The nurse would determine that which of the following clients has ...

[tsand2]

The nurse would determine that which of the following clients has the greatest risk of developing heart failure?
 
  1. A 50-year-old African American female who smokes
   2. A 69-year-old African American male with hypertension
   3. A 75-year-old Caucasian male who is overweight
   4. A 52-year-old Caucasian female with asthma

Question 2

During hospitalization for congestive heart failure, a client awakens during the night frightened and short of breath. This client most likely is experiencing:
 
  1. Multisystem heart failure.
   2. Cardiomyopathy.
   3. Paroxysmal nocturnal dyspnea.
   4. High-output failure.

[pikon]

Answer to Question 1

2. A 69-year-old African American male with hypertension

Rationale:
Age, race, and hypertension lead to an increased risk for developing heart failure. Race and smoking are risk factors, but being female and younger decreases the overall risk. Age and obesity are risk factors, but not as much as age, being African American, and having hypertension. Asthma is not considered a significant risk factor in the development of heart failure.

Answer to Question 2

3. Paroxysmal noctural dyspnea.

Rationale:
Paroxysmal nocturnal dyspnea occurs when edema fluid that has accumulated during the day is reabsorbed into the circulation at night. This causes fluid overload and pulmonary congestion. The client awakens at night short of breath and frightened. The client is not experiencing multisystem heart failure, cardiomyopathy, or high-output failure.