Question 1

A patient with heart failure reports a 5-lb weight gain during the past week and episodes of feeling more short of breath.What is the nurse's best response?&#10;A) &#34;These changes are to be expected because you have heart failure.&#34;&#10;B) &#34;You will probably need a decreased dose of your diuretic drug.&#34;&#10;C) &#34;I will ask the dietitian to discuss a weight loss diet with you.&#34;&#10;D) &#34;Your prescriber must be notified because your heart failure is getting worse.&#34;

Accepted Answer

Patient weight gain and increased shortness of breath are signs of worsening heart failure.The prescriber should be notified because the plan of care may need to be modified.If the patient is taking a diuretic,it is likely that the dose may be increased.

Question 2

A patient asks the nurse how a prescribed diuretic can help heart failure.What is the nurse's best response?&#10;A) &#34;Urinating more prevents heart failure from damaging your kidneys.&#34;&#10;B) &#34;Diuretics reduce blood pressure so your heart won't have to work as hard.&#34;&#10;C) &#34;Taking a diuretic reduces salt levels so you don't have to limit your intake of salty foods.&#34;&#10;D) &#34;The diuretic counteracts the side effects of the other drugs prescribed for your heart failure.&#34;

Accepted Answer

The actions of diuretic drugs help heart failure in several ways.They can relax blood vessels and lower blood pressure so that less effort is needed for the heart contraction to move blood into the general circulation.Removing extra fluid from the circulation also can reduce blood pressure.In addition,some diuretics work on the heart muscle itself.

Question 3

After giving the first dose of any antihypertensive drug for heart failure,what action must the nurse take for patient safety?&#10;A) Recheck the drug order for accuracy.&#10;B) Ensure that the call light is within reach.&#10;C) Place a wheelchair in the patient's room.&#10;D) Raise all four siderails on the patient's bed.

Accepted Answer

Antihypertensive drugs decrease blood pressure and increase a patient's risk for dizziness,light-headedness,and hypotension.After giving the first dose of any antihypertensive drug,the nurse should be sure that the call light is within easy reach and instruct the patient to call for assistance when getting out of bed.A wheelchair is not necessary and standards of practice state that the nurse should not raise all four siderails because there is a risk for falls if the patient tries to get out of bed alone.

Question 4

A patient taking lisinopril (Zestril)for heart failure reports a nagging,nonproductive cough.What is the nurse's best first action?&#10;A) Ask the patient whether he or she has received the annual influenza vaccination.&#10;B) Ask the patient how much the cough is interfering with sleep or other activities.&#10;C) Document the report as the only action.&#10;D) Notify the prescriber immediately.

Accepted Answer

Many conditions can cause a cough,but a dry,nonproductive cough is the most common side effect of lisinopril and all other ACE inhibitors.Coughs associated with pulmonary infections or worsening of heart failure are usually productive.After assessing the patient's issues with the cough,if the patient is uncomfortable or if the cough interferes with sleeping and other activities,report these problems to the prescriber.

Question 5

The nurse prepares to administer a drug for heart failure to a patient.Which assessment finding does the nurse report to the prescriber before administering the drug?&#10;A) Systolic blood pressure increase from 128 to 136&#10;B) Urine output of 2100 mL in 24 hours&#10;C) Weight gain of 1 pound in 3 days&#10;D) Heart rate of 54 beats per minute

Accepted Answer

Some drugs for heart failure also slow the heart rate.If the heart rate is slow before taking the drug,the drug can slow the heart rate so much that the patient cannot adequately perfuse and oxygenate his or her vital organs.Usually,if the heart rate is less than 60 beats per minute,the prescriber is notified.The next dose may be held until the pulse rate returns to normal.

Question 6

A patient with heart failure asks the nurse why the antihypertensive drug enalopril (Vasotec)has been prescribed.What is the nurse's best response?&#10;A) &#34;Hypertension is the most common cause of heart failure.&#34;&#10;B) &#34;Lowering your blood pressure will allow your heart to pump more easily.&#34;&#10;C) &#34;This drug will decrease the amount of blood your heart has to pump, leading to less work for you heart.&#34;&#10;D) &#34;Enalopril will cause your heart to reestablish its normal electrical functions so that it works more effectively as a pump.&#34;

Accepted Answer

Decreasing blood pressure helps improve the heart's action as a pump and decreases the heart's workload.Diuretics are used to decrease blood volume.Enalopril is an angiotensin-converting enzyme (ACE)inhibitor that interferes with the transition of angiotensin I to angiotensin II.Angiotensin II is a potent vasoconstrictor that causes increased blood pressure and increased workload for the heart.

