Deck 26: Nursing Care of Patients With Heart Failure

Question 1

The nurse is auscultating the lungs of a patient with heart failure. Which can the nurse expect to document?

A)Pericardial rub
B)Stridor
C)Crackles
D)Rhonchi

Answer 1

Crackles

Question 2

A patient with heart failure is prescribed bedrest, but becomes angry and walks to the bathroom independently to use the commode. How should the nurse handle this situation?

A)Obtain a bedside commode.
B)Walk the patient to the bathroom.
C)Obtain a bedpan for the patient to use.
D)Call for help while holding the patient in bed.

Answer 2

Obtain a bedside commode.

Question 3

The HCP informs the licensed practical nurse/licensed vocational nurse (LPN/LVN) that the patient has stage 3 heart failure. The patient asks what this means. Which explanation by the nurse is most appropriate?

A)"This means you are at risk for heart failure."
B)"This means you have no symptoms of heart failure but structural disease."
C)"This means you have heart failure with reduced ejection fraction and symptoms."
D)"This means you have refractory heart failure, which requires extraordinary support of hospice care."

Answer 3

"This means you have heart failure with reduced ejection fraction and symptoms."

Question 4

The nurse reinforced teaching for a patient awaiting a heart transplant. Which statements indicate that the patient understands the usual criteria used for a potential heart donor? (Select all that apply.)

A)Age less than 55 years
B)No hypertension or diabetes
C)Absence of malignant disease
D)Presence of no active infections
E)Presence of no significant cardiac disease 6.Weight within 35 lb of prospective recipient

Question 5

A patient with heart failure has clavicle muscle retractions, nostril flaring, and labored breathing. Vital signs are blood pressure 162/84 mm Hg, pulse 120 beats/min, and respirations 32/min. Which patient data requires immediate action?

A)Quiet, shallow respirations
B)Jaw jutting forward to inhale
C)Leaning on the over-bed table
D)Use of neck accessory muscles

Question 6

The nurse is teaching a patient who is receiving information about food choices high in potassium. Which food choice made by the patient indicates an understanding of the teaching? 1.1 cup of spaghetti noodles

A)1 large baked potato
B)1/2 cup of rice
C)Two slices of white bread

Question 7

During a home visit, the nurse learns that a patient with chronic heart failure is planning to quit cardiac rehabilitation because of the fear of dying while on the treadmill. Which response by the nurse is best?

A)"I don't blame you for feeling frustrated, I hate to exercise too."
B)"People don't die on the treadmill; it's to make your heart stronger."
C)"It sounds like you want to give up. I'll call the doctor and have you transferred to the hospice program."
D)"You sound upset. Did you know research shows that cardiac rehab programs give people better medical outcomes and a higher quality of life?"

Question 8

The nurse is assessing a patient who underwent cardiac surgery. Which finding warrants a phone call to the HCP?

A)The nurse notes 80 mL of drainage in the chest tube collection chamber.
B)The patient reports level 4 and dull incision pain.
C)The nurse notes 240 mL of clear yellow urine after 2 hours.
D)The patient has a cough producing yellow-green sputum.

Question 9

The nurse is caring for a patient and notes the patient is coughing up pink, frothy sputum. Which action should the nurse take?

A)Document the finding as normal.
B)Encourage the patient to drink more fluids.
C)Notify the health care provider (HCP).
D)Instruct the patient to ambulate frequently.

Question 10

The nurse is reviewing orders for a patient and notes the patient is prescribed valsartan/sacubitril (Entresto). Which medication in the patient's medication history would lead the nurse to seek clarification before administering the Entresto?

A)Bumetanide (Bumex)
B)Lanoxin (Digoxin)
C)Metoprolol succinate (Toprol XL)
D)Enalapril (Vasotec)

Question 11

A patient with a potassium level of 3.0 mEq/L is to receive furosemide (Lasix) 20 mg by mouth. What action should the nurse take?

A)Give the Lasix 30 minutes early.
B)Give the Lasix as scheduled now.
C)Consult the RN before giving Lasix.
D)Hold this scheduled dose of the Lasix.

