The nurse provides discharge instructions to a client with pulmonary hypertension. The nurse concludes that the client understands the information if the client reports which sign of exacerbation?

A. Productive cough: While a cough can occur with respiratory infections or pulmonary conditions, it is not a primary sign of pulmonary hypertension exacerbation. Monitoring for cough is important, but it is not the key indicator of worsening pulmonary pressures. B. Fever: Fever indicates infection rather than exacerbation of pulmonary hypertension. Although infections can worsen pulmonary status, fever alone does not reflect the hemodynamic changes characteristic of disease progression. C. Weight loss: Weight loss may occur over time due to chronic illness or poor nutrition but is not an acute sign of pulmonary hypertension exacerbation. It does not reliably indicate immediate clinical deterioration. D. Dyspnea at rest: Increased shortness of breath at rest reflects worsening pulmonary pressures and right heart strain, which are hallmark signs of pulmonary hypertension exacerbation. Recognizing this symptom demonstrates the client’s understanding of when to seek prompt medical attention.