Deck 8: Heart Failure

Question 1

Which of the following statements is NOT true related to pulmonary dysfunction in patients with left ventricular failure?

A)With severe alveolar flooding,PaO₂ is markedly decreased
B)With moderate left heart failure,FVC may be increased
C)With mild pulmonary vascular congestion,PaO₂ may be improved
D)PaCO₂ may increase with severe pulmonary congestion

Answer 1

B

Question 2

Which of the following mechanisms is NOT helpful to the heart in compensating for a failing left ventricle and a falling cardiac output?

A)Increased contractility due to increased stretch
B)Increased heart rate due to release of epinephrine by the nervous system
C)Increased system vascular resistance due to release of catecholemines
D)Increased myocardial muscle thickness due to chronic high work load

Answer 2

C

Question 3

What is the normal value for ejection fraction in a healthy heart?

A)40%
B)50%
C)60%
D)70%

Answer 3

D

Question 4

What is the primary electrolyte and fluid balance problem associated with heart failure that results in reduced renal perfusion?

A)Potassium retention and excessive water elimination
B)Potassium loss and water retention
C)Sodium loss and water elimination
D)Sodium retention and water retention

Question 5

What type of diet often helps the patient with heart failure?

A)High fiber diet
B)High potassium diet
C)Low sodium diet
D)High protein diet

Question 6

What term is used to describe shortness of breath in the reclining position?

A)Orthopnea
B)Platypnea
C)Orthodeoxia
D)Eupnea

Question 7

Which of the following risk factors is NOT associated with the increased incidence of congestive heart failure?

A)Inadequate potassium intake
B)Obesity
C)Smoking
D)Diabetes

Question 8

Which of the following findings on an ECG suggest cor pulmonale and not left ventricular failure?

A)QT dispersion
B)Frequent PVCs
C)Bundle branch block
D)Right axis deviation

Question 9

Which of the following ABG findings is most suggestive of a severe case of congestive heart failure?

A)Respiratory alkalosis
B)PaO₂ = 40 mmHg
C)Metabolic acidosis
D)PaCO₂ = 44 mmHg

Question 10

Which of the following is NOT one of the primary ways in which edema forms from leakage of fluid out of the capillaries?

A)Increased capillary permeability
B)Increased capillary hydrostatic pressure
C)Increased blood protein concentrations
D)Lymphatic obstruction

Question 11

What percent of patients admitted to the hospital and diagnosed with congestive heart failure actually have cor pulmonale?

A)5-10%
B)10-30%
C)25-40%
D)50%

Question 12

Which of the following is NOT associated with acute left ventricular failure?

A)Elevated pulmonary artery diastolic pressure
B)Increased blood flow to the apical regions of the lung
C)Pulmonary edema
D)Portal hypertension

Question 13

What is the mortality rate for patients with severe cases of congestive heart failure?

A)40-50%
B)50-70%
C)80-90%
D)None of the above

Question 14

When looking at the chest radiograph,what term is associated with an abnormal increase in blood flow to the apices?

A)Ascites
B)Cephalization
C)Caudalization
D)Homans' sign

Question 15

What is the 1-year survival rate for patients diagnosed with congestive heart failure?

A)25%
B)50%
C)75%
D)90%

Question 16

Which two clinical findings are NOT typical for congestive heart failure patients?

A)Dyspnea and cough
B)Reduced exercise tolerance and anxiety
C)Inspiratory crackles and peripheral pallor
D)Bradycardia and warm extremities

Question 17

Which of the following medications is considered an ACE inhibitor that lowers cardiac workload in congestive heart failure patients?

A)Captopril
B)Isosorbide
C)Nitropursside
D)Prazosin

Question 18

Which of the following clinical findings is least associated with congestive heart failure?

A)Presence of an S3 or S4 or both
B)Expiratory polyphonic wheezing
C)Prolonged inspiratory time
D)Pedal edema

Question 19

Which of the following findings on the chest radiograph suggests a more severe case of congestive heart failure?

A)Pleural effusions
B)Kerley A and B lines
C)Widening of the pulmonary arteries
D)Interstitial edema

Question 20

About how many new cases of congestive heart failure are diagnosed in the United States each year?

A)150,000
B)250,000
C)550,000
D)1 million

Question 21

Your patient develops severe pulmonary edema with severe hypoxemia and a PaCO₂ of 55 mmHg.What therapy would you recommend to the attending physician?

A)Oxygen via non-rebreathing mask
B)CPAP with FIO₂ of 1.0
C)CPAP with BiPAP and an FIO₂ of 1.0
D)Intubate and use blow-by at an FIO₂ of 0.50

Question 22

What is the most frequently used inotropic drug used for patients with heart failure?

A)Dopamine
B)Digitalis
C)Lasix
D)Nitroprusside

Question 23

If your patient with heart failure develops bradycardia,what drug would you suggest to be used?

A)Atropine
B)Isuprel
C)Epinephrine
D)Norepinephrine