Question 1

One of the three types of HF involves systolic dysfunction. Potential causes of this most common form of HF include:

Accepted Answer

Systolic dysfunction in heart failure is often caused by myocardial ischemia and injury, such as that which occurs after a myocardial infarction (MI), leading to impaired contraction of the heart muscle.

Question 2

Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure (HF) because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes that take place in HF is NOT addressed by ACE inhibitors?

Accepted Answer

C

Question 3

Which of the following classes of drugs is contraindicated in HF?

Accepted Answer

Calcium channel blockers, particularly the non-dihydropyridine class, are generally contraindicated in heart failure due to their negative inotropic effects, which can worsen heart failure symptoms.

Question 4

What assessment that can be done at home is the most reliable to use for making decisions to change HF medications?

Accepted Answer

Monitoring weight at home is crucial for heart failure patients as sudden weight gain can indicate fluid retention, suggesting the need for medication adjustment.

Question 5

HF is a leading cause of death and hospitalization in older adults (greater than 65 years old). The drug of choice for this population is:

Accepted Answer

ACE inhibitors are a cornerstone in the management of heart failure (HF), particularly in older adults, due to their proven benefits in reducing mortality, morbidity, and hospitalization rates.

Question 6

Class I recommendations for stage A HF include:

Accepted Answer

Treatment of thyroid disorders, especially if they are associated with tachyarrhythmias, is a Class I recommendation for stage A HF.

Question 7

Treatments for HF, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:

Accepted Answer

Stage A treatment focuses on managing risk factors, including hypertension and hyperlipidemia, to prevent heart failure from developing.

Question 8

HF patients frequently take more than one drug. When are anticoagulants typically used?

Accepted Answer

Anticoagulants are typically used in heart failure patients when there is concurrent atrial fibrillation (AFib) because AFib increases the risk of forming blood clots, which can lead to strokes.

Question 9

Stage B patients should have nonselective beta blockers added to their HF treatment regimen when:

Accepted Answer

Nonselective beta blockers are recommended for patients with heart failure (HF) who have an ejection fraction less than 40% and for those who have had a recent myocardial infarction (MI), as they have been shown to improve survival and reduce morbidity in these populations.

Question 10

What can chest x-rays contribute to the diagnosis and management of HF?

Accepted Answer

Chest x-rays can provide an idea of general cardiac size and pulmonary great vessel distribution, which can be helpful in assessing heart failure.

Question 11

Digoxin has a very limited role in treatment of HF. It is used mainly for patients with:

Accepted Answer

Digoxin is primarily used in heart failure patients who have symptoms despite optimal treatment with other medications, and it is particularly useful in patients with an audible S3, which indicates systolic dysfunction. It is not specifically indicated based on ejection fraction levels, primary cause of heart failure like mitral stenosis, or renal insufficiency status.

Question 12

The American Heart Association (AHA) and the American College of Cardiology (ACC) have devised a classification system for HF that can be used to direct treatment. Patients with symptoms and underlying disease are classified as stage:

Accepted Answer

Stage C of the American Heart Association (AHA) and the American College of Cardiology (ACC) classification system for heart failure (HF) includes patients who have been diagnosed with heart failure and have current or prior symptoms of HF, indicating underlying heart disease.

Question 13

Evidence is strong that HF interventions are best initiated when:

Accepted Answer

HF (Heart Failure) interventions are most effective when initiated at the earliest indication of the condition. Early intervention can help manage symptoms, slow disease progression, and improve quality of life.

Question 14

Stage C patients usually require a combination of three to four drugs to manage their HF. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true?

Accepted Answer

Diuretics from the potassium-sparing class can lead to hyperkalemia, especially when used with an angiotensin receptor blocker (ARB), as both can increase potassium levels. This combination should be used with caution, not as a general recommendation.

Question 15

In the later part of the 20^th century, increased life expectancy for patients with HF has been associated with the use of:

Accepted Answer

ACE inhibitors have been shown to improve survival in patients with heart failure (HF) when started early in the disease process. They work by blocking the angiotensin-converting enzyme, which leads to a decrease in blood pressure and a reduction in the workload on the heart.

Question 16

ACE inhibitors are contraindicated in pregnancy. While treatment of HF during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?

Accepted Answer

Beta blockers are considered to be safe for use in the later parts of pregnancy for the treatment of heart failure, under the guidance of a specialist.

Question 17

ACE inhibitors are a foundational medication in HF. Which group of patients cannot take them safely?

Accepted Answer

ACE inhibitors are contraindicated in pregnant women due to the risk of fetal harm and should be used cautiously in elderly patients with reduced renal clearance, but there is no specific contraindication for women under age 30.