Question 7

A patient is prescribed nitroglycerin ointment.What technique does the nurse use to avoid experiencing side effects from this drug?&#10;A) Squeezes the ointment onto the special paper&#10;B) Cleanses the skin before applying the drug&#10;C) Rotates the drug application skin sites&#10;D) Wears a pair of disposable gloves

Accepted Answer

Common side effects of nitroglycerin ointment include hypotension and headaches.When a nurse is administering this drug,if his or her skin comes into contact with this drug as it is squeezed onto the special lined paper,these side effects may develop.Wearing gloves prevents skin contact with the drug and the risk for side effects.

Question 8

Which safety precaution does the nurse teach a patient going home on any antihypertensive drug for heart failure?&#10;A) Always change positions slowly&#10;B) Never get up without assistance&#10;C) Take the drug in the evening before bedtime&#10;D) Avoid all over-the-counter drugs while taking this drug

Accepted Answer

Antihypertensive drugs lower blood pressure,placing the patient at increased risk for dizziness and hypotension.Changing positions slowly gives the body time to adjust,preventing dizziness and falls.The patient can get up at home without assistance if he or she changes positions slowly.Some,but not all,over-the-counter drugs may not be safe with these drugs.The nurse should teach the patient to always consult with the prescriber before taking an over-the-counter drug.

Question 9

When are vasodilator drugs usually prescribed for heart failure?&#10;A) When angiotensin-converting enzyme (ACE) inhibitors cannot be taken&#10;B) When venous dilation is also needed&#10;C) When beta blockers are also being taken&#10;D) When heart failure is improving

Accepted Answer

Vasodilators act directly on the peripheral arteries,causing them to dilate,which leads to decreased blood pressure and workload on the heart.When patients cannot take ACE inhibitors or angiotensin II receptor blockers,vasodilators are often prescribed.

Question 10

Which statement by a patient receiving nitroglycerin ointment indicates the need for additional teaching by the nurse?&#10;A) &#34;I will remove the previous dose before I put on the new dose.&#34;&#10;B) &#34;I will reapply the dose every 4 hours around the clock.&#34;&#10;C) &#34;I must avoid rubbing my skin when I put on a new dose.&#34;&#10;D) &#34;I will put tape over the paper so that the dose stays in place.&#34;

Accepted Answer

Nitroglycerin ointment or patches lose their effectiveness when used continuously.It works much better when there is a "drug free" time during a 24-hour period.Usually the drug is removed at night when the patient has his or her longest sleeping period because the heart is less stressed during that time.

Question 11

Which symptom is commonly assessed by the nurse when a patient has left ventricular heart failure?&#10;A) Weight gain&#10;B) Swelling in the legs&#10;C) Jugular vein distention&#10;D) Crackles in the lungs

Accepted Answer

The answer of Which symptom is commonly assessed by the...

Question 12

Which condition alerts the nurse to assess a patient for worsening heart failure?&#10;A) Blood pressure of 106/40 mm Hg&#10;B) Pounding headache&#10;C) Foul urine odor&#10;D) Ankle swelling

Accepted Answer

The answer of Which condition alerts the nurse to assess...

Question 13

Which two factors are most likely to result in improved cardiac output?&#10;A) Greater preload; greater afterload&#10;B) Greater preload; reduced afterload&#10;C) Reduced preload; greater afterload&#10;D) Reduced preload; reduced afterload

Accepted Answer

The answer of Which two factors are most likely to...

Question 14

What is the most common cause of heart failure?&#10;A) Cardiomyopathy&#10;B) Hypertension&#10;C) Myocardial infarction&#10;D) Substance abuse

Accepted Answer

The answer of What is the most common cause of...

Question 15

Why must the muscles of the left ventricle be the strongest ones in the heart?&#10;A) The mitral (bicuspid) valve is larger than the aortic valve.&#10;B) The left ventricle receives blood under high pressure from the pulmonary system.&#10;C) The pressure in the aorta is higher than the pressures elsewhere in the circulatory system.&#10;D) Blood in the left ventricle is oxygenated, making it thicker and harder to move than deoxygenated blood.

Accepted Answer

The answer of Why must the muscles of the left...

Question 16

A patient is prescribed isosorbide (Isordil).Which condition does the nurse teach the patient is an expected side effect of this drug?&#10;A) Frequent headaches&#10;B) Cold hands and feet&#10;C) Change in urine color&#10;D) Distaste for sweet foods or drinks

Accepted Answer

The answer of A patient is prescribed isosorbide (Isordil).Which condition...

