Deck 38: Pharmacotherapy of Heart Failure

Question 1

A patient with heart failure reports that he is short of breath only when he climbs stairs or plays with his grandchildren.The nurse recognizes that according to the NYHA classification, this is considered:
1)Mild heart failure.
2)Severe heart failure.
3)Stage B heart failure.
4)Stage 2 heart failure.

Answer 1

4

Question 2

A physical assessment finding that the nurse would expect to be present in the client with left-sided heart failure is:
1)Lung congestion.
2)Jugular vein distension.
3)Peripheral edema.
4)Enlarged liver.

Answer 2

1

Question 3

As the nurse completes a medical history on a client admitted with heart failure, which of the following diseases should the nurse associate with heart failure?
1)Chronic obstructive pulmonary disease (COPD)
2)Myocardial infarction
3)Stroke
4)Epilepsy

Answer 3

2

Question 4

Which of the following assessment findings would the nurse expect in a client with right-sided congestive heart failure (CHF)as opposed to left-sided failure?
1)Orthopnea
2)Pedal edema
3)Pulmonary edema
4)Dyspnea

Question 5

The client receives digoxin (Lanoxin).Which assessment findings would indicate adverse effects to this medication?
1)Anorexia and nausea
2)Tachycardia and hypotension
3)Blurred vision and tachycardia
4)Anorexia and constipation

Question 6

A client admitted with heart failure overhears the physician discussing plans to "digitalize" him, and asks the nurse what this means.The nurse explains:
1)"You will be given a series of digoxin injections over the next few days."
2)"You are given twice the usual dose of digoxin every day until therapeutic results are seen."
3)"You will be given increasing doses of digoxin until you reach a toxic level, and then the drug will be stopped."
4)"The dose of digoxin gradually is increased until the heart tissue is saturated and symptoms of heart failure subside."

Question 7

A patient asks what the major difference between the between the New York Heart Association (NYHA)and American Heart Association/American College of Cardiologists (AHA/ACC)heart failure classification schemes is.The nurse should answer that:
1)The NYHA classifications omit asymptomatic patients.
2)The AHA/ACC classifications include extra classifications for the most severe patients.
3)The AHA/ACC classifications include patients who do not have heart failure, but are at risk.
4)There is no true difference between the classifications.

Question 8

The nurse administers isosorbide dinitrate (Isordil).What is the best instruction to give the client?
1)"Rinse your mouth thoroughly after the tablet has dissolved."
2)"Do not walk around until the tablet has dissolved."
3)"Rinse your mouth and brush your teeth before this medication."
4)"Take it with a glass of water."

Question 9

The client receives enalapril (Vasotec)as treatment for heart failure.What is the best nursing assessment following the initial administration of this drug?
1)Assess the client for ototoxicity.
2)Assess the client for a serious rash.
3)Assess the client's blood pressure.
4)Assess the client for an irregular pulse.

Question 10

The client has hypertension, and asks the nurse how this can lead to heart failure.What is the best response by the nurse?
1)"Hypertension causes resistance in your blood vessels, or afterload; your heart works harder, and weakens."
2)"Hypertension limits the amount of blood entering your left ventricle, or afterload; your heart works harder, and weakens."
3)"Hypertension limits the ability of your heart to stretch before emptying, or afterload; your heart works harder, and weakens."
4)"Hypertension causes resistance in your aorta, or afterload; your heart works harder and weakens."

Question 11

The client has heart failure, and receives digoxin (Lanoxin).Prior to discharge, what will the best teaching plan of the nurse include?
1)"If you miss a dose, take two doses."
2)"Report a weight gain of two or more pounds per day."
3)"Stop the medication if your pulse is 56."
4)"Report mental changes such as euphoria."

Question 12

The nurse teaches the client about digoxin (Lanoxin)toxicity and determines that learning has occurred when the client makes which statements? Select all that apply.
1)"I can drink orange juice every morning."
2)"If I have nausea, it means I must stop the medication."
3)"I must check my pulse, and not take the medication if it is less than 60."
4)"It is okay to keep taking my ginseng."
5)"I should limit my fluids while taking this medication."

Question 13

The nurse is educating a client with heart failure on monitoring for signs and symptoms.The nurse knows the teaching has been effective when the client responds:
1)"I should weigh myself every day."
2)"As long as I'm not short of breath, I don't have heart failure."
3)"My heart rate and blood pressure should high."
4)"If I sleep on three pillows, I will be fine."

Question 14

The nurse teaches the client about lisinopril (Prinivil), and evaluates that additional teaching is required when the client makes which statement?
1)"I will avoid using salt substitutes for seasoning."
2)"I will monitor my blood pressure until my next appointment."
3)"I don't need to worry about having blood tests done."
4)"It takes a while for this medication to take effect."

Question 15

The client with heart failure asks how is blood pressure and heart rate can be high if the heart is failing.The nurse responds:
1)"The blood pressure and heart rate are inaccurate readings."
2)"The heart must be recovering"
3)"The blood pressure and heart rate are trying to compensate because the heart cannot pump enough blood."
4)"The client must be excited."

Question 16

The client comes to the Emergency Department complaining of coughing and difficulty breathing.The client's diagnosis is heart failure.He asks the nurse how difficulty breathing could be a heart problem.What is the best response by the nurse? Select all that apply.
1)"The right side of your heart has weakened and blood has entered your lungs."
2)"The left side of your heart has weakened and blood has entered your lungs."
3)"What you have is called congestive heart failure."
4)"The right side of your heart has enlarged, and cannot effectively pump blood."
5)"The left side of your heart is weak, and pumps blood too quickly."

Question 17

The client has a history of cardiac disease, and receives digoxin (Lanoxin).The nurse determines that education about dietary needs with this medication has been effective when the client makes which selection for lunch?
1)Hamburger, French fries, and chocolate chip cookies
2)Green bean soup, whole-wheat bread, and an apple
3)Baked fish, sweet potatoes, and banana pudding
4)Cottage cheese-and-peach salad, and blueberry pie

Question 18

The client will receive an IV infusion of milrinone (Primacor)as treatment for acute heart failure.What is the priority plan of the nurse?
1)Plan to take vital signs every 15 minutes.
2)Plan to monitor the ECG continuously.
3)Plan to monitor for hypertension.
4)Plan to monitor for atrial fibrillation.

Question 19

The nurse is assessing a client.Which of the following findings is most concerning?
1)Diffuse wheezes
2)Capillary refill of 2 seconds
3)Mitral murmur
4)Clubbed nails