Download Questions for Heart Failure 1. A patient admitted from the emergency

Questions for Heart Failure
 1. A patient admitted from the emergency department with a diagnosis of heart failure has
edema in his lower extremities of +4. Which nursing intervention would aid in decreasing this
edema?
o Ambulate in the hallway
o Elevate lower extremities
o Keep the extremities in a dependent position
o Stand at the bedside
 2. A patient has heart failure. His physician’s orders include complete bed rest. The nurse
knows that this order means he
o Is encouraged to rest as much as possible
o Is confined to bed but may assume responsibility for all of his personal care
o Is confined to bed but is allowed to go to the bathroom as needed
o Must remain as quiet as possible, with any task requiring physical effort done for him
 3. The patient achieves comfort in breathing only when he assumes a sitting posture. During the
charting of this position, the nurse can describe this as
o Dyspnea
o Orthophrenia
o Orthopnea
o Orthuria
 4. The patient has been hospitalized for congestive heart failure three times in the last 4
months. While preparing the discharge teaching plan, the nurse assesses that he does not
comply with his medication regimen. The nurse’s immediate course of action would be to
o Reteach him about his medications
o Have a serious talk with him and his family about compliance
o Arrange for home visits after discharge
o Collect more information to identify his reasons for noncompliance
 5. Dependent edema of the extremities, enlargement of the liver, oliguria, jugular vein
distention, and abdominal distention are signs and symptoms of
o Right-sided heart failure
o Left-sided heart failure
o Cardiac dysrhythmias
o Valvular heart disease
 6. Restlessness, diaphoresis, severe dyspnea, tachypnea, hemoptysis, audible wheezing, and
crackles are signs and symptoms of
o Heart failure
o Respiratory failure
o Pulmonary edema
o Peripheral edema
 7. The nurse identifies the problem of a potential complication - pulmonary edema-for a patient
in acute congestive heart failure. For which symptom of this problem does the nurse assess?
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o Pink, frothy sputum
o Lethargy and faintness
o Decreased urinary output
o Bradycardia
8. During the nursing history and physical assessment of a patient with left-sided heart failure,
which finding might the nurse expect related to the patient’s diagnosis?
o Orthopnea with bubbling crackles throughout the lungs
o Anorexia with weight loss of 3 pounds in 1 week
o Increased urinary output, especially during waking hours
o Periorbital and facial edema
9. A patient has a diagnosis of heart failure. When the nurse walks into his room, he is
orthopneic. The patient is
o Sitting or standing in order to breathe deeply and comfortably
o Complaining of sudden awakenings from sleep because of shortness of breath
o Complaining of pain in lower extremities
o Unable to respond to simple questions
10. Edema and pulmonary congestion are treated with
o Unlimited activity, high protein diet, weights weekly
o Bed rest, normal diet, weights four times daily
o Increase in fluids, no activity restrictions
o Diuretics, restriction of sodium, restriction of fluid intake
11. ACE inhibitors help the congestive heart failure patient by
o Blocking angiotensin
o Blocking aldosterone
o Blocking creatine
o Increasing angiotensin
12. One contraindication to starting the heart failure on beta blockers would be
o Allergy to sulfa
o Symptomatic bradycardia
o Hypertension
o Ejection fraction of 25%
13. Spironolactone is an example of a/an
o Potassium wasting diuretic
o ACE inhibitor
o Aldosterone antagonist
o Beta blocker
o Calcium channel blocker
14. The emotional response most likely to coincide with acute heart failure is
o Anger
o Stoicism
o Anxiety
o Depression
 15. Before administering digoxin (Lanoxin) to the client in heart failure, the nurse should assess
the client’s
o Temperature
o Blood pressure
o Heart rate
o Breath sounds
 16. Which value should the nurse report immediately to the physician for the cardiac patient in
heart failure?
o Sodium 139
o Potassium 3.o
o Chloride 99
o Glucose 144
 17. The client in heart failure who is frightened due to severe dyspnea would benefit most from
which of the following nursing interventions?
o Tell the patient to relax
o Allow the patient to walk the halls
o Stay with the client and provide reassurance
o Explain to the patient the strain on his heart
 18. Epinephrine and norepinephrine are released in response to
o Rapid heart rate
o Increased work of breathing
o Decreased cardiac output
o Conservation of water by the kidneys
 19. The body uses this process to help compensate for changes in order that our body won’t
suffer devastating effects on a daily basis.
