Question 1

A client in heart failure asks the nurse how difficulty breathing is related to a heart problem. Which information should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

"What you have is called congestive heart failure."
"The left side of your heart has weakened and blood has entered your lungs."

Accepted Answer

&#34;What you have is called congestive heart failure.&#34;&#10;&#34;The left side of your heart has weakened and blood has entered your lungs.&#34;&#10;

Question 2

Which adverse effect of lisinopril (Prinivil) should be reported to the healthcare provider?&#10;A) Cough&#10;B) Fever&#10;C) Increased urine output&#10;D) Facial flushing

Accepted Answer

Cough is a potential adverse effect of lisinopril that can be indicative of angioedema, a serious allergic reaction that can occur with ACE inhibitors. It is important to report this to the healthcare provider for evaluation and potential discontinuation of the medication. Fever, increased urine output, and facial flushing are common side effects of lisinopril that do not typically require medical attention unless severe or persistent.

Question 3

A client prescribed furosemide (Lasix) and digoxin (Lanoxin) reports using an over-the-counter antacid for recurrent heartburn. Based on this information, which effect should the nurse be concerned about?

A) Hyponatremia
B) Hypermagnesemia
C) Increased effectiveness of furosemide (Lanoxin)
D) Decreased effectiveness of digoxin (Lanoxin)

Decreased effectiveness of digoxin (Lanoxin)

Accepted Answer

The nurse should be concerned about the antacid decreasing the effectiveness of digoxin because antacids can decrease absorption of digoxin from the gastrointestinal tract. This can lead to lower blood levels of digoxin and reduced therapeutic effectiveness. The use of antacids can also interfere with the absorption of furosemide, but this is a lesser concern than the interaction with digoxin. Hyponatremia and hypermagnesemia are not directly related to the use of these medications and antacids.

Question 4

Which action of Lisinopril (Prinivil) results in a decrease in the blood volume?&#10;A) Antagonistic effect on angiotensin-converting enzyme.&#10;B) Decrease aldosterone secretion.&#10;C) Causes hypernatremia and increased renal tubule permeability resulting in a diuretic effect.&#10;D) Causes a diuretic effect by lowering the amount of sodium lost in the urine.

Accepted Answer

Lisinopril (Prinivil) inhibits the secretion of aldosterone, which results in decreased retention of sodium and water and therefore decreases blood volume.

Question 5

The nurse completes the dietary education for a client prescribed digoxin (Lanoxin). Which dietary choice indicates the client understood the teaching?&#10;A) Cottage cheese, peach salad, and blueberry pie&#10;B) Baked fish, sweet potatoes, and banana pudding&#10;C) Green bean soup, whole-wheat bread, and an apple&#10;D) Hamburger, French fries, and chocolate chip cookies

Accepted Answer

Baked fish and sweet potatoes are both high in potassium, which can help counteract the potential for hypokalemia (low potassium levels) from digoxin use. Banana pudding can also be a good choice, as bananas are a good source of potassium. Cottage cheese, blueberry pie, green bean soup, whole-wheat bread, and apples do not provide significant amounts of potassium and are not necessarily contraindicated, but do not demonstrate understanding of the dietary education related to digoxin. Hamburger, French fries, and chocolate chip cookies are high in sodium and/or fat and should be avoided or consumed in moderation when taking digoxin.

Question 6

Which factor increases cardiac output?&#10;A) Reduced cardiac contractility&#10;B) Hypovolemia&#10;C) Peripheral vascular resistance&#10;D) Increase in preload

Accepted Answer

Increase in preload (the volume of blood in the heart just before it contracts) leads to an increase in cardiac output. This is because the heart stretches more, which increases the force of its contraction, and thus, more blood is pumped out with each beat.

Question 7

Which statements made by a client indicates an understanding of the education provided by the nurse regarding digoxin (Lanoxin) toxicity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

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Accepted Answer

The answer of Which statements made by a client indicates...

Question 8

A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the client?&#10;A) &#34;Hypertension increases the resistance in the blood vessels causing the heart to work harder to pump the blood out against the resistance of the arteries.&#34;&#10;B) &#34;Hypertension limits the ability of the heart to stretch before emptying resulting in the heart working harder to pump the blood out into the arterial system.&#34;&#10;C) &#34;Hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood forward.&#34;&#10;D) &#34;Hypertension limits the amount of blood entering the left ventricle increasing the workload of the heart to pump an adequate amount of blood into the circulatory system.&#34;

Accepted Answer

Hypertension increases the resistance in the blood vessels causing the heart to work harder to pump the blood out against the resistance of the arteries. Over time, this increased workload can lead to heart failure.

