Question 1

With which disorder is jugular vein distention prominent?

Accepted Answer

Heart Failure

Question 2

A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which of the following assessment findings for this client?

Accepted Answer

Pulmonary congestion

Question 3

Sixty six-year-old David Steiner is already being treated for hypertension. His doctor, concerned about the potential for heart failure, has him come back for check-ups regularly. What does hypertension have to do with heart failure?

Accepted Answer

Hypertension causes the heart\'s chambers to enlarge and weaken

Question 4

A client with right-sided heart failure is admitted to the medical-surgical unit. What information obtained from the client may indicate the presence of edema?

Accepted Answer

The client says his rings have become tight and are difficult to remove.

Question 5

The nurse is preparing to administer hydralazine and isosorbide dinitrate (Dilatrate). When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse?

Accepted Answer

Hold the medication and call the physician

Question 6

Which pulse should the nurse palpate during rapid assessment of an unconscious adult

Accepted Answer

Carotid

Question 7

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient?

Accepted Answer

Electrolyte and water loss

Question 8

When the nurse observes that the patient has increased difficulty breathing when lying flat, the nurse records that the patient is demonstrating

Accepted Answer

orthopnea

Question 9

Which is a potassium-sparing diuretic used in the treatment of heart failure?

Accepted Answer

Spironolactone (Aldactone)

Question 10

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate

Accepted Answer

Morphine sulfate

Question 11

A client with chronic heart failure is receiving digoxin (Lanoxin), 0.25 mg by mouth daily, and furosemide (Lasix), 20 mg by mouth twice daily. The nurse instructs the client to notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause:

Accepted Answer

visual disturbances

Question 12

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of:

Accepted Answer

acute pulmonary edema

Question 13

Which of the following medications is categorized as a loop diuretic

Accepted Answer

Furosemide (Lasix)

Question 14

Which of the following is a characteristic of right-sided heart failure

Accepted Answer

JVD

Question 15

Which of the following is a key diagnostic laboratory test for heart failure?

Accepted Answer

B-type natriuretic peptide (BMP)

Question 16

The nursing instructor is teaching their clinical group how to assess a client for congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea?

Accepted Answer

By questioning how many pillows the client normally uses for sleep

Question 17

The student nurse is caring for a client with heart failure. Diuretics have been ordered. What method would help the nurse evaluate the client\'s response to diuretics?

Accepted Answer

Using a urinary catheter

Question 18

Which of the following describes difficulty breathing when a patient is lying flat?

Accepted Answer

Orthopnea

Question 19

The nurse recognizes which of the following symptoms as a classic sign of cardiogenic shock?

Accepted Answer

Restlessness and confusion

Question 20

Which of the following nursing interventions should a nurse perform when a patient with valvular disorder of the heart has a heart rate less than 60 beats per minute before administering beta-blockers?

Accepted Answer

Withhold the drug and inform the primary health care provider

Question 21

Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest?

Accepted Answer

IV

Question 22

You are caring for a client with suspected right-sided heart failure. What would you know that clients with suspected right-sided heart failure may experience

Accepted Answer

Gradual unexplained weight gain

Question 23

Ronald is a 46-year-old who has developed congestive heart failure. He has to learn to adapt his diet and you are his initial counselor. Which of the following should you tell him to avoid?

Accepted Answer

Canned peas

Question 24

A nurse taking care of a patient recently admitted to the ICU observes the patient coughing up large amounts of pink, frothy sputum. Auscultation of the lungs reveals course crackles to lower lobes bilaterally. Based on this assessment, the nurse recognizes this patient is developing which of the following problems?

Accepted Answer

Decompensated heart failure with pulmonary edema

Question 25

A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity

Accepted Answer

Potassium level of 2.8 mEq/L

Question 26

In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure?

Accepted Answer

Leg edema

Question 27

The nursing instructor is discussing heart failure with their clinical group. The instructor talks about heart failure in terms of a decreasing ejection fraction of the heart. What diagnostic test is used to measure the ejection fraction of the heart?

Accepted Answer

echocardiogram

Question 28

Which of the following clinical manifestations are consistent with right-sided heart failure (HF)?

Accepted Answer

Positive hepatojugular reflux

Question 29

The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately?

Accepted Answer

persistent cough

Question 30

Which of the following body system responses correlates with systolic heart failure (HF)?

Accepted Answer

decreased in renal perfusion

Question 31

On his return to the cardiac step-down unit after his diagnostic procedure, a client awaits the report from his cardiologist. As the client\'s nurse, you review the process of measuring ejection fraction and explain to the client that it measures the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects?

Accepted Answer

55%

Question 32

A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure?

Accepted Answer

Bibasilar crackles

Question 33

A patient with congestive heart failure is admitted to the hospital with complaints of shortness of breath. How should the nurse position the patient in order to decrease preload?