o Renin-angiotensin-aldosterone system
o Compensatory mechanisms
o Suppression of cardiac output
o Parasympathetic responses
 20. This will result in less oxygen being exchanged due to heart failure.
o Edema of bronchi
o Fluid entering the alveoli
o Ischemia to the atria
o Bradycardia
 21. An appropriate nursing diagnosis due to decreased cardiac output would be
o Alteration in skin integrity
o Ineffective tissue perfusion
o Activity intolerance
o Self-health maintenance, impaired
 22. The major goal of treatment for heart failure is to
o Reduce the heart rate
o Increase UOP
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o Increase cardiac output
o Weekly weights
23. Digitalis preparations are given primarily to
o Increase myocardial contractility
o Release epinephrine and norepinephrine
o Raise the heart’s oxygen supply
o Ease the contractions of the left ventricle
24. Decreased urine output, tachycardia, tachypnea, and crackles would signify
o Ejection fraction above 70%
o Left-sided heart failure
o Pulmonary edema
o Right-sided heart failure
25. Pressure in the aorta and arteries that tells the left ventricle how much force is needed to
eject blood is called
o Ejection fraction
o Absolute LV value
o Peripheral vascular resistance
o Vascular flow rate
26. An intra-aortic balloon pump would be inflated during
o Contraction
o Systole
o Ejection of blood from the left ventricle
o Diastole
27. Nocturia would occur due to
o Increase in blood flow in the periphery
o Decrease in heart rate at night
o Venous return as legs are elevated
o Rise in pulmonary pressures
28. The only feasible way to monitor left-sided heart pressures several times a day would be to
o Place a PICC with pressure monitoring devices
o Monitor right-sided heart pressures with a Swan-Ganz catheter
o Leave a cardiac cath in place to measure the pressures
o Place the patient on an IABP and admit them to ICU
29. Discharge instructions for the heart failure patient should include
o Returning for digoxin levels every other day until the value is between 2-3
o Daily weights with reports of 2 or more pounds gained in a 24 hour period
o Consumption of a consistent carbohydrate diet with adequate potassium intake
o Follow-up appointment with PCP within the next 6 months
30. This classification of meds, of which digoxin is a member, increases force of contraction
which increases cardiac output and slows the heart rate to reduce the workload of the heart.
o Inotropes
o Beta-blockers
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o ACE inhibitors
o Aldosterone antagonists
31. The most short term device for the patient awaiting a heart transplant that will completely
bypass the left ventricle would be the
o Intra-aortic balloon pump
o Swan-Ganz
o Ventricular assist device
o Pacemaker insertion
32. Severe pulmonary fluid overload in a relatively short period of time is termed
o Tachypnea
o Flash pulmonary edema
o Severe pulmonary congestion
o Right-sided heart failure
33. Be cautious with this medication if your patient has a low potassium level.
o Inderol
o Capoten
o Metoprolol
o Digoxin
34. A pacer spike is seen just prior to the QRS complex. You know this is what type of pacer?
o Mono pacer
o Ventricular pacer
o Atrial pacer
o Defibrillator pacer
35. Transplanted skeletal muscle around the heart is termed a
o Cardioectomy
o Cardiomyoplasty
o Cardioventriculogram
o Cardioversion
36. The most common cause of right sided heart failure is
o Pulmonary artery disease
o Increased pulmonary pressures
o Pulmonary congestion
o Left-sided heart failure
37. Right-sided heart failure due to pulmonary disease is termed
o Right-sided heart failure
o Cardiopulmonali
o Cor pulmonale
o Cordon pulmonalie
38. The body’s compensatory mechanisms will
o Correct cardiac output issues in heart failure
o Decrease the hearts need for extra oxygen
o Create a negative pulmonary pressure rise
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o Add to the problems of heart failure
39. Altered mental status, cyanosis, chest pain, crackles, wheezes, and tachypnea are all signs of
o Pulmonary vascular resistance
o Left-sided heart failure
o Right-sided heart failure
o Jugular vein distention
40. How do aldosterone antagonists help heart failure patients?
o By decreasing sodium and potassium reabsorption
o By reabsorption of sodium
o By blocking the reabsorption of sodium
o By eliminating greater amounts of potassium
41. Heart failure patients are most prone to this dysrhythmia.
o Heart block
o SVT
o A-fib
o V-fib
42. EKG changes in the heart failure patient could be from
o Overload and ischemia
o Dysfunction of the atria
o SA node malfunction
o Cardiac anomalies
43. Right-sided heart failure symptoms are typically more
o Severe
o Systemic
o Pulmonary
o Resistant to treatment
44. A patient on furosemide (Lasix) will need which of the following assessments?
o Lung sounds and CBC
o Blood pressure and potassium
o Blood sugar and sodium
o Complete assessment including past 24 hour output
45. Decreased activity intolerance would be a nursing diagnosis most likely related to what in
the heart failure patient?
o Discomfort in legs while ambulating
o Dyspnea during stair climbing
o Pump failure
o Noticeable shortness of breath with any exertion