Deck 28: Drugs Used to Treat Heart Failure

Question 1

Which is the initial manifestation of digoxin toxicity in children?

A) Hallucinations
B) Weakness
C) Atrial dysrhythmia
D) Diuresis

Answer 1

Atrial dysrhythmia

Question 2

Before administering digoxin (Lanoxin), the nurse takes the adult patient's apical pulse for 1 full minute. What additional nursing considerations will be taken before administration of the medication? (Select all that apply.)

A) Review of the digoxin blood level
B) Administration of the medication with pulse less than 60 beats/min
C) Review of serum electrolytes, liver, and kidney function studies
D) Administration of the medication with a pulse of 110 beats/min
E) Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

Answer 2

Review of the digoxin blood level
Review of serum electrolytes, liver, and kidney function studies
Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

Question 3

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI). Which symptoms would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.)

A) Reports of recent weight loss
B) Complaints of peripheral edema
C) Diminished exercise tolerance
D) Shortness of breath with activity
E) Blood pressure elevation

Answer 3

Diminished exercise tolerance
Shortness of breath with activity

Question 4

Which drug is used to obtain vasodilation in the treatment of chronic heart failure?

A) ACTH
B) ACE inhibitors
C) ARBs
D) ANB agents

Question 5

Which action of ACE inhibitors results in effective treatment of heart failure?

A) Increased afterload
B) Increased aldosterone
C) Increased preload
D) Increased cardiac output

Question 6

Which nursing assessment is most important to determine fluid status for a patient with heart failure?

A) Auscultation of lungs
B) Daily weights
C) Intake and output
D) Measurement of abdominal girth

Question 7

Which actions will the nurse take when caring for a patient with heart failure? (Select all that apply.)

A) Administer diuretics at bedtime.
B) Assess electrolyte levels.
C) Report daily weight fluctuations.
D) Encourage sodium intake.
E) Maintain skin hygiene.

Question 8

Which contributing factors to heart failure are modifiable? (Select all that apply.)

A) Hypertension
B) Addiction to smoking
C) Genetic history
D) Exercise tolerance
E) Age

Question 9

A patient with heart failure has been prescribed nesiritide (Natrecor). Which statements are true regarding this medication? (Select all that apply.)

A) It increases preload.
B) Cardiac ventricles secrete this hormone in response to fluid overload.
C) It suppresses aldosterone.
D) It promotes norepinephrine secretion.
E) It causes vasodilation.

Question 10

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?

A) "Report nausea and vomiting to your health care provider."
B) "Decrease the amount of high-potassium foods you eat."
C) "Omit your dose of digoxin if your pulse is 60."
D) "Visual disturbances are common adverse effects."

Question 11

Which are true statements about vasodilators? (Select all that apply.)

A) They reduce systemic vascular resistance.
B) They increase afterload.
C) They reduce preload.
D) They decrease pulmonary congestion.
E) They increase tissue perfusion to muscles and organs.
F) They increase the volume of blood returning to the heart.

Question 12

The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?

A) Potassium supplements
B) Furosemide (Lasix)
C) Acetylsalicylic acid (aspirin)
D) Antibiotics

Question 13

The nurse is caring for a 3-year-old girl who has a congenital heart anomaly. The patient's current medications include digoxin and furosemide (Lasix). The apical pulse rate is 100 beats/min. Which action will the nurse take?

A) Administer the medication.
B) Contact the pediatric cardiologist for further orders.
C) Hold the digoxin.
D) Request that another unit nurse assess the child.

Question 14

The nurse is to administer digoxin to an 18-month-old patient who weighs 16.5 lb. Guidelines for administration read as follows: 0.0075 mg to 0.010 mg/kg/day. Which is a safe medication dosage?

A) 0.05 mg
B) 0.12 mg
C)0.074 mg
D) 0.75 mg

Question 15

The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?

A) "This medication dilates your coronary arteries."
B) "This medication will help your kidneys get rid of fluid."
C) "This medication reduces volume returning to your heart so it doesn't overstretch."
D) "This medication reduces the resistance your heart has to pump against."

Question 16

Which action will the nurse implement while providing care to a patient with heart failure?

A) Encourage fluid intake of 2 L/day.
B) Ambulate the patient within 1 hour after eating.
C) Maintain the patient in the supine position.
D) Weigh the patient daily.

Question 17

Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?

A) Inotropic
B) Chronotropic
C) Isotonic
D) Isopropyl

Question 18

Which drug will be administered to a patient being admitted with severe digoxin intoxication?

A) Amiodarone (Cordarone)
B) Spironolactone (Aldactone)
C) Digoxin immune Fab (Digibind)
D) Digitalis glycoside

Question 19

An older adult male patient with long-term heart failure has presented for an office visit. The nurse obtains information that he has recently begun taking St. John's wort. What results with the use of this herbal supplement?

A) Digoxin toxicity
B) Altered potassium electrolyte balance
C) Reduced therapeutic benefits of digoxin
D) Enhanced digoxin effectiveness without producing toxicity