Clinical Nurse Leader Practice Exam

Which symptom is primarily associated with right-sided heart failure?

1. SOB on exertion

2. Heart murmur and distended veins

3. Peripheral edema

4. Cool extremities and weak peripheral pulses

The correct answer is: Peripheral edema

Peripheral edema is primarily associated with right-sided heart failure because this condition leads to the heart's inability to effectively pump blood out to the lungs for oxygenation. As a result, blood backs up in the systemic venous circulation. This backup causes increased pressure in the veins, which ultimately leads to fluid leakage into surrounding tissues. The accumulation of fluid manifests as swelling, particularly in the lower extremities, abdomen, and other dependent areas. In contrast, shortness of breath (SOB) on exertion is more commonly linked to left-sided heart failure, where pulmonary congestion occurs due to the left ventricle's failure to eject blood efficiently. Heart murmurs and distended veins can indicate various cardiac conditions and can occur in both sides of heart failure but are not as specifically indicative of right-sided failure as peripheral edema. Lastly, cool extremities and weak peripheral pulses may suggest signs of decreased cardiac output generally and are not exclusively associated with right-sided heart failure. Thus, peripheral edema stands out as a hallmark symptom of right-sided heart failure.