Question 12

The nurse is caring for a group of patients. Which patient should the nurse see first?

A)A patient with a sodium level of 137 mEq/L
B)A patient with urine output of 50 mL/hr
C)A patient with an elevated BNP level
D)A patient with sudden onset of confusion

Question 13

A patient is receiving digoxin (Lanoxin) daily. Which symptom should the nurse report for follow-up related to the digoxin?

A)Anorexia
B)Constipation
C)Skin flushing
D)Blood pressure 118/68 mm Hg

Question 14

The nurse is caring for a patient with pulmonary edema. The nurse should place the patient in which position?

A)Right side-lying
B)Trendelenburg's
C)Fowler's
D)Prone

Question 15

The nurse is reinforcing teaching for a patient being discharged home on captopril (Capoten). Which statement made by the patient indicates an understanding of the teaching?

A)"I should take the first doses in the morning so I don't get dizzy."
B)"I will check my heart rate and blood pressure before taking the medication."
C)"I cannot take this medication with any other medication."
D)"I will weigh myself daily and monitor urine output."

Question 16

As part of discharge teaching, the nurse is instructing a patient on the use of digoxin (Lanoxin). What should be included in the teaching? (Select all that apply.)

A)Report if a persistent cough occurs.
B)Change position quickly to avoid orthostatic hypotension.
C)Take medication exactly as directed at the same time each day.
D)Report blurred vision, photophobia, or seeing yellowish green halos.
E)Take pulse before taking medication and if below 60 or above 100, call the physician.

Question 17

The nurse is reviewing laboratory results for a newly admitted patient. Which result should be of most concern to the nurse?

A)B-type natriuretic peptide (BNP) 900 pg/mL
B)Thyroid-stimulating hormone (TSH) 3.2 mµ/L
C)Blood urea nitrogen (BUN) 18 mg/dL
D)Sodium 138 mEq/L

Question 18

The nurse is teaching a patient about prevention of paroxysmal nocturnal dyspnea. Which topic should the nurse include in the teaching?

A)Sleep in the prone position.
B)Sleep on the right side.
C)Lay flat with legs elevated.
D)Use three pillows to sleep upright.

Question 19

The nurse is caring for a group of patients. Which patient is at highest risk for developing heart failure?

A)An African American female with hypertension
B)An Asian male with liver disease
C)A Hispanic female with renal failure
D)A Caucasian male with atrial fibrillation

Question 20

During a visit to the home of a patient with heart failure and diabetes, the nurse learns that the patient "feels strange." Data collected includes blood pressure 172/94 mm Hg, pulse 112 beats/min, respirations 22/min, heart rhythm regular, and coarse crackles in lower lung bases. What action should the nurse take?

A)Consult the registered nurse (RN).
B)Give the patient orange juice.
C)Assist patient to bed for a nap.
D)Recheck vital signs in 30 minutes.

Question 21

The nurse is calculating the intake for a patient who received 50 mL of an antibiotic, 120 mL of juice, 60 mL of water, and 240 mL of green tea. Calculate the patient's total intake. Enter the numeral only.

Question 22

The nurse is preparing to administer bumetanide (Bumex) 0.50 mg IV. The available dose is 0.25 mg/mL. How many mL will the nurse administer? Enter the numeral only.

Question 23

The nurse is reviewing compensatory mechanisms with a patient in heart failure. What should the nurse include when providing this teaching? (Select all that apply.)

A)Urine output increases.
B)Muscle mass of the heart decreases.
C)Oxygen demand of the heart is lowered.
D)Epinephrine and norepinephrine are released.
E)Kidneys activate the renin-angiotensin-aldosterone system.
F)Heart muscles stretch to increase the force of myocardial contraction.

Question 24

The nurse is caring for a patient with heart failure receiving enalapril (Vasotec) 5 mg by mouth daily. The available dose is 10-mg tablets. How many tablets will the nurse administer? Enter the numeral only.

Question 25

The HCP wants to be notified if a patient recovering from a heart transplant has a urine output less than 0.5 mL/kg/hr. The patient weighs 176 lb. What is the amount of urine the patient has to produce before the HCP is notified?