Question 1

When planning care for a patient with heart failure, which concept should the nurse keep in mind?&#10;A) The sympathetic nervous system is activated when cardiac output drops.&#10;B) The renin-angiotensin-aldosterone system is inhibited when cardiac output drops.&#10;C) Heart muscle demonstrates excessive contractility.&#10;D) Inflammatory mediators inhibit heart muscle repair and remodeling.

Accepted Answer

When cardiac output drops in heart failure, the sympathetic nervous system is activated to increase heart rate and contractility to compensate for decreased cardiac output.

Question 2

When assessing a patient with heart failure affecting only the left ventricle, the nurse would expect which of the following conditions?&#10;A) Systemic venous congestion&#10;B) Elevated jugular venous pressure&#10;C) Peripheral edema&#10;D) Pulmonary venous congestion

Accepted Answer

Left ventricular heart failure leads to pulmonary venous congestion due to the backup of blood into the lungs, as the left ventricle is unable to effectively pump blood out to the systemic circulation.

Question 3

Which of the following is the best response given to a patient by the nurse when a patient with heart failure asks for an explanation of his ejection fraction?&#10;A) &#34;It is the amount of blood pumped from the heart with each beat.&#34;&#10;B) &#34;It is the percentage of blood pumped by the heart with each beat.&#34;&#10;C) &#34;It is the amount of blood the heart pumps each minute.&#34;&#10;D) &#34;It is the amount of blood the heart pumps each minute divided by the body surface area.&#34;

Accepted Answer

The ejection fraction is defined as the percentage of blood that is pumped out of the heart's ventricles with each contraction or heartbeat.

Question 4

When assessing the patient with high-output heart failure, the nurse is most likely to find:&#10;A) vasoconstriction and hypotension.&#10;B) vasoconstriction and hypertension.&#10;C) vasodilation and hypotension.&#10;D) vasodilation and hypertension.

Accepted Answer

High-output heart failure is characterized by vasodilation and hypotension due to the body's inability to meet the increased metabolic demands despite increased cardiac output.

Question 5

Which statement by a patient with chronic heart failure indicates to the nurse that more teaching is needed?&#10;A) &#34;The disease will be marked by periods of exacerbations.&#34;&#10;B) &#34;I will need to make lifestyle modifications to control the disease.&#34;&#10;C) &#34;If I follow strict self-care, I can cure the disease.&#34;&#10;D) &#34;Any type of stress can cause a worsening of the disease.&#34;

Accepted Answer

Chronic heart failure is a long-term condition that cannot be cured, but it can be managed with lifestyle changes and medical treatment.

Question 6

A patient with heart failure reports some shortness of breathing with activity, such as cleaning the house or grocery shopping, but no shortness of breath at rest. According to the New York Heart Association staging system, the nurse would classify this patient as:

A) Class I.
B) Class II.
C) Class III.
D) Class IV.

Accepted Answer

Class II heart failure is characterized by slight limitation of physical activity, where the patient is comfortable at rest but experiences symptoms with ordinary physical activity.

Question 7

A patient with heart failure reports some shortness of breathing with activity, such as cleaning the house or grocery shopping, but no shortness of breath at rest. According to the American College of Cardiology (ACC)/American Heart Association (AHA) staging, the nurse would classify this patient as:

A) Stage A.
B) Stage B.
C) Stage C.
D) Stage D.

Accepted Answer

Stage C heart failure according to the ACC/AHA classification involves patients who have current or prior symptoms of heart failure associated with underlying structural heart disease. The symptoms described, such as shortness of breath with activity, align with Stage C.

Question 8

When caring for a patient with heart failure, which concept about cardiac output should the nurse keep in mind?&#10;A) A faster heart rate increases the cardiac output.&#10;B) A slower heart rate increases cardiac output.&#10;C) Preload is the volume of blood in the ventricle after contraction.&#10;D) Afterload is the pressure of the heart during ventricular filling.

Accepted Answer

A faster heart rate can increase cardiac output because cardiac output is the product of heart rate and stroke volume. However, if the heart rate is too fast, it can decrease filling time and reduce stroke volume, potentially decreasing cardiac output.

Question 9

Which action would the intensive care nurse take to measure the preload of a patient with heart failure?&#10;A) Take the patient's blood pressure.&#10;B) Calculate the mean arterial pressure.&#10;C) Measure the pulmonary artery pressure.&#10;D) Calculate the systemic vascular resistance.

Accepted Answer

Measuring the pulmonary artery pressure provides an estimate of the preload, as it reflects the pressure in the left atrium and left ventricle during diastole, which is related to the volume of blood returning to the heart.