Accepted Answer

Head of the bed elevated at 45 degrees and lower arms supported by pillows

Question 34

A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should:

Accepted Answer

place in high fowlers

Question 35

A total artificial heart (TAH) is an electrically powered pump that circulates blood into the pulmonary artery and the aorta, thus replacing the functions of both the right and left ventricles. What makes it different from an LVAD?

Accepted Answer

An LVAD only supports a failing left ventricle

Question 36

The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure

Accepted Answer

Dyspnea on exertion

Question 37

Which of the following is the hallmark of systolic heart failure?

Accepted Answer

low ejection fraction (EF)

Question 38

Which treatment is the best therapy for a stable client with digoxin toxicity?

Accepted Answer

Time and symptomatic treatment

Question 39

A patient with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, bradycardia, and muffled heart sounds. The senior nursing student recognizes these symptoms occur when

Accepted Answer

Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

Question 40

A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client\'s fluid status?

Accepted Answer

Weighing the client daily at the same time each day

Question 41

A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, \"His pulmonary artery wedge pressures have been in the high normal range.\" The CSU nurse should be especially observant for

Accepted Answer

pulmonary crackles

Question 42

A client is admitted to the ICU with a diagnosis of heart failure. The client is exhibiting symptoms of weakness, ascites, weight gain, and jugular vein distention. The nurse would know that the client is exhibiting signs of what kind of heart failure?

Accepted Answer

Right-sided heart failure

Question 43

The nurse assessing a patient with an exacerbation of heart failure identifies which of the following symptoms as a cerebrovascular manifestation of heart failure (HF)?

Accepted Answer

Dizziness

Question 44

Which of the following symptoms should the nurse expect to find as an early symptom of chronic heart failure?

Accepted Answer

Fatigue

Question 45

Which of the following is a key diagnostic indicator of heart failure?

Accepted Answer

BNP

Question 46

A nurse is administering lanoxin, which she knows increases contractility as well as cardiac output. Contractility refers to which of the following?

Accepted Answer

The force of the contraction related to the status of the myocardium

Question 47

A client is receiving furosemide (Lasix), a loop diuretic, to prevent fluid overload. The order is for 50 mg intraveneous now. The pharmacy supplies Lasix 80 mg per 2 mL. How many mL will the nurse give the client? Enter the correct number ONLY

Accepted Answer

1.25

Question 48

A patient has been diagnosed with systolic heart failure. The nurse would expect the patient\'s ejection fraction to be at which level?

Accepted Answer

Severely reduced

Question 49

Which of the following therapies are for patient who have advanced heart failure (HF) after all other therapies have failed?

Accepted Answer

Heart transplant

Question 50

You are working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for you to closely monitor an older adult receiving digitalis preparations for cardiac disorders?

Accepted Answer

Older adults are at increased risk for toxicity.

Question 51

A client with chronic heart failure is able to continue with his regular physical activity and does not have any limitations as to what he can do. According to the New York Heart Association (NYHA), what classification of chronic heart failure does this client have?

Accepted Answer

Class I (Mild)

Question 52

A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure?

Accepted Answer

Potassium

Question 53

The nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains afterload to the student and then asks the student what nursing interventions might cause decreased afterload. The student correctly answers which of the following?

Accepted Answer

Administration of a vasodilating drug (as ordered by a physician)

Question 54

A client has been prescribed furosemide (Lasix) 80 mg twice daily. The cardiac monitor technician informs the nurse that the client has started having rare premature ventricular contractions followed by runs of bigeminy lasting 2 minutes. During the assessment, the nurse determines that the client is asymptomatic and has stable vital signs. Which of the following actions should the nurse perform next?

Accepted Answer

Check the client\'s potassium level.

Question 55

The nurse is preparing to administer furosemide (Lasix) to a client with severe heart failure. What lab study should be of most concern for this client while taking Lasix?

Accepted Answer

Potassium level of 3.1

Question 56

The pathophysiology of pericardial effusion is associated with all of the following except:

Accepted Answer

Increased venous return.

Question 57

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement?

Accepted Answer

\"I sleep on three pillows each night.\"

Question 58

Which of the following is a key diagnostic indicator of heart failure (HF)?

Accepted Answer

Brain natriuretic peptide (BNP)

Question 59

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump?

Accepted Answer

Echocardiogram

Question 60

The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client?

Accepted Answer

Low-sodium diet

Question 61

A patient taking an ACE inhibitor has developed a dry, hacking cough. Because of this side effect, the patient no longer wants to take that medication. What medication that has similar hemodynamic effects does the nurse anticipate the physician ordering?

Accepted Answer

Valsartan (Diovan)

Question 62

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as:

Accepted Answer

a third heart sound (S3).

Question 63

A nurse suspects that a client has digoxin toxicity. The nurse should assess for:

Accepted Answer

vision changes.

Question 64

What mechanical device increases coronary perfusion and cardiac output and decreases myocardial workload and oxygen consumption in a client with cardiogenic shock?

Accepted Answer

Intra-aortic balloon pump

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