Which subjective assessment data supports the nurse's conclusion that a client is experiencing orthopnea?

Choice A rationale Nocturnal coughing, while disruptive to sleep, often indicates conditions like post-nasal drip, asthma, or gastroesophageal reflux disease (GERD). It is a symptom of airway irritation or reflux, not specifically positional dyspnea. Orthopnea is characterized by dyspnea relieved by sitting or standing, rather than just coughing. Choice B rationale Recurrent wheezing attacks are classic symptoms of reactive airway diseases such as asthma, stemming from bronchoconstriction and inflammation. While wheezing can be exacerbated by exertion or position, its primary association is with airway narrowing and increased respiratory effort due to bronchial hyperresponsiveness, not orthopnea. Choice C rationale Orthopnea is a form of dyspnea that occurs when lying flat, typically due to the redistribution of fluid into the pulmonary circulation, increasing pulmonary capillary pressure. Sleeping on multiple pillows elevates the upper body, which decreases venous return to the heart, thus reducing pulmonary congestion and alleviating the sensation of breathlessness. Choice D rationale Exertional dyspnea, or shortness of breath with activity, signifies an inability of the respiratory and cardiovascular systems to meet increased metabolic demands. This is commonly seen in conditions like heart failure or COPD. While related to respiratory effort, it is distinct from the positional nature of orthopnea.