Question 9

Which statement is accurate regarding the use of beta-adrenergic blockers for use in clients with heart failure?&#10;A) Higher doses are used initially until optimal vital signs are achieved.&#10;B) Dosage changes are done on a daily basis for the first 2 weeks.&#10;C) This drug class does not have an effect on the bronchioles of the lungs.&#10;D) They are generally used in combination with other heart-failure drugs.

Accepted Answer

Beta-adrenergic blockers are generally used in combination with other heart-failure drugs. They are not used at higher doses initially, and dosage changes are not typically done on a daily basis. While beta-blockers may have an effect on bronchioles in some patients, they are still considered safe and effective for most heart failure patients.

Question 10

A client is prescribed an intravenous infusion of milrinone (Primacor) for acute heart failure. Which is a priority nursing assessment during the infusion?&#10;A) Monitor for symptoms of atrial fibrillation&#10;B) Continuous ECG monitoring&#10;C) Vital signs every 15 minutes&#10;D) Monitor for hypertension

Accepted Answer

Milrinone can cause potential cardiac dysrhythmias such as ventricular ectopic beats and supraventricular tachycardia, which can be identified through continuous ECG monitoring. Vital signs should also be monitored, but continuous ECG monitoring is a higher priority. Monitoring for hypertension is also important, but it is not the highest priority during milrinone infusion. Monitoring for symptoms of atrial fibrillation is not specific enough and does not address the potential for other dysrhythmias that milrinone can cause.

Question 11

The nurse has provided education for a client with diabetes mellitus prescribed metoprolol (Lopressor) for hypertension. Which statement made by the client indicates an understanding of the information?

A) "I might not need to check my blood sugars as often with metoprolol (Lopressor)."
B) "I might be able to change from insulin to a pill with metoprolol (Lopressor)."
C) "I might need less insulin when I take metoprolol (Lopressor)."
D) "I might need more insulin when I take metoprolol (Lopressor)."

Accepted Answer

The answer of The nurse has provided education for a...

Question 12

Which classification of prescription should the nurse anticipate to be prescribed to a client newly diagnosed with chronic heart failure?&#10;A) Angiotensin-converting enzyme (ACE) inhibitor&#10;B) Beta-adrenergic blockers&#10;C) Cardiac glycosides&#10;D) Diuretics

Accepted Answer

The answer of Which classification of prescription should the nurse...

Question 13

Which information should the nurse include in the discharge plan for a client prescribed digoxin (Lanoxin)?&#10;A) &#34;Report the development of a metallic taste in the mouth.&#34;&#10;B) &#34;Report mental changes such as feelings of depression.&#34;&#10;C) &#34;Stop the prescription if your pulse is irregular.&#34;&#10;D) &#34;If you miss a dose, take two doses.&#34;

Accepted Answer

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

Question 14

The nurse has provided education for a client with diabetes mellitus prescribed metoprolol (Lopressor) for hypertension. Which statement made by the client indicates an understanding of the information?

A) "I might not need to check my blood sugars as often with metoprolol (Lopressor)."
B) "I might be able to change from insulin to a pill with metoprolol (Lopressor)."
C) "I might need less insulin when I take metoprolol (Lopressor)."
D) "I might need more insulin when I take metoprolol (Lopressor)."

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Accepted Answer

The answer of The nurse has provided education for a...

Question 15

Which should the nurse recognize are adverse effects associated with digoxin (Lanoxin)?&#10;A) Tachycardia and hypotension&#10;B) Blurred vision and tachycardia&#10;C) Anorexia and nausea&#10;D) Anorexia and constipation

Accepted Answer

The answer of Which should the nurse recognize are adverse...

Question 16

Which prescription should the nurse anticipate to increase the myocardial contractility for a client with heart failure?&#10;A) Digoxin (Lanoxin)&#10;B) Lisinopril (Prinivil)&#10;C) Carvedilol (Coreg)&#10;D) Furosemide (Lasix)

Accepted Answer

The answer of Which prescription should the nurse anticipate to...

Question 17

Which client prescribed metoprolol (Toprol-XL) is most at risk for adverse effects?&#10;A) The client with an apical pulse rate of 100&#10;B) The client with compensated heart failure&#10;C) The client with chronic bronchitis&#10;D) The client with a history of migraines

Accepted Answer

The answer of Which client prescribed metoprolol (Toprol-XL) is most...

