Cardiac-Vascular Nursing (CVRN) Practice Exam

Which symptom warrants immediate concern in a patient with a history of severe heart failure?

1. Shortness of breath while lying flat

2. Intermittent chest pain

3. Occasional dizziness

4. Daily fatigue

The correct answer is: Shortness of breath while lying flat

Shortness of breath while lying flat, known as orthopnea, is a significant symptom that warrants immediate concern in a patient with a history of severe heart failure. This symptom indicates that the patient's heart is struggling to maintain adequate circulation and oxygenation while in a supine position. In heart failure, fluid redistribution when lying down can exacerbate pulmonary congestion, leading to worsening shortness of breath. This symptom raises alarm for potential deterioration in heart function and may signal an acute exacerbation of heart failure, requiring prompt medical assessment and intervention. While intermittent chest pain, occasional dizziness, and daily fatigue can also be concerning, they do not directly indicate acute worsening of heart function as clearly as orthopnea does. Occasional symptoms may not necessitate immediate action or indicate a significant destabilization in heart failure, whereas the immediate risk associated with orthopnea can escalate quickly, highlighting why it is critical to address this symptom promptly.