Question 10

Which data in a patient undergoing pulmonary heart catheterization confirms a diagnosis of systolic heart failure?&#10;A) Decreased right atrial pressure&#10;B) Elevated pulmonary artery wedge pressure&#10;C) Increased cardiac index&#10;D) Decreased pulmonary artery pressure

Accepted Answer

Elevated pulmonary artery wedge pressure indicates increased left atrial pressure, which is consistent with systolic heart failure due to impaired left ventricular function.

Question 11

Which information should the nurse include in a teaching care plan for a patient with systolic heart failure?&#10;A) Monitor weight once a week.&#10;B) Restrict salt intake.&#10;C) Ensure sufficient bedrest.&#10;D) Drink plenty of fluids with meals.

Accepted Answer

The answer of Which information should the nurse include in...

Question 12

Which statement made by a patient with a biventricular pacemaker indicates that more teaching is needed?&#10;A) &#34;My right ventricle contracts at the same time as the left ventricle.&#34;&#10;B) &#34;This type of pacemaker mimics normal cardiac function.&#34;&#10;C) &#34;Biventricular pacing decreases regurgitation of my mitral valve.&#34;&#10;D) &#34;This pacemaker can deliver a shock if I develop a life-threatening heart rhythm.&#34;

Accepted Answer

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

Question 13

Which finding would the nurse expect when assessing a patient with diastolic heart failure?&#10;A) Lack of peripheral edema&#10;B) Dyspnea at rest&#10;C) Normal ejection fraction&#10;D) Increased urinary output

Accepted Answer

The answer of Which finding would the nurse expect when...

Question 14

When assessing a patient, which finding by the nurse would support a diagnosis of left-sided heart failure?&#10;A) Hepatic engorgement&#10;B) Nausea and vomiting&#10;C) Elevated jugular venous pressure&#10;D) Paroxysmal nocturnal dyspnea

Accepted Answer

The answer of When assessing a patient, which finding by...

Question 15

Which first-line medication would the nurse anticipate being in the plan of care for a patient with systolic heart failure to reduce vasoconstriction and afterload?&#10;A) Diuretics&#10;B) Nitrates&#10;C) Beta blocker&#10;D) ACE inhibitor

Accepted Answer

The answer of Which first-line medication would the nurse anticipate...

Question 16

Which manifestation does the nurse expect a patient to exhibit in high-output heart failure?&#10;A) Cool skin&#10;B) Strong peripheral pulses&#10;C) Flat neck veins&#10;D) Dry, scaly skin

Accepted Answer

The answer of Which manifestation does the nurse expect a...

Question 17

Which of the following medications would the nurse anticipate administering to a patient with systolic heart failure to reduce fluid volume and relieve congestion?&#10;A) Diuretics&#10;B) Inotropes&#10;C) Nitrates&#10;D) Beta blockers

Accepted Answer

The answer of Which of the following medications would the...

Question 18

What response should the nurse give when a patient with heart failure asks what the physician meant by saying his left ventricular assist device (LVAD) was destination therapy?&#10;A) &#34;Your LVAD will support your heart until a heart is available for transplant.&#34;&#10;B) &#34;Your LVAD will support your heart because you are not a candidate for heart transplant.&#34;&#10;C) &#34;Your LVAD will allow your heart to rest and recover.&#34;&#10;D) &#34;Your LVAD takes the place of your heart.&#34;

Accepted Answer

The answer of What response should the nurse give when...

Question 19

When caring for a patient who has advanced from stage C to stage D of the American College of Cardiology (ACC)/American Heart Association (AHA) heart failure classification system, the nurse instructs the patient and family that this stage includes the addition of:

A) lifestyle modification and management of underlying disorder.
B) ACE inhibitors, angiotensin receptor blockers (ARBs), blood pressure control, or beta blockers.
C) diuretics, aldosterone blockers, or vasodilators.
D) interventional therapy with left ventricular assist device or heart transplantation.

Accepted Answer

The answer of When caring for a patient who has...

Question 20

To effectively care for patients with heart disease, the staff development nurse is teaching new nurses hired for the intensive care unit about the Frank-Starling law. Which concept will the instructor teach?

A) Increasing preload causes an increase in left ventricular contractility.
B) Increasing preload causes a decrease in left ventricular contractility.
C) Increasing afterload causes a decrease in left ventricular contractility.
D) Increasing afterload causes an increase in left ventricular contractility.

Accepted Answer

The answer of To effectively care for patients with heart...

Deck 26: Heart Failure