Deck 17: Heart Failure

Question 1

Which is a potent vasodilator produced by vascular endothelial cells?
1)Nitric oxide
2)Endothelin
3)Tumor necrosis factor-alpha
4)Digitalis

Answer 1

1

Question 2

Which statement best differentiates cardiac afterload from cardiac preload?
1)Cardiac afterload is the volume of blood in the heart at the end of diastole.
2)Cardiac afterload is the amount of resistance that the ventricle must overcome.
3)Cardiac afterload is the factor that affects cardiac output.
4)Cardiac afterload is the amount of blood that enters the right atrium.

Answer 2

2

Question 3

In which way does the nurse define oncotic pressure?
1)A pressure reading within the inferior vena cava
2)A force that attempts to pull fluid from the interstitial and intracellular spaces
3)A force that attempts to push fluid out of the capillary pores into interstitial and intracellular spaces
4)A pressure reading upon inflation of the balloon on the tip of the Swan-Ganz catheter

Answer 3

2

Question 4

How is high-output failure different from low-output failure?
1)In high-output failure, the heart can weaken and the ventricle can fail.
2)In high-output failure, the heart is unable to fill with adequate amounts of blood.
3)In high-output failure, there is a lack of delivery of adequate oxygen to the tissues.
4)In high-output failure, there is a lack of sufficient blood to recirculate through the heart.

Question 5

The nurse is reviewing instructions with a client being discharged home after experiencing heart failure. When reviewing medications, the client asks about the addition of captopril to the previous medication regimen. Which action of captopril will the nurse explain to the client?
1)Captopril lowers resistance against the left ventricle.
2)Captopril is considered a potassium-sparing diuretic.
3)Captopril decreases blood volume and sodium retention.
4)Captopril inhibits peripheral vasoconstriction.

Question 6

The registered nurse is reviewing information with coronary staff nurses about the renin-angiotensin-aldosterone system (RAAS). Which statement made by an attending nurse indicates understanding?
1)"RAAS is a mechanism that regulates arterial blood pressure."
2)"RAAS is a mechanism that decreases blood pressure."
3)"RAAS is a mechanism that increases blood volume in response to increased renal perfusion."
4)"RAAS is a mechanism with detrimental effects that decrease workload for the left ventricle."

Question 7

In which manner does the heart function when a client is diagnosed with heart failure?
1)The decrease in preload causes high blood volume, filling the ventricle.
2)The ventricular muscle pumps out the excess blood.
3)The stroke volume decreases when the ventricle ejects its blood.
4)The contractility and stroke volume decrease.

Question 8

The nurse is assessing a client after cardiac testing. One test result indicates a cardiac output of 4,500 mL per minute. Using the calculation to determine normal cardiac output, which conclusion does the nurse draw?
1)The client's cardiac output is normal.
2)The client's cardiac output is slightly higher than normal.
3)The client's cardiac output is lower than normal.
4)The client's cardiac output is grossly higher than normal.

Question 9

In which way is chronic heart failure different from acute heart failure?
1)Chronic heart failure is the rapid, sudden development of heart failure.
2)Chronic heart failure gradually develops over a long period.
3)Chronic heart failure is caused by substantial ventricular muscle injury.
4)Chronic heart failure is referred to as cardiogenic shock.

Question 10

The registered nurse is teaching nursing staff about ischemic cardiomyopathy. Which statement made by one of the attending nurses indicates effective learning?
1)"There is scarring of the heart muscle caused by coronary artery insufficiency."
2)"There is enlargement and hypertrophy of the left or right ventricles."
3)"It is a disorder that restricts the ventricle's ability to fully expand."
4)"It is a genetic predisposition for the muscular enlargement of the interventricular septal wall."

Question 11

Which pathology is a cause specifically for right ventricle failure (RVF)?
1)Pulmonary emboli
2)Endocarditis
3)Myocarditis
4)Rheumatic fever

Question 12

The registered nurse is teaching nursing staff about the normal level for central venous pressure. Which statement made by one of the attending nurses indicates effective learning?
1)"The normal range for central venous pressure is 4 to 13 mm Hg."
2)"The normal range for central venous pressure is 60 to 80 mm Hg."
3)"The normal range for central venous pressure is 12 to 15 mm Hg."
4)"The normal range for central venous pressure is 1 to 5 mm Hg."

