Deck 36: Pharmacotherapy of Heart Failure

Question 1

Which physical assessment finding does the nurse would expect in a client with left-sided heart failure?

A)Enlarged liver
B)Lung congestion
C)Jugular vein distension
D)Peripheral edema

Answer 1

Lung congestion

Question 2

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

A)"Do not walk around until the tablet has dissolved."
B)"Rinse your mouth thoroughly after the tablet has dissolved."
C)"Take it with a glass of water."
D)"Rinse your mouth and brush your teeth before taking this medication."

Answer 2

"Take it with a glass of water."

Question 3

Which assessment finding would the nurse expect in a client with right-sided congestive heart failure (CHF)as opposed to left-sided failure?

A)Orthopnea
B)Pulmonary edema
C)Dyspnea
D)Peripheral edema

Answer 3

Peripheral edema

Question 4

The nurse is educating a client diagnosed with heart failure (HF).Which statements made by the client indicate the teaching was effective regarding compensatory mechanisms? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"My heart enlarged in order to compensate for the effects of heart failure."
B)"My nervous system kicks in to compensate for the effects of heart failure."
C)"My body will decrease blood flow to other organs in order to compensate for heart failure."
D)"My body will increase urine output in order to compensate for the effects of heart failure."
E)"My body will produce anti-inflammatory agents to compensate for heart failure."

Question 5

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

A)"If you miss a dose,take two doses."
B)"Report mental changes such as euphoria."
C)"Stop the medication if your pulse is 56."
D)"Report a weight gain of two or more pounds per day."

Question 6

The nurse is caring for a client with heart failure.Which assessment findings indicate the client is currently experiencing stage 2 heart failure? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Fatigue with physical activity
B)Palpitations with physical activity
C)No symptoms with physical activity
D)Dyspnea with physical activity
E)Angina at rest

Question 7

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?

A)Cottage-cheese-and-peach salad and blueberry pie
B)Baked fish,sweet potatoes,and banana pudding
C)Green bean soup,whole-wheat bread,and an apple
D)Hamburger,french fries,and chocolate chip cookies

Question 8

The nurse is assessing a client with heart failure.Which finding is of greatest concern?

A)Mitral murmur
B)Diffuse wheezes
C)Capillary refill of 2 seconds
D)Clubbed nails

Question 9

A client asks about the difference between the New York Heart Association (NYHA)and American Heart Association/American College of Cardiologists (AHA/ACC)heart failure classification models.Which response by the nurse is the most appropriate?

A)"The NYHA classifications omit asymptomatic clients."
B)"The AHA/ACC model includes extra classifications for the most severe cases.'
C)"There is no true difference between the classifications."
D)"The AHA/ACC classifications include clients who do not have,but are at risk for,heart failure."

Question 10

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.

A)"It is okay to keep taking my ginseng."
B)"I can drink orange juice every morning."
C)"If I have nausea I will notify my health care provider."
D)"I must check my pulse,and not take the medication if it is less than 60."
E)"I should limit my fluids while taking this medication."

Question 11

A client has hypertension and asks the nurse how this condition can lead to heart failure.Which is the best response by the nurse?

A)"Hypertension limits the ability of your heart to stretch before emptying,or afterload; your heart works harder and weakens."
B)"Hypertension causes resistance in your aorta,or afterload; your heart works harder and weakens."
C)"Hypertension causes resistance in your blood vessels,or afterload; your heart works harder and weakens."
D)"Hypertension limits the amount of blood entering your left ventricle,or afterload; your heart works harder and weakens."

Question 12

The nurse is educating a client with heart failure on monitoring for signs and symptoms.Which statement by the client indicates appropriate understanding of the teaching session?

A)"I should weigh myself every day."
B)"As long as I'm not short of breath,I don't have heart failure."
C)"If I sleep on three pillows,I will be fine."
D)"My heart rate and blood pressure would be high."

Question 13

A client diagnosed with heart failure reports shortness of breath only when climbing stairs or playing with grandchildren.According to the NYHA classification,the nurse documents which stage of heart failure for this client?

A)Stage B heart failure
B)Severe heart failure
C)Stage 2 heart failure
D)Mild heart failure

Question 14

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

A)"It takes a while for this medication to take effect."
B)"I don't need to worry about having blood tests done."
C)"I will avoid using salt substitutes for seasoning."
D)"I will monitor my blood pressure until my next appointment."

Question 15

As the nurse completes a medical history on a client admitted with heart failure,which disease should the nurse associate with heart failure?

A)Chronic obstructive pulmonary disease (COPD)
B)Stroke
C)Epilepsy
D)Myocardial infarction

Question 16

The nurse is caring for a client who is diagnosed with heart failure.The nurse knows that which conditions may have contributed to the development of heart failure in this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Uncontrolled hypertension
B)Coronary artery disease
C)Diabetes
D)HIV
E)Mitral stenosis

Question 17

The nurse is caring for a client who is being treated pharmacologically for the symptoms of heart failure.Which interventions would be included in the nurse's role of pharmacologic management of this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Teaching the client how to space medications to decrease adverse effects
B)Teaching the client the long-term benefits of beta blockers
C)Continually monitoring the client during IV infusions
D)Decreasing medication dosages when the client complains of adverse effects
E)Changing a medication that is no longer working to decrease the client's symptoms

Question 18

A client comes to the emergency department complaining of coughing and difficulty breathing.The diagnosis is heart failure.The client asks the nurse how difficulty breathing could be a heart problem.Which response by the nurse is the most appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"The right side of your heart has enlarged,and cannot effectively pump blood."
B)"What you have is called congestive heart failure."
C)"The left side of your heart is weak,and pumps blood too quickly."
D)"The right side of your heart has weakened and blood has entered your lungs."
E)"The left side of your heart has weakened and blood has entered your lungs."

Question 19

A client with heart failure asks how blood pressure and heart rate can be high if the heart is failing.Which response by the nurse is the most appropriate?

A)"The heart must be recovering."
B)"The blood pressure and heart rate are trying to compensate because the heart cannot pump enough blood."
C)"The blood pressure and heart rate are inaccurate readings."
D)"The client must be excited."

Question 20

The client is prescribed an IV infusion of milrinone (Primacor)for the treatment acute heart failure.What is the priority plan of the nurse?

A)Monitor the ECG continuously.
B)Monitor for hypertension.
C)Take vital signs every 15 minutes.
D)Monitor for atrial fibrillation.

Question 21

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?

A)"The dose of digoxin gradually is increased until the heart tissue is saturated and symptoms of heart failure subside."
B)"You will be given a series of digoxin injections over the next few days."
C)"You will be given increasing doses of digoxin until you reach a toxic level,and then the drug will be stopped."
D)"You are given twice the usual dose of digoxin every day until therapeutic results are seen."

Question 22

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

A)Assess the client for an irregular pulse.
B)Assess the client's blood pressure.
C)Assess the client for ototoxicity.
D)Assess the client for a serious rash.

Question 23

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

A)Anorexia and constipation
B)Tachycardia and hypotension
C)Anorexia and nausea
D)Blurred vision and tachycardia

Question 24

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.

A)Potassium levels
B)BUN
C)Creatinine
D)Liver function tests
E)Serum drug levels