Question 18

HF is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:

Accepted Answer

Each of the situations listed (marked worsening of symptoms or hypotension with syncope, progressive renal insufficiency or failure, and remaining symptomatic on optimal heart failure medication) are indicators that a patient's heart failure (HF) may not be adequately controlled in the primary care setting and may require the specialized knowledge and treatment options available from a cardiologist.

Question 19

Diagnosis of HF cannot be made by symptoms alone because many disorders share the same symptoms. The most specific and sensitive diagnostic test for HF is:

Accepted Answer

Two-dimensional echocardiograms are the most specific and sensitive diagnostic test for heart failure (HF) because they can directly visualize the heart's structure and function, identifying structural anomalies and cardiac dysfunction.

Question 20

Changing a diuretic to the aldosterone agonist class is frequently beneficial to HF patients except in the following circumstance:

Accepted Answer

Aldosterone agonists can cause an increase in potassium levels in the blood, which can be dangerous for patients who already have high potassium levels (hyperkalemia).

Quiz 38: Heart Failure

One of the three types of HF involves systolic dysfunction. Potential causes of this most common form of HF include:

Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure (HF) because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes that take place in HF is NOT addressed by ACE inhibitors?

Which of the following classes of drugs is contraindicated in HF?

What assessment that can be done at home is the most reliable to use for making decisions to change HF medications?

HF is a leading cause of death and hospitalization in older adults (greater than 65 years old) . The drug of choice for this population is:

Class I recommendations for stage A HF include:

Treatments for HF, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:

HF patients frequently take more than one drug. When are anticoagulants typically used?

Stage B patients should have nonselective beta blockers added to their HF treatment regimen when:

What can chest x-rays contribute to the diagnosis and management of HF?

Digoxin has a very limited role in treatment of HF. It is used mainly for patients with:

The American Heart Association (AHA) and the American College of Cardiology (ACC) have devised a classification system for HF that can be used to direct treatment. Patients with symptoms and underlying disease are classified as stage:

Evidence is strong that HF interventions are best initiated when:

Stage C patients usually require a combination of three to four drugs to manage their HF. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true?

In the later part of the 20^th century, increased life expectancy for patients with HF has been associated with the use of:

ACE inhibitors are contraindicated in pregnancy. While treatment of HF during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?

ACE inhibitors are a foundational medication in HF. Which group of patients cannot take them safely?

HF is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:

Diagnosis of HF cannot be made by symptoms alone because many disorders share the same symptoms. The most specific and sensitive diagnostic test for HF is:

Changing a diuretic to the aldosterone agonist class is frequently beneficial to HF patients except in the following circumstance:

Quiz 38: Heart Failure

One of the three types of HF involves systolic dysfunction. Potential causes of this most common form of HF include:

Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure (HF) because they have more than one action to address the pathological changes in this disorder. Which of the following pathological changes that take place in HF is NOT addressed by ACE inhibitors?

Which of the following classes of drugs is contraindicated in HF?

What assessment that can be done at home is the most reliable to use for making decisions to change HF medications?

HF is a leading cause of death and hospitalization in older adults (greater than 65 years old) . The drug of choice for this population is:

Class I recommendations for stage A HF include:

Treatments for HF, including drug therapy, are based on the stages developed by the ACC/AHA. Stage A patients are treated with:

HF patients frequently take more than one drug. When are anticoagulants typically used?

Stage B patients should have nonselective beta blockers added to their HF treatment regimen when:

What can chest x-rays contribute to the diagnosis and management of HF?

Digoxin has a very limited role in treatment of HF. It is used mainly for patients with:

The American Heart Association (AHA) and the American College of Cardiology (ACC) have devised a classification system for HF that can be used to direct treatment. Patients with symptoms and underlying disease are classified as stage:

Evidence is strong that HF interventions are best initiated when:

Stage C patients usually require a combination of three to four drugs to manage their HF. In addition to ACE inhibitors and beta blockers, diuretics may be added. Which of the following statements about diuretics is NOT true?

In the later part of the 20th century, increased life expectancy for patients with HF has been associated with the use of:

ACE inhibitors are contraindicated in pregnancy. While treatment of HF during pregnancy is best done by a specialist, which of the following drug classes is considered to be safe, at least in the later parts of pregnancy?

ACE inhibitors are a foundational medication in HF. Which group of patients cannot take them safely?

HF is a chronic condition that can be adequately managed in primary care. However, consultation with or referral to a cardiologist is appropriate when:

Diagnosis of HF cannot be made by symptoms alone because many disorders share the same symptoms. The most specific and sensitive diagnostic test for HF is:

Changing a diuretic to the aldosterone agonist class is frequently beneficial to HF patients except in the following circumstance:

In the later part of the 20^th century, increased life expectancy for patients with HF has been associated with the use of: