While completing the cardiovascular system health history, a client reports difficulty falling asleep unless she is in an upright position. Which of the following potential problems should the nurse further investigate?

Chest pain

Orthopnea

Edema

Palpitations

Answer and Explanation

The Correct Answer is B

A. Chest pain: This symptom is important but does not specifically correlate with difficulty sleeping unless upright.

B. Orthopnea: Difficulty breathing while lying flat (orthopnea) is typically associated with heart failure and would require further investigation to understand its impact on the client's sleep.

C. Edema: While edema can be a sign of cardiovascular problems, it does not directly explain the difficulty in sleeping unless in an upright position.

D. Palpitations: Palpitations might affect sleep but are less directly linked to the need to sleep upright compared to orthopnea.

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Correct Answer is A

Explanation

A. Increased jugular venous pressure: Right-sided heart failure often leads to increased jugular venous pressure due to the backup of blood in the systemic venous system.

B. Decreased right-sided volume: Right-sided heart failure typically results in increased blood volume in the right heart chambers, not decreased.

C. Decreased stroke volume: While right-sided heart failure can affect stroke volume, increased jugular venous pressure is a more direct indicator of right-sided heart failure.

D. Decreased central venous pressure: Right-sided heart failure usually results in increased, not decreased, central venous pressure.

A. Dependent edema B. Stasis ulceration C. Arterial occlusion D. Venous insufficiency

Correct Answer is D

Explanation

A. Dependent edema is characterized by swelling in the lower extremities due to gravity and may not always present with pigmentation changes.

B. Stasis ulceration involves ulcerative lesions typically occurring on the lower legs, often associated with venous insufficiency, but the pigmentation alone does not confirm ulceration.

C. Arterial occlusion typically presents with symptoms such as pain, pallor, and decreased pulses, not necessarily with warm skin and brown pigmentation.

D. Venous insufficiency is characterized by symptoms such as warm skin, brown pigmentation around the ankles (due to hemosiderin deposition from blood pooling), and swelling.

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While completing the cardiovascular system health history, a client reports difficulty falling asleep unless she is in an upright position. Which of the following potential problems should the nurse further investigate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

On examination, the nurse would expect what finding if a client is in right-sided heart failure?

Correct Answer is A

Explanation

The nurse refers an older adult client for further evaluation after the nurse assesses warm skin and brown pigmentation around the ankles. The nurse suspects which of the following?

Correct Answer is D

Explanation

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