Which statement indicates that the patient is suffering from congestive heart failure rather than pneumonia?

The statement "I feel like I'm drowning when I sleep" is indicative of congestive heart failure (CHF) because it reflects a specific symptom known as orthopnea. Patients with CHF often experience difficulty breathing when lying flat due to fluid accumulation in the lungs, which can worsen at night or when they are attempting to sleep. This sensation can lead individuals to sleep in a more upright position to alleviate their discomfort, which aligns with the feeling of drowning when they are supine.

In contrast, other statements such as experiencing fever and chills are more characteristic of pneumonia, suggesting an infectious process. The presence of a productive cough with thick mucus also points toward pneumonia, as this can indicate secretions associated with respiratory infections. Extreme fatigue, while a common symptom in many conditions, does not specifically indicate CHF over pneumonia; it is a general symptom that can manifest in a variety of health issues, including both heart failure and pneumonia. Thus, the specific nature of feeling like one is drowning ties more closely to the respiratory distress that occurs in CHF, distinguishing it from pneumonia.