AH 2 Chapter 32 Review Questions
Which are potential benefits of a client receiving the drug digoxin? A. Reduced heart rate B. Increased contractility C. Venous vasodilation D. Slowed conduction through the AV node E. Inhibition of sympathetic activity with enhanced parasympathetic activity F. Enhanced renal excretion of sodium and water
A, B, D, E
To improve gas exchange, how much supplemental oxygen would the nurse provide a client with HF? A. 2 L/min by nasal canula B. 100% by nonrebreather mask C. Within the range prescribed by the HCP to keep saturation at 90% or more D. 50% by endotracheal tube and mechanical ventilator
C
What is the most reliable method of monitoring for fluid gain or loss in a client with heart failure? A. Check for pitting edema in dependent body parts. B. Auscultate the lungs for worsening crackles or wheezes. C. Weigh the client daily at the same time and using the same scale. D. Assess the client's skin turgor and condition of mucous membranes.
C
When a client admits that he or she sometimes has trouble catching his or her breath, which question would the nurse ask to obtain more information about the client's symptoms? A. "Do you have a history of any medical problems like high blood pressure?" B. "What did your health care provider tell you about your diagnosis?" C. "What was your most strenuous activity during the past week?" D. "How do you feel about being told that you have heart failure?"
C
When a client develops heart failure, what initial compensatory mechanism of the heart does the nurse expect to occur that will maintain cardiac output (CO)? A. Parasympathetic stimulation B. Ventricular hypertrophy C. Sympathetic stimulation D. Renin-angiotensin activation system
C
What does the nurse suspect when assessment of a client with HF reveals pulses that alternate in strength? A. Pulsus alternans B. Pulsus paradoxus C. Orthostatic hypotension D. Angina
A
What early sign of left ventricular failure is a client most likely to report to the nurse? A. Nocturnal coughing B. Swollen legs C. Weight gain D. Nocturia
A
Which instruction would the nurse give the assistive personnel (AP) who is helping a client with HF and excessive aldosterone secretion? A. Restrict the client's fluids to 2 L/day and keep accurate intake and output. B. Severely restrict fluids to 500 mL of fluid plus the client's urine output from the past 24 hours. C. Give the client as much water as he or she wants to prevent dehydration. D. Frequently offer the client ice chips and moistened mouth swabs and limit fluids to 1 L/day.
A
What are the priority nursing actions related to caring for an older adult client with HF who is prescribed digoxin? Select all that apply. A. Monitor the ECG strip for early signs of toxicity such as bradycardia. B. Auscultate the apical pulse heart rate and rhythm for a full minute before administering the drug. C. Observe for signs of toxicity, which are often nonspecific such as anorexia, fatigue, and blurred vision. D. Report any changes in heart rate or rhythm to the health care provider. E. Monitor serum digoxin and potassium levels. F. Check the health care provider's prescription for parameters to hold the drug.
A, B, C, D, E, F
Which major self-management categories will the nurse include when teaching a client, newly diagnosed with heart failure, who is about to be discharged? Select all that apply. A. Symptoms, what to do when they get worse B. Medications C. Activity D. Heart transplants E. Weight F. Diet
A, B, C, E, F
Which assessment findings would the nurse expect to find in a client with left heart failure? Select all that apply. A. Wheezes or crackles B. Jugular vein distention C. S3 heart sound D. Paroxysmal nocturnal dyspnea E. Ascites F. Oliguria during the day
A, C, D, F
Which early symptoms indicate to the nurse that a client's HF is getting worse and pulmonary edema is developing? Select all that apply. A. Crackles in the lung bases B. Frothy, blood-tinged sputum C. Dyspnea at rest D. Cyanosis E. Disorientation F. Level of crackles rises higher in the lungs
A, C, E
Which key points would the nurse include when teaching a client about signs and symptoms of return or worsening of heart failure, that must be reported to the primary health care provider? Select all that apply. A. Cold symptoms (e.g., cough) lasting more than 3 to 5 days B. Rapid weight loss of 3 lb in a week C. Excessive awakening at night to urinate D. Increase in exercise tolerance lasting 2 to 3 days E. Development of dyspnea or angina at rest or worsening angina F. Increased swelling in feet, ankles, or hands
A, C, E, F
Which drugs would the nurse prepare to administer to a client with HF who has developed pulmonary edema? Select all that apply. A. Nitroglycerin sublingual B. Lorazepam IV C. Oxygen at 1 L/min nasal canula D. Furosemide IV E. Metoprolol IV F. Nitroglycerin IV
A, D, F
Which interventions would the nurse expect to include in the care of a client with pulmonary edema caused by HF? Select all that apply. A. Sodium restriction B. Fluid restriction C. Administration of potassium supplement D. Position client in semi-Fowler or high-Fowler E. Weekly weight monitoring F. Administration of loop diuretics
A, D, F
What is the priority concept for a client who has heart failure? A. Gas exchange B. Perfusion C. Comfort D. Infection
B
What is the priority intervention when a client comes to the emergency department (ED) with extreme anxiety, tachycardia, struggling for air, and a moist cough productive of frothy and blood-tinged sputum? A. Prepare for endotracheal intubation and mechanical ventilation. B. Administer high-flow oxygen therapy by face mask. C. Prepare for continuous positive airway pressure ventilation. D. Apply a pulse oximeter and a cardiac monitor.
B
When a client has an ejection fraction of less than 30%, about which potential treatment does the nurse prepare to educate the client? A. Heart transplant B. Implantable cardioverter/defibrillator C. Ventricular reconstructive procedure D. Implanted mechanical pump
B
When the client asks the nurse about the best method of diagnosing heart failure, what teaching would the nurse provide? A. Radionuclide studies B. Echocardiography C. Multigated acquisition (MUGA) scan D. Pulmonary artery catheter
B
Which statement by a client with heart failure indicates to the nurse the need for additional teaching? A. "If my heart feels like it's racing, I should call my health care provider." B. "I must weigh myself once a week and watch for signs of fluid retention." C. "I'll need periods of rest and activity and I should avoid activity after meals." D. "I'll need to consider and plan my activities for the day, and rest as needed."
B
What assessment findings would the nurse expect to find in a client with right heart failure? Select all that apply. A. Weight loss B. Dependent edema C. Neck vein distention D. Angina E. Hepatomegaly F. Weak peripheral pulses
B, C, E
Based on the etiology and main cause of heart failure, the nurse knows that which client has the greatest need for health promotion measures to prevent heart failure? A. Client with asthma B. Client with renal insufficiency C. Client with hypertension D. Client with Parkinson disease
C
When a client with heart failure walks 200 feet down the hall and develops a feeling of heaviness in the legs, how does the nurse interpret this finding? A. The client is building endurance. B. The activity is appropriate. C. The client could walk farther. D. The activity is too stressful.
D
When would the nurse expect the release of B-type natriuretic peptide (BNP) for a client with heart failure? A. When the client has an enlarged liver B. When a client's ejection fraction is lower than normal C. When a client develops ventricular hypertrophy D. When a client has fluid overload
D
Which statement by a client with a history of hypertension and heart problems would cause the nurse to suspect development of heart failure? A. "I've had a fever frequently." B. "I noticed a very fine red rash on my chest." C. "I get a pain in my shoulder when I cough." D. "I've had to remove all of my rings for the past month."
D