Question 13

A middle-aged adult is diagnosed with Class III (moderate) heart failure. In which way is Class III heart failure different from other classes of heart failure in the client, according to the New York Association of Classification of Heart Failure?
1)The client with Class III (moderate) heart failure will feel comfortable with ordinary physical activity.
2)The client with Class III (moderate) heart failure will feel fatigue and palpitations but only with ordinary activity.
3)The client with Class III (moderate) heart failure will have fatigue, palpitations, or dyspnea while doing less-than-normal physical activities.
4)The client with Class III (moderate) heart failure will be unable to carry out physical activities comfortably.

Question 14

A nurse is caring for four clients with heart disease in the intensive care unit. One of the clients has been diagnosed with decreased calcium availability. Which client is administered a drug to increase calcium availability? Client 1
Client 2
Client 3
Client 4
Drugs
Dobutamine
Digoxin
Milrinone
Angiotensin-converting enzyme inhibitors
1)Client 1
2)Client 2
3)Client 3
4)Client 4

Question 15

Heart failure is classified into four different stages by the American College of Cardiology/American Heart Association. In which way is the condition of a client in stage B different from the condition of clients in other stages?
1)The client in stage B is supported by a mechanical circulatory assist device.
2)The client in stage B is undergoing treatment for prior symptoms of heart failure.
3)The client in stage B has a history of a previous myocardial infarction.
4)The client in stage B has diabetes mellitus and a family history of cardiomyopathy.

Question 16

An older adult client presents with swollen ankles and fingers, and reports that low-level activity causes fatigue and heart palpitations. The client is diagnosed with heart failure. Which symptom indicates the client's condition is considered to be a Class III, moderate heart failure?
1)Dyspnea
2)Confusion
3)Cold, pale extremities
4)Inability sleep

Question 17

How is stage C heart failure different from other stages of heart failure, according to the American College of Cardiology/American Heart Association classification?
1)Clients will have unidentifiable structural or functional heart abnormalities.
2)Clients may develop structural heart disease associated with heart failure.
3)Clients may have current or prior symptoms of heart failure.
4)Clients may have advanced structural heart disease.

Question 18

Which condition according to the Framingham Criteria for Diagnosis of Congestive Heart Failure is caused by nighttime cough?
1)Paroxysmal nocturnal dyspnea
2)Jugular vein distension
3)Pulmonary crackles
4)Cardiomegaly

Question 19

Which condition is the initial cause of an afterload increase in the right ventricle?
1)Cirrhosis of the liver
2)Pulmonary hypertension
3)Elevated systolic pressure
4)Blocked coronary arteries

Question 20

The registered nurse is reviewing cardiac output with nursing staff. Which statement by an attending nurse indicates understanding?
1)"Cardiac output is the amount of blood that the heart pumps out of the left ventricle."
2)"Cardiac output is increased in heart failure."
3)"Cardiac output is unvaried by body size."
4)"Adrenergic stimulation slows heart rate, and cholinergic stimulation raises heart rate."

Question 21

Which statements are true regarding cardiac contractility? Select all that apply.
1)Cardiac contractility is the ability of the myocardium to stretch and contract.
2)The muscle filaments may be unable to change the force of contraction.
3)The stroke volume decreases as the preload increases.
4)The contractility can also be influenced by preload.
5)The heart's workload increases as afterload increases.

Question 22

Indicate the progression of a catheter to obtain the pulmonary capillary wedge pressure (PCWP). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Threaded through vena cava
2) Enters a peripheral vein
3) Enters right atrium
4) Enters right ventricle
5) Enters into pulmonary artery

Question 23

Prioritize the steps of the procedure employed to directly measure the left heart pressures using a catheter. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The catheter is advanced against the flow of blood into the aorta.
2) The catheter is inserted into a femoral artery.
3) The catheter is advanced into the left ventricle.
4) The catheter is used to measure the aortic, systolic, and diastolic pressures.

Question 24

Prioritize the steps to accurately assess jugular venous pressure in a client experiencing heart failure. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Place a centimeter ruler on the sternal angle of the client's chest.
2) Place the client on a bed with the head of the bed raised to a 45- to 60-degree angle.
3) Measure the distance from the sternal angle to the horizontal level of the distended neck veins.
4) Check that the sternal angle is approximately 5 cm above the right atrium.

Question 25

Various test results for a middle-aged client indicate right ventricular backward failure, jugular venous distention, and ascites. The client also has hepatomegaly and splenomegaly. Which other signs and symptoms of right ventricular failure would the nurse expect to see with this client? Select all that apply.
1)Cough
2)Dyspnea
3)Orthopnea
4)Confusion
5)Cool, pale extremities