Deck 26: Drugs for Heart Failure

Question 1

The patient receives digoxin (Lanoxin).Which assessment findings would indicate adverse effects to this medication?
1)Tachycardia and hypotension
2)Blurred vision and tachycardia
3)Anorexia and nausea
4)Anorexia and constipation

Answer 1

3

Question 2

The patient takes insulin for diabetes mellitus.The physician orders metoprolol (Lopressor)for hypertension.After medication teaching,the nurse determines that learning has occurred when the patient makes which statement?
1)"I might not need to check my blood sugars as often with metoprolol (Lopressor)."
2)"I might be able to change from insulin to a pill with metoprolol (Lopressor)."
3)"I might need less insulin when I take metoprolol (Lopressor)."
4)"I might need more insulin when I take metoprolol (Lopressor)."

Answer 2

3

Question 3

The patient comes to the emergency department complaining of coughing and difficulty breathing.The patient's diagnosis is heart failure.He asks the nurse how difficulty breathing could be a heart problem.What is the best response by the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"The right side of your heart has weakened and blood has entered your lungs."
2)"The right side of your heart has enlarged and cannot effectively pump blood."
3)"What you have is called congestive heart failure."
4)"The left side of your heart is weak and pumps blood too quickly."
5)"The left side of your heart has weakened and blood has entered your lungs."

Answer 3

3,5

Question 4

The nurse teaches the patient about lisinopril (Prinivil)and evaluates that additional teaching is required when the patient makes which statement?
1)"I will monitor my blood pressure until my next appointment."
2)"I will avoid using salt substitutes for seasoning."
3)"It takes a while for this medication to take effect."
4)"I don't need to worry about having blood tests done."

Question 5

The physician orders metoprolol (Toprol-XL)for several patients.The nurse will hold the medication and contact the physician for which patient?
1)The patient with an apical pulse rate of 100
2)The patient with compensated heart failure
3)The patient with chronic bronchitis
4)The patient with a history of migraines

Question 6

The patient has hypertension and asks the nurse how this can lead to heart failure.What is the best response by the nurse?
1)"Hypertension causes resistance in your blood vessels,or afterload;your heart works harder,and weakens."
2)"Hypertension limits the ability of your heart to stretch before emptying,or afterload;your heart works harder,and weakens."
3)"Hypertension causes resistance in your aorta,or afterload;your heart works harder and weakens."
4)"Hypertension limits the amount of blood entering your left ventricle,or afterload;your heart works harder,and weakens."

Question 7

The patient has a history of cardiac disease and receives digoxin (Lanoxin).The nurse determines that education about dietary needs with this medication has been effective when the patient makes which selection for lunch?
1)Cottage cheese,peach salad,and blueberry pie
2)Baked fish,sweet potatoes,and banana pudding
3)Green bean soup,whole-wheat bread,and an apple
4)Hamburger,French fries,and chocolate chip cookies

Question 8

The nurse volunteers at a senior citizen center.The nurse assesses which senior citizen as having the greatest risk of developing heart failure?
1)A 50-year-old black female who smokes
2)A 75-year-old white male who is overweight
3)A 69-year-old black male with hypertension
4)A 52-year-old white female with asthma

Question 9

The patient will receive an IV infusion of milrinone (Primacor)as treatment for acute heart failure.What is the priority plan by the nurse?
1)Plan to monitor for atrial fibrillation.
2)Plan to monitor the ECG continuously.
3)Plan to take vital signs every 15 minutes.
4)Plan to monitor for hypertension.

Question 10

The patient receives enalapril (Vasotec)as treatment for heart failure.What is the best nursing assessment following the initial administration of this drug?
1)Assess the patient for ototoxicity.
2)Assess the patient's blood pressure.
3)Assess the patient for an irregular pulse.
4)Assess the patient for a serious rash.

