Question 1

A client admitted with heart failure overhears the health care provider discussing plans to "digitalize" the client and asks the nurse what this means. Which response by the nurse is the most appropriate?

Accepted Answer

"Digitalize" refers to the process of administering a series of doses of digoxin to rapidly achieve therapeutic levels in the body, without reaching toxic levels. This is done to saturate the heart tissue and alleviate symptoms of heart failure, as described in option A.

Question 2

MCSA A student nurse is planning on administering a diuretic to a client with heart failure. Her instructor asks her to describe the action diuretics have on heart failure. What is the best response of the student?

Accepted Answer

Diuretics work by increasing urine output, which reduces fluid volume, and therefore decreases blood pressure. This helps to alleviate the symptoms of heart failure, such as fluid accumulation in the lungs and edema in the feet and legs. Option A is incorrect because diuretics cause vasodilation, not venodilation. Option C is incorrect because diuretics do not increase the force of contraction of the heart. Option D is incorrect because diuretics do not slow the heart rate, although they may decrease blood pressure.

Question 3

A client in the emergency department complains of chest pain, diaphoresis, shortness of breath, lightheadedness, and dizziness. The cardiac monitor displays ventricular tachycardia at 180 beats per minute. What is the nurse's most immediate concern for this client?

Accepted Answer

The client's symptoms, including chest pain and ventricular tachycardia, indicate a high likelihood of acute myocardial infarction (heart attack). The client's heart is not effectively pumping blood to the body, which can lead to cardiac arrest and death. Therefore, the nurse's most immediate concern is preventing cardiac death by providing prompt treatment, such as cardioversion or defibrillation, and initiating interventions to reduce myocardial oxygen demand and increase oxygen supply.

Question 4

The nurse is caring for a client who is prescribed digoxin (Lanoxin) for a cardiac dysrhythmia. The nurse teaches the client about digoxin (Lanoxin) toxicity and determines that learning has occurred when the client makes which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is caring for a client...

Question 5

The nurse teaches a client about lisinopril (Prinivil), and evaluates that additional teaching is required when the client makes which statement?

Accepted Answer

This statement indicates a lack of understanding about the need for regular monitoring of kidney function, which may be affected by lisinopril. Blood tests may be necessary to check kidney function and electrolyte levels.

Question 6

MCSA Which of the following combination of drugs would be considered for a client with an ejection fraction of less than 40%

Accepted Answer

Enalapril (an ACE inhibitor) and carvedilol (a beta blocker) are both recommended for clients with heart failure with reduced ejection fraction (less than 40%) based on clinical trials and guidelines. They work together to improve heart function, reduce symptoms, and reduce the risk of hospitalization and death. Option B (digoxin and furosemide) is a possible combination for symptomatic relief, but it does not address the underlying pathophysiology of heart failure. Option C (lisinopril and isosorbide dinitrate) is not commonly used together and may have limited benefits in heart failure. Option D (metoprolol and HCTZ) is not recommended as HCTZ may worsen heart failure and is generally not used in clients with ejection fraction less than 40%.

Question 7

A client diagnosed with atrial fibrillation is prescribed a calcium channel blocker to help control the ventricular rate. what change does the nurse monitor the ECG for?

Accepted Answer

Calcium channel blockers can affect the electrical conduction system of the heart, resulting in a prolongation of the PR interval on the ECG. This is because the medication slows down the conduction from the atria to the ventricles, which can result in a delayed or absent P wave, and a longer PR interval.

Question 8

MCSA A student nurse is preparing to give Carvedilol (Coreg) to her client with heart failure. She tells her instructor that it decreases both the contractility and heart rate of clients. Her instructor asks her what this places the client at risk for. What is the best response of the student?

Accepted Answer

Carvedilol is a beta-blocker that can decrease heart rate and contractility, potentially leading to worsening heart failure symptoms if the heart cannot pump effectively.

Question 9

The client has a history of cardiac disease and receives furosemide (Lasix) and digoxin (Lanoxin). The nurse determines that education about dietary needs with these medications has been effective when the client makes which selection for lunch?

Accepted Answer

This option includes a balanced meal with protein, complex carbohydrates, and potassium-rich fruit. Furosemide is a loop diuretic that can cause increased potassium excretion, so it is important to eat potassium-rich foods. Additionally, this option does not include excessive amounts of sodium or fat, which can worsen cardiac disease. Options A, C, and D are all high in sodium or fat and do not provide a balanced meal with potassium-rich options.

Question 10

MCMA A student is preparing to care for clients with heart failure. Which classifications of drugs are appropriate for the nurse to review before practice?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of MCMA A student is preparing to care...

Question 11

The nurse is caring for a client being treated pharmacologically for heart failure. Which laboratory values is the nurse careful to monitor during treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Potassium levels are important to monitor because certain heart failure medications can lead to hyperkalemia. BUN and creatinine levels should be monitored to assess kidney function, as heart failure can lead to reduced kidney function. Serum drug levels should be monitored to ensure therapeutic levels are achieved and to prevent toxicity. Liver function tests may be important to monitor depending on the specific medication being used, but it is not a general requirement for heart failure treatment.

