A heart failure client has an echocardiogram performed revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client:

a) "You need to increase the amount of exercise you do to get your heart muscle back in shape."
b) "This means your heart is not pumping as much blood out of the heart with each beat."
c) "This means you have a lot of pressure built-up inside your heart."
d) "Your ventricular muscle is getting too stiff to beat normally."