A nurse cares for a client with right-sided heart failure. The client asks, Why do I need to weigh myself every day? How should the nurse respond?
a. Weight is the best indication that you are gaining or losing fluid.
b. Daily weights will help us make sure that you're eating properly.
c. The hospital requires that all inpatients be weighed daily.
d. You need to lose weight to decrease the incidence of heart failure.
Question 2While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?
a. Assess for symptoms of left-sided heart failure.
b. Document this as a normal finding.
c. Call the health care provider immediately.
d. Transfer the client to the intensive care unit.
Question 3A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?
a. I sleep with four pillows at night.
b. My shoes fit really tight lately.
c. I wake up coughing every night.
d. I have trouble catching my breath.
Question 4A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?
a. I have been drinking more water than usual.
b. I am awakened by the need to urinate at night.
c. I must stop halfway up the stairs to catch my breath.
d. I have experienced blurred vision on several occasions.
Question 5A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident
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