Question 12

The client is prescribed enalapril (Vasotec) as treatment for heart failure. Which is the priority nursing assessment following the initial administration of this drug?

Accepted Answer

Enalapril is an ACE inhibitor and can cause a drop in blood pressure as a side effect, which is why it is important to assess the client's blood pressure following initial administration. While the other options are important nursing assessments, they are not the priority following the initial administration of enalapril.

Question 13

A client experienced a myocardial infarction (MI) 12 hours ago.what aspect of the client care is it most important to monitor?

Accepted Answer

In the case of a myocardial infarction, monitoring the client's cardiac rhythm is the most important aspect of care as it can indicate the extent of damage to the heart and the need for interventions such as medication, defibrillation, or cardiopulmonary resuscitation. While all options may be important to monitor, cardiac rhythm takes priority in this scenario.

Question 14

A client who is diagnosed with heart failure is prescribed digoxin (Lanoxin). Prior to discharge, what will the teaching plan of the nurse include?

Accepted Answer

A weight gain of two or more pounds per day can indicate fluid retention, which is a sign of worsening heart failure and should be reported to a healthcare provider.

Question 15

The client is prescribed digoxin (Lanoxin) for the treatment of heart failure. Which assessment findings would indicate adverse effects of this medication?

Accepted Answer

Anorexia and nausea are common adverse effects of digoxin toxicity, along with vomiting, diarrhea, and visual disturbances (e.g., blurred vision, yellow-green halos).

Question 16

MCSA Which of the following medications is effective for the treatment of heart failure by decreasing heart rate and lowering blood pressure?

Accepted Answer

The answer of MCSA Which of the following medications is...

Question 17

A client presents in the emergency department with complaints of lightheadedness, dizziness, and shortness of breath. The cardiac monitor shows the client to be in atrial fibrillation with a ventricular rate of 156. Which finding from the client's history is least likely to have resulted in this rhythm disorder?

Accepted Answer

Atrial fibrillation can be caused by underlying conditions such as hypertension, diabetes, and congestive heart failure. However, benign prostatic hyperplasia is not typically associated with atrial fibrillation.

Question 18

The nurse administers isosorbide dinitrate (Isordil). Which is the correct instruction to give the client?

Accepted Answer

Isosorbide dinitrate should be taken with a glass of water to help with absorption.

Question 19

A client is prescribed oral verapamil (Isoptin) for the treatment of atrial fibrillation. Which statement indicates that the client understands the medication teaching provided by the nurse?

Accepted Answer

The answer of A client is prescribed oral verapamil (Isoptin)...

Question 20

The nurse admits a client to the emergency department with new-onset atrial fibrillation and a heart rate of 168 beats per minute. The client is complaining of dizziness and shortness of breath. The nurse starts an intravenous line in anticipation of administering which drug?

Accepted Answer

Ibutilide (Corvert) is used for acute conversion of atrial fibrillation and atrial flutter to normal sinus rhythm. Given the client's symptoms and heart rate, this drug is the most appropriate choice as it is rapidly acting and can be given intravenously. Digoxin (Lanoxin) is not used for acute conversion of atrial fibrillation and has a slower onset of action. Disopyramide (Rythmodan) and Lidocaine (Xylocaine) are not indicated for atrial fibrillation.

Quiz 11: Pharmacology of Alterations in the Cardiovascular System

A client admitted with heart failure overhears the health care provider discussing plans to "digitalize" the client and asks the nurse what this means. Which response by the nurse is the most appropriate?

MCSA A student nurse is planning on administering a diuretic to a client with heart failure. Her instructor asks her to describe the action diuretics have on heart failure. What is the best response of the student?

A client in the emergency department complains of chest pain, diaphoresis, shortness of breath, lightheadedness, and dizziness. The cardiac monitor displays ventricular tachycardia at 180 beats per minute. What is the nurse's most immediate concern for this client?

The nurse teaches a client about lisinopril (Prinivil) , and evaluates that additional teaching is required when the client makes which statement?

MCSA Which of the following combination of drugs would be considered for a client with an ejection fraction of less than 40%

A client diagnosed with atrial fibrillation is prescribed a calcium channel blocker to help control the ventricular rate. what change does the nurse monitor the ECG for?

MCSA A student nurse is preparing to give Carvedilol (Coreg) to her client with heart failure. She tells her instructor that it decreases both the contractility and heart rate of clients. Her instructor asks her what this places the client at risk for. What is the best response of the student?

The client has a history of cardiac disease and receives furosemide (Lasix) and digoxin (Lanoxin) . The nurse determines that education about dietary needs with these medications has been effective when the client makes which selection for lunch?

MCMA A student is preparing to care for clients with heart failure. Which classifications of drugs are appropriate for the nurse to review before practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

The nurse is caring for a client being treated pharmacologically for heart failure. Which laboratory values is the nurse careful to monitor during treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.