NURS 6531 Case Study: 65-Year-Old
Female Patient with Insomnia - Latest
2025/2026 Resource for First-Time
Exam Success - Based on Primary
Care, 6th Edition by Lynne M.
Dunphy, Jill E. Winland-Brown, Brian
Porter, and Debera J. Thomas
,Cardiac – Patient 1
Client was brought to the emergency department by his son with reports of difficulty breathing and
inability to walk short distances without becoming extremely short of breath. Client is a 72-year-old
African American man with a history of obesity, hypertension, coronary artery disease, and diabetes
mellitus.
Client reports fatigue related to difficulty sleeping at night as a result of a nonproductive cough that is
unresolved with cough drops.
Client reports a weight gain of 10 pounds in the past week, despite his decreased appetite.
The son reports that his father has been unable to care for himself as a result of the fatigue and
increasing shortness of breath. He states “he has not showered in over a week.”
Assessment findings:
Cardiovascular: Sinus tachycardia with occasional premature ventricular contractions (PVCs). No
murmur noted
,Respiratory: Tachypnea, inspiratory crackles auscultated throughout bilateral lung fields, dyspnea with
mild exertion, orthopnea, nonproductive chronic cough
Gastrointestinal: Positive bowel sounds
Genitourinary: Clear yellow urine, urinary frequency, and nocturia
Peripheral: +4 pitting edema in bilateral lower extremities
Vital signs:
Temperature: 98.6°F (37°C)Heart rate: 120 beats/minRespiratory rate: 26 breaths/minBlood pressure:
152/90 mm HgPulse oximetry reading of 93%
Imaging Studies
Electrocardiogram (ECG) reveals ventricular hypertrophy
Chest x-ray reveals cardiomegaly
Echocardiogram results pending
The nurse is preparing a plan of care for the client. Based on the information provided, choose the
potential condition with anticipated medication and side effect from the list of options provided.
, Potential Conditions
gastroparesis
acute renal failure
HF
hypothyroidism
Anticipated Meds
finasteride
furosemide
docusate sodium
nitroglycerin
levothyroxine
SEs to monitor
hypokalemia
Female Patient with Insomnia - Latest
2025/2026 Resource for First-Time
Exam Success - Based on Primary
Care, 6th Edition by Lynne M.
Dunphy, Jill E. Winland-Brown, Brian
Porter, and Debera J. Thomas
,Cardiac – Patient 1
Client was brought to the emergency department by his son with reports of difficulty breathing and
inability to walk short distances without becoming extremely short of breath. Client is a 72-year-old
African American man with a history of obesity, hypertension, coronary artery disease, and diabetes
mellitus.
Client reports fatigue related to difficulty sleeping at night as a result of a nonproductive cough that is
unresolved with cough drops.
Client reports a weight gain of 10 pounds in the past week, despite his decreased appetite.
The son reports that his father has been unable to care for himself as a result of the fatigue and
increasing shortness of breath. He states “he has not showered in over a week.”
Assessment findings:
Cardiovascular: Sinus tachycardia with occasional premature ventricular contractions (PVCs). No
murmur noted
,Respiratory: Tachypnea, inspiratory crackles auscultated throughout bilateral lung fields, dyspnea with
mild exertion, orthopnea, nonproductive chronic cough
Gastrointestinal: Positive bowel sounds
Genitourinary: Clear yellow urine, urinary frequency, and nocturia
Peripheral: +4 pitting edema in bilateral lower extremities
Vital signs:
Temperature: 98.6°F (37°C)Heart rate: 120 beats/minRespiratory rate: 26 breaths/minBlood pressure:
152/90 mm HgPulse oximetry reading of 93%
Imaging Studies
Electrocardiogram (ECG) reveals ventricular hypertrophy
Chest x-ray reveals cardiomegaly
Echocardiogram results pending
The nurse is preparing a plan of care for the client. Based on the information provided, choose the
potential condition with anticipated medication and side effect from the list of options provided.
, Potential Conditions
gastroparesis
acute renal failure
HF
hypothyroidism
Anticipated Meds
finasteride
furosemide
docusate sodium
nitroglycerin
levothyroxine
SEs to monitor
hypokalemia
