ATI TEAS (Test of Essential Academic Skills) Version 7ReadingHard
A nurse is reviewing a patient's electronic health record (EHR) and sees a physician's note stating: 'Patient presents with acute onset dyspnea on exertion and orthopnea. Chest X-ray shows bilateral pulmonary infiltrates. Prescribed furosemide 40mg PO daily.' The nurse infers the patient is likely experiencing which of the following conditions?
- ACongestive Heart Failure (CHF).
- BPneumonia.
- CPulmonary embolism.
- DAsthma exacerbation.
Show answer & explanationAnswer & explanation
Correct answer: A. Congestive Heart Failure (CHF).
Dyspnea on exertion (shortness of breath with activity), orthopnea (shortness of breath when lying flat), and bilateral pulmonary infiltrates (fluid in the lungs) are classic signs of fluid overload often seen in Congestive Heart Failure. Furosemide (a diuretic) is prescribed to remove excess fluid, further supporting this inference.
Why the other options are wrong
- B. Pneumonia often presents with infiltrates, but usually unilateral or focal, and less typically with prominent orthopnea. While possible, other symptoms point more strongly to CHF.
- C. Pulmonary embolism typically presents with sudden dyspnea and pleuritic chest pain, and X-ray findings are often normal or show atelectasis, not bilateral infiltrates.
- D. Asthma typically presents with wheezing and bronchospasm, not usually orthopnea or bilateral infiltrates.
Clinical Indicators for CHF
Key clinical indicators for Congestive Heart Failure include dyspnea on exertion, orthopnea, bilateral pulmonary infiltrates (pulmonary edema), and response to diuretics.
- Dyspnea on exertion and orthopnea are common symptoms.
- Bilateral pulmonary infiltrates suggest fluid in the lungs.
- Diuretics like furosemide are standard treatment to reduce fluid overload.
Memory trick: Symptoms, X-ray, and meds form a diagnostic triangle.