Question 11

Which of the following medications would be of most help to increase myocardial contractility in a patient with heart failure?
1)Digoxin (Lanoxin)
2)Lisinopril (Prinivil)
3)Carvedilol (Coreg)
4)Furosemide (Lasix)

Question 12

Which of the following would lead to an increase in cardiac output?
1)Reduced cardiac contractility
2)Hypovolemia
3)Peripheral vascular resistance
4)Increase in preload

Question 13

Which individual listed below would be at the greatest risk for developing heart disease?
1)35-year-old with diabetes mellitus and prehypertension
2)75-year-old with Parkinson's disease and normal blood pressure
3)52-year-old with osteoporosis and stage 1 hypertension
4)68-year-old with stage 2 hypertension and recent myocardial infarction

Question 14

Which of the following is the most serious adverse effect associated with milrinone (Primacor)?
1)Ventricular dysrhythmia
2)Nausea
3)Headache
4)Atrial dysrhythmia

Question 15

The patient receives furosemide (Lasix)and digoxin (Lanoxin)together.Which laboratory findings will the nurse assess as increasing the patient's risk for digoxin (Lanoxin)toxicity?
1)Hyponatremia and hyperkalemia
2)Hypermagnesemia and hyponatremia
3)Hypercalcemia and hyperkalemia
4)Hypokalemia and hypocalcemia

Question 16

Which vital sign is of greatest concern to the nurse prior to administering digoxin (Lanoxin)?
1)Heart rate
2)Temperature
3)Blood pressure
4)Respiratory rate

Question 17

Lisinopril (Prinivil)is often used to treat heart failure because it lowers blood volume.Which of the following best explains how lisinopril lowers blood volume?
1)It has an antagonistic effect on angiotensin-converting enzyme.
2)It lowers aldosterone secretion,a hormone that increases sodium reabsorption.
3)It causes hypernatremia and increased renal tubule permeability,resulting in a diuretic effect.
4)It causes a diuretic effect by lowering the amount of sodium lost in the urine.

Question 18

The patient receives captopril (Capoten)as treatment for heart failure.Which adverse effect will the nurse plan to report to the physician?
1)The patient develops a cough.
2)The patient develops diarrhea.
3)The patient develops dehydration.
4)The patient develops facial flushing.

Question 19

Which statement is accurate regarding the physiological changes associated with heart failure?
1)Blood backs up into the lungs due to right ventricular hypertrophy.
2)The walls of the heart shrink,leading to lower cardiac output.
3)Cardiac remodeling occurs after prolonged ventricular hypertrophy.
4)Blood pressure increases,resulting in lowered afterload.

Question 20

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

Question 21

The nurse is caring for a patient who is being treated pharmacologically for the symptoms of heart failure.What would be included in the nurse's role of pharmacologic management of this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Teaching the patient how to space medications to decrease adverse effects
2)Teaching the patient the long-term benefits of beta blockers
3)Continually monitoring the patient during IV infusions
4)Decreasing medication dosages when the patient complains of adverse effects
5)Changing a medication that is no longer working to decrease the patient's symptoms

Question 22

The nurse is educating a patient diagnosed with heart failure (HF).The nurse knows that instruction regarding compensatory mechanisms has been effective when the patient states, Credit will be given only if all correct choices and no incorrect choices are selected.
1)"My heart enlarged in order to compensate for the effects of heart failure."
2)"My nervous system kicks in to compensate for the effects of heart failure."
3)"My body will decrease blood flow to other organs in order to compensate for heart failure."
4)"My body will increase urine output in order to compensate for the effects of heart failure."
5)"My body will produce anti-inflammatory agents to compensate for heart failure."

Question 23

The nurse is caring for a patient who has been diagnosed with heart failure.The nurse knows that which conditions may have contributed to the development of heart failure in this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Uncontrolled hypertension
2)Coronary artery disease
3)Diabetes
4)HIV
5)Mitral stenosis

Question 24

The nurse is caring for a patient with heart failure.Which assessment findings indicate the patient is currently experiencing class 2 heart failure? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Fatigue with physical activity
2)Palpitations with physical activity
3)No symptoms with physical activity
4)Dyspnea with physical activity
5)Angina at rest

Question 25

The nurse is concerned that a patient is developing right heart failure.What did the nurse assess in this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Ankle edema
2)Enlarged liver
3)Displaced apical heart rate
4)Shortness of breath
5)Cough

Question 26

The nurse is caring for a patient being treated pharmacologically for heart failure.Which laboratory values is the nurse careful to monitor during treatment? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Potassium levels
2)BUN
3)Creatinine
4)Liver function tests
5)Serum drug levels