.

I understand that I may need to sleep sitting up in a reclining chair.

Answer and Explanation

The Correct Answer is D

Choice A reason: Daily weight monitoring and reporting a 3-pound gain in one day indicates fluid retention, a sign of worsening heart failure. This is correct and shows understanding of self-monitoring to prevent complications, requiring no further teaching.

Choice B reason: Notifying the provider about increasing shortness of breath at rest is appropriate, as it signals worsening heart failure due to reduced cardiac output or pulmonary edema. This reflects proper understanding of symptom monitoring, requiring no additional teaching.

Choice C reason: A low-sodium diet reduces fluid retention in heart failure by decreasing sodium-induced water retention, preventing worsening of edema or congestion. This statement is correct and demonstrates understanding of dietary management, requiring no further teaching.

Choice D reason: Sleeping in a reclining chair may occur in severe heart failure due to orthopnea, but it is not a standard recommendation. It suggests poor symptom control, requiring further teaching on optimizing medical management, such as medication adherence and fluid monitoring, to prevent this need.

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Correct Answer is B

Explanation

Choice A reason: Giving half the dose of metoprolol is inappropriate without a medical order, as it may reduce therapeutic efficacy. The client’s vital signs (BP 132/78, HR 86) are stable, indicating no need to alter the prescribed dose, which is intended to manage hypertension and heart failure.

Choice B reason: Metoprolol, a beta-blocker, reduces heart rate and blood pressure in hypertension and heart failure. The client’s vital signs (BP 132/78, HR 86) are within acceptable ranges, indicating the full 25 mg dose is safe and appropriate to maintain therapeutic control of their condition.

Choice C reason: Delaying the dose until the pulse is below 60 is unnecessary, as the client’s heart rate of 86 is not bradycardic. Metoprolol is indicated for heart rates above 60 in heart failure and hypertension, and withholding it could worsen blood pressure control.

Choice D reason: Omitting the dose due to a pulse of 86 is inappropriate, as this heart rate is not dangerously low. Metoprolol is prescribed to manage hypertension and heart failure, and withholding it without clinical justification could lead to uncontrolled symptoms or disease progression.

A. Start your exercise program with high-impact activities B. Keep exercising but slow down if you get dizzy or short of breath C. Do not exercise unsupervised D. Eventually aim to work up to 30 minutes of exercise each day

Correct Answer is B

Explanation

Choice A reason: High-impact activities, such as running, increase cardiac demand and oxygen consumption, which can exacerbate heart failure symptoms due to reduced cardiac reserve. These activities are contraindicated, as they may lead to decompensation, worsening dyspnea, or fatigue in clients with heart failure.

Choice B reason: In heart failure, exercise improves cardiovascular fitness but must be moderated to avoid over PLEASE ASSIST WITH FORMATTING overexertion. Slowing down if dizzy or short of breath prevents decompensation by reducing cardiac strain, ensuring safety while promoting gradual physical activity.

Choice C reason: Unsupervised exercise is not universally contraindicated in heart failure, as tailored exercise programs can be safe with medical clearance. Requiring constant supervision is overly restrictive and may discourage beneficial physical activity, which is important for improving heart failure outcomes with proper guidance.

Choice D reason: Aiming for 30 minutes of daily exercise is a long-term goal for heart failure clients but may be unrealistic initially due to limited exercise tolerance. Gradual progression under medical supervision is needed, as immediate high-duration exercise could lead to overexertion and worsening symptoms.

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The nurse is teaching a client with heart failure how to avoid complications and future hospitalizations. Which of the following statements by the client requires additional teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer metoprolol 25 mg PO to a client with a history of hypertension and heart failure. The client’s vital signs are: BP 132/78 mm Hg, HR 86 beats per minute, and respiratory rate 18 breaths per minute. Which action should the nurse take?

Correct Answer is B

Explanation

The nurse is addressing exercise and physical activity during discharge education with a client diagnosed with heart failure. What should the nurse teach this client about exercise?

Correct Answer is B

Explanation

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