HESI Registered Nurse EXIT Practice Exam

Which symptom in a client with heart failure indicates worsening of their condition?

1. Increased fatigue

2. Swelling of the ankles

3. Difficulty sleeping at night

4. Rapid weight gain

The correct answer is: Rapid weight gain

Rapid weight gain in a client with heart failure serves as a significant indicator of worsening condition due to fluid retention, which is commonly seen as heart failure progresses. In heart failure, the heart's ability to pump blood effectively is compromised, leading to congestion and fluid buildup in tissues and cavities of the body. When patients experience an increase in weight, typically by more than 2-3 pounds in one day or 5 pounds in a week, it often signifies that they are retaining excess fluid, which could point to worsening heart function or decompensation. In contrast, increased fatigue can be a common symptom related to heart failure but may not be an immediate indicator of a decline in cardiac function. While swelling of the ankles can also indicate fluid retention, it is a less definitive measure than weight gain since it can fluctuate and be influenced by several factors. Difficulty sleeping at night is commonly experienced in heart failure but is often related to other issues such as pulmonary congestion or anxiety, rather than being a direct and acute indicator of deterioration. Therefore, rapid weight gain is a critical symptom that healthcare providers monitor closely in managing patients with heart failure, as it can necessitate prompt medical intervention to prevent further complications.