Question 17

A patient with heart failure is prescribed oral captopril (Capoten)and carvedilol (Coreg).The heart rate after giving these drugs is decreased from 84 per minute to 68 per minute.What is the nurse's best action?

A) Hold the next dose
B) Immediately notify the prescriber
C) Document the finding as the only action
D) Schedule the captopril and carvedilol to be given at different times

Accepted Answer

The answer of A patient with heart failure is prescribed...

Question 18

Which precaution does the nurse stress when teaching a patient about a prescribed nitroglycerin transdermal patch?&#10;A) &#34;If a patch comes loose, tape it tightly to the skin with several layers of tape.&#34;&#10;B) &#34;Do not remove old patches, just let them fall off over time.&#34;&#10;C) &#34;Take care to apply the patches directly over your heart.&#34;&#10;D) &#34;Remove the old patch before applying the new patch.&#34;

Accepted Answer

The answer of Which precaution does the nurse stress when...

Question 19

Which statement made by a patient with heart failure indicates that more teaching is needed about the prescribed drug therapy?&#10;A) &#34;I always try to take my heart failure drugs at the same time each day.&#34;&#10;B) &#34;Now I am using a weekly pill dispenser to keep my drugs straight.&#34;&#10;C) &#34;Now that my heart failure is cured I can cut back the drugs I take.&#34;&#10;D) &#34;If I gain more than 3 pounds in a week I will call my doctor.&#34;

Accepted Answer

The answer of Which statement made by a patient with...

Question 20

A patient with heart failure is prescribed oral captopril (Capoten)and carvedilol (Coreg).The heart rate after giving these drugs is decreased from 84 per minute to 68 per minute.What is the nurse's best action?

A) Hold the next dose
B) Immediately notify the prescriber
C) Document the finding as the only action
D) Schedule the captopril and carvedilol to be given at different times

Accepted Answer

The answer of A patient with heart failure is prescribed...

Question 21

What does the nurse teach a patient who has been prescribed potassium (K-Dur)?&#10;A) &#34;If you miss a dose, double your next dose to keep your blood level of potassium normal.&#34;&#10;B) &#34;Take your potassium with food or a full glass or water to avoid nausea and vomiting.&#34;&#10;C) &#34;Be sure to use salt substitutes instead of salt so that your body will not retain water.&#34;&#10;D) &#34;Eat lots of foods that are high in potassium such as bananas, spinach, broccoli, and sweet potatoes.&#34;

Accepted Answer

The answer of What does the nurse teach a patient...

Question 22

Which vasodilator drug can be safely prescribed for a patient with heart failure during pregnancy?&#10;A) hydralazine (Apresoline)&#10;B) isosorbide (Isordil)&#10;C) minoxidil (Lonitin)&#10;D) nitroglycerin (Nitrostat)

Accepted Answer

The answer of Which vasodilator drug can be safely prescribed...

Question 23

Which are sympathetic nervous system compensatory mechanisms of the body for heart failure?&#10;A) Increased heart rate&#10;B) Decreased respiratory rate&#10;C) Increased contractility&#10;D) Decreased body temperature&#10;E) Increased cardiac output

Accepted Answer

The answer of Which are sympathetic nervous system compensatory mechanisms...

Question 24

A patient is being discharged with prescribed sublingual nitroglycerin.Which teaching points does the nurse include in the patient's care plan?&#10;A) Keep the tablet in place until it is dissolved.&#10;B) Swallow the tablet with a full glass of water.&#10;C) A tingling sensation means that the drug is potent.&#10;D) Do not eat anything until after the tablet is dissolved.&#10;E) Call your prescriber if chest pain persists after one tablet.

Accepted Answer

The answer of A patient is being discharged with prescribed...

Question 25

A patient taking digoxin (Lanoxin)has all of the following laboratory blood values.Which value does the nurse report to the prescriber before administering the next dose of digoxin? A) Sodium 133 mEq/L B) Potassium 2.8 mEq/L C) Blood urea nitrogen 9 mg/dL D) White blood cell count 11,000 cells/mm³

Accepted Answer

The answer of A patient taking digoxin (Lanoxin)has all of...

Question 26

A patient with heart failure asks the nurse why two diuretic drugs,furosemide (Lasix)and spironolactone (Aldactone),have been prescribed.What is the nurse's best response?&#10;A) &#34;Your prescriber wants you to lose fluids and that's why you are taking two diuretics.&#34;&#10;B) &#34;Each of these diuretics works in a different way to decrease workload on your heart.&#34;&#10;C) &#34;Using two diuretics will double the amount of fluid you lose to decrease the work your heart must do.&#34;&#10;D) &#34;Let me contact your prescriber because patients usually do not take two diuretics at the same time.&#34;

Accepted Answer

The answer of A patient with heart failure asks the...