Question 18

Which client has the greatest risk for developing heart disease?&#10;A) A 35-year-old with diabetes mellitus and prehypertension&#10;B) A 75-year-old with Parkinson's disease and normal blood pressure&#10;C) A 52-year-old with osteoporosis and stage 1 hypertension&#10;D) A 68-year-old with stage 2 hypertension and recent myocardial infarction

Accepted Answer

The answer of Which client has the greatest risk for...

Question 19

Which client is at greatest risk for developing heart failure?&#10;A) A 50-year-old African American female who smokes&#10;B) A 75-year-old Caucasian male who is overweight&#10;C) A 69-year-old African American male with hypertension&#10;D) A 52-year-old Caucasian female with asthma

Accepted Answer

The answer of Which client is at greatest risk for...

Question 20

Which statement is accurate regarding the physiological changes associated with heart failure?&#10;A) Blood backs up into the lungs due to right ventricular hypertrophy.&#10;B) The walls of the heart shrink, leading to lower cardiac output.&#10;C) Cardiac remodeling occurs after prolonged ventricular hypertrophy.&#10;D) Blood pressure increases, resulting in lowered afterload.

Accepted Answer

The answer of Which statement is accurate regarding the physiological...

Question 21

Which should the nurse anticipate to be included in the treatment plan for a client with stage A heart failure?&#10;A) Angiotensin-converting enzyme (ACE) inhibitor&#10;B) Lifestyle modifications&#10;C) Beta-blocker&#10;D) Cardiac glycoside

Accepted Answer

The answer of Which should the nurse anticipate to be...

Question 22

Which classifications of prescriptions are used to increase cardiac output by increasing the force of myocardial contractions? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Angiotensin receptor blockers
B) Cardiac glycosides
C) Adrenergic blockers
D) Phosphodiesterase inhibitors
E) Angiotensin-converting enzyme inhibitor

Accepted Answer

The answer of Which classifications of prescriptions are used to...

Question 23

Which conditions contribute to heart failure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.&#10;A) Uncontrolled hypertension&#10;B) Coronary artery disease (CAD)&#10;C) Diabetes (DM)&#10;D) HIV&#10;E) Mitral stenosis

Accepted Answer

The answer of Which conditions contribute to heart failure? Note:...

Question 24

Which vital sign is of the greatest concern to the nurse prior to administering digoxin (Lanoxin)?&#10;A) Apical pulse&#10;B) Temperature&#10;C) Blood pressure&#10;D) Respiratory rate

Accepted Answer

The answer of Which vital sign is of the greatest...

Question 25

Which statements made by the client indicate an understanding of the compensatory mechanisms associated with heart failure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. 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."

Accepted Answer

The answer of Which statements made by the client indicate...

Question 26

Which is the most serious adverse effect associated with milrinone (Primacor)?&#10;A) Ventricular dysrhythmia&#10;B) Nausea&#10;C) Headache&#10;D) Atrial dysrhythmia

Accepted Answer

The answer of Which is the most serious adverse effect...

Question 27

Which findings should the nurse anticipate when assessing a client developing right-sided heart failure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Ankle edema
B) Enlarged liver
C) Displaced apical heart rate
D) Shortness of breath
E) Coughing

Accepted Answer

The answer of Which findings should the nurse anticipate when...

Question 28

Which statement made by the client indicates an understanding of self-care while taking prescriptions to treat their heart failure?&#10;A) &#34;I will cut back on my smoking.&#34;&#10;B) &#34;I will check my pulse every few days.&#34;&#10;C) &#34;I will schedule my lab work if I am not feeling well.&#34;&#10;D) &#34;I will weigh myself every day in the morning after I wake up.&#34;

Accepted Answer

The answer of Which statement made by the client indicates...

Question 29

Which describes the action of vasodilators in the relief of symptoms of heart failure?&#10;A) Decrease afterload&#10;B) Reduce preload&#10;C) Improve cardiac contractility&#10;D) Reduce fluid overload

Accepted Answer

The answer of Which describes the action of vasodilators in...

Question 30

Which laboratory values should the nurse assess for the client receiving lisinopril (Prinivil)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Uric acid
B) Blood urea nitrogen (BUN)
C) Serum bilirubin
D) ALT/AST
E) Serum drug levels

Accepted Answer

The answer of Which laboratory values should the nurse assess...

Deck 27: Drugs for Heart Failure