Deck 17: Heart Failure

Question 1

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

Answer 1

2

Question 2

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.

Answer 2

1

Question 3

How is systolic dysfunction different from diastolic dysfunction?
1) In systolic dysfunction, the ventricle has difficulty ejecting blood out of the chamber.
2) In systolic dysfunction, the ventricle has difficulty relaxing and is unable to expand fully.
3) In systolic dysfunction, the ventricle pumps out insufficient blood volume.
4) In systolic dysfunction, the ventricle has low blood volume.

Answer 3

1

Question 4

Which fluid is found at the capillary-cell interface fluid compartment that is found inside the capillary?
1) Intracellular fluid
2) Interstitial fluid
3) Extracellular fluid
4) None of the above

Question 5

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?
1) Client 1
2) Client 2
3) Client 3
4) Client 4

Question 6

How 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 of time.
3) Chronic heart failure is caused by substantial ventricular muscle injury.
4) Chronic heart failure is referred to as cardiogenic shock.

Question 7

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.

Question 8

How 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 the excessive blood out.
3) The stroke volume decreases when the ventricle ejects its blood.
4) The contractility and stroke volume decreases.

Question 9

A client 50 years of age is diagnosed with Class III (moderate) heart failure. How 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 symptoms such as 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 10

Heart failure is classified into four different stages by the American College of Cardiology/American Heart Association. How 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 with diabetes mellitus has a family history of cardiomyopathy.

Question 11

A registered nurse is teaching nursing students about the normal level for central venous pressure. Which statement made by one of the student 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 12

A registered nurse is teaching nursing students about cardiac output. Which statement indicates effective learning by the student nurse?
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."
Exhibit

Question 13

A registered nurse is teaching nursing students about the renin-angiotensin-aldosterone system (RAAS). Which statement made by the nursing student indicates effective learning?
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 14

What is the term for 'rapid irregular rhythms' of the ventricle?
1) Tachydysrhythmias
2) Bradydysrhythmias
3) Atrial dysrhythmias
4) None of the above

Question 15

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

Question 16

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 17

What is 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

Question 18

A 78-year-old man presents to his physician for evaluation of edema. He reports a 3-month history of peripheral edema. Which edema may have developed in the client?
1) Edema in the skin
2) Edema in the ankle
3) Edema in the feet and lower legs
4) None of the above

Question 19

A 60-year-old client who complains of swelling in the ankles and fingers, abdominal swelling, fullness of the stomach, and a weight gain of 2 lbs. or more per day is diagnosed with mild or moderate heart failure. What are the symptoms that could be observed secondary to decreased cerebral perfusion?
1) Dyspnea and nocturnal cough
2) Confusion, difficulty concentrating, and headache
3) Cold, pale legs and feet
4) None of the above

Question 20

Which is a potent vasodilator produced by vascular endothelial cells?
1) Nitric oxide
2) Endothelin
3) Tumor necrosis factor-alpha
4) None of the above

Question 21

Prioritize the procedure employed to directly measure right heart pressures, using a catheter. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
A. Insert the catheter into a large vein.
B. The catheter is connected to a transducer.
C. The catheter is advanced into the inferior vena cava and right atrium.
D. The catheter is threaded into the subclavian vein.

Question 22

Prioritize 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.)
A. The catheter is advanced against the flow of blood into the aorta.
B. The catheter is inserted into a femoral artery.
C. The catheter is advanced into the left ventricle.
D. The catheter is then used to measure the aortic pressure, systolic, and diastolic pressures.

Question 23

Which statements are true regarding cardiac contractility?
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 contractibility can also be influenced by preload.
5) The heart's workload increases as afterload increases.

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.)
A. Place a centimeter ruler on the sternal angle of the client's chest.
B. Place the client on a bed with the head of the bed raised to a 45° to 60° angle.
C. Measure the distance from the sternal angle to the horizontal level of the distended neck veins.
D. Check that the sternal angle is approximately 5 cm above the right atrium.

Question 25

Various test results of a 55-year-old client indicate right ventricular backward failure, jugular venous distention, and ascites. The client also has hepatomegaly and splenomegaly. What are the other signs and symptoms of right ventricular failure that could lead the physician to confirm the condition?
1) Cough
2) Dyspnea
3) Orthopnea
4) Confusion
5) Cool, pale extremities
Other