Question 27

A patient is prescribed digoxin (Lanoxin)0.03 mg as a liquid dose.The drug on hand is digoxin 0.05 mg/mL.How many milliliters does the nurse give?&#10;_____ mL

Accepted Answer

The answer of A patient is prescribed digoxin (Lanoxin)0.03 mg...

Question 28

A patient is receiving magnesium by intravenous infusion.Which assessment finding indicates that the patient's blood magnesium level may be too high?&#10;A) Respirations are 10 per minute and shallow.&#10;B) Heart rate is 66 beats per minute and regular.&#10;C) The patient reports difficulty staying asleep.&#10;D) Hourly urine output is 30 mL.

Accepted Answer

The answer of A patient is receiving magnesium by intravenous...

Question 29

The nurse is creating a care plan for a patient with heart failure.Which lifestyle changes does the nurse include in the plan of care?&#10;A) Fluid restriction of 1000 mL per day&#10;B) Weight loss program&#10;C) Smoking cessation program&#10;D) Aerobic exercise program&#10;E) Low-salt, low-fat diet

Accepted Answer

The answer of The nurse is creating a care plan...

Question 30

A patient is to receive nesiritide (Natrecor).Which patient assessments does the nurse check before giving this drug?&#10;A) Heart rate&#10;B) Swallowing reflex&#10;C) IV line for patency&#10;D) Oral intake&#10;E) Respiratory rate factors

Accepted Answer

The answer of A patient is to receive nesiritide (Natrecor).Which...

Question 31

A patient receiving dobutamine (Dobutrex)at 180 mcg/minute is having all of the following physiologic responses.Which response indicates that the drip rate may be too high?&#10;A) Systolic blood pressure increase from 106 to 122 mm Hg&#10;B) Hourly urine output of 100 mL&#10;C) Facial flushing&#10;D) Chest pain

Accepted Answer

The answer of A patient receiving dobutamine (Dobutrex)at 180 mcg/minute...

Question 32

A patient with heart failure is prescribed oral captopril (Capoten)and carvedilol (Coreg).The heart rate after giving these drugs is decreased from 84 per minute to 68 per minute.What is the nurse's best action?

A) Hold the next dose
B) Immediately notify the prescriber
C) Document the finding as the only action
D) Schedule the captopril and carvedilol to be given at different times

Accepted Answer

The answer of A patient with heart failure is prescribed...

Question 33

A patient with heart failure is receiving dobutamine (Dobutrex)intravenously at home.Which sign or symptom does the home health nurse tell the patient to report?&#10;A) Burning or pain at the intravenous (IV) site&#10;B) Heart rate between 60 and 70 beats per minute&#10;C) Urine output of 1600 mL over 24 hours&#10;D) Brief episode of shortness of breath

Accepted Answer

The answer of A patient with heart failure is receiving...

Question 34

What is the most important action for the nurse to perform before administering a patient's daily dose of digoxin (Lanoxin)?&#10;A) Check the patient's apical pulse for a full 60 seconds.&#10;B) Assess the patient's dependent body areas for edema formation.&#10;C) Ask whether the patient has experienced any heart palpitations during the last 24 hours.&#10;D) Verify that the time of administration today is within one-half hour of the time the drug was administered yesterday.

Accepted Answer

The answer of What is the most important action for...

Question 35

A patient with heart failure is prescribed oral captopril (Capoten)and carvedilol (Coreg).The heart rate after giving these drugs is decreased from 84 per minute to 68 per minute.What is the nurse's best action?

A) Hold the next dose
B) Immediately notify the prescriber
C) Document the finding as the only action
D) Schedule the captopril and carvedilol to be given at different times

Accepted Answer

The answer of A patient with heart failure is prescribed...

Question 36

A patient asks the nurse how prescribed digoxin (Lanoxin)will help improve heart failure.What is the nurse's best response?&#10;A) &#34;It dilates your arteries and decreases your blood pressure.&#34;&#10;B) &#34;It directly perfuses your kidneys which decreases your fluid volume and blood pressure.&#34;&#10;C) &#34;It increases your heart rate which will result in improved cardiac output.&#34;&#10;D) &#34;It increases the force of heart contractions and slows down the heart rate to improve cardiac output.&#34;

Accepted Answer

The answer of A patient asks the nurse how prescribed...

Deck 14: Drugs for Heart Failure