Chapter 29: Management of Patients With Complications from Heart Disease
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? a) Class IV (Severe) b) Class I (Mild) c) Class II (Mild) d) Class III (Moderate)
B
A client with stage IV heart failure has a living will indicating that he doesn't want to be placed on a ventilator. A nurse is caring for this client when he begins experiencing severe dyspnea. The nurse should: a) ask the client's family to consent to ventilator placement. b) administer oxygen, morphine, and a bronchodilator for client comfort. c) administer oxygen and hope the client will change his mind. d) call for respiratory therapy to intubate the client.
B
A nurse has come upon an unresponsive, pulseless victim. She has placed a 911 call and begins CPR. The nurse understands that if the patient has not been defibrillated within which time frame, the chance of survival is close to zero? a) 15 minutes b) 10 minutes c) 20 minutes d) 25 minutes
B
A nurse is assessing a client with suspected cardiac tamponade. How should the nurse assess the client for pulsus paradoxus? a) Measure the blood pressure in right arm as the client inhales slowly, then measure the blood pressure in the left arm as the client exhales slowly. b) Measure the blood pressure in either arm as the client slowly exhales and then as the client breathes normally. c) Measure blood pressure in the right arm, then in the left arm as the client slows the pace of his inhalations and exhalations. d) Measure blood pressure in either arm with the client holding his breath, then with the client breathing normally.
B
A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the patient notes a history of left-sided HF. The patient is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem? A) Right-sided heart failure B) Acute pulmonary edema C) Pneumonia D) Cardiogenic shock
B
A patient with HF is placed on a low-sodium diet. Which statement by the patient indicates that the nurse's nutritional teaching plan has been effective? A) "I will have a ham and cheese sandwich for lunch." B) "I will have a baked potato with broiled chicken for dinner." C) "I will have a tossed salad with cheese and croutons for lunch." D) "I will have chicken noodle soup with crackers and an apple for lunch."
B
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? a) Head of the bed elevated at 30 degrees and legs elevated on pillows b) Head of the bed elevated at 45 degrees and lower arms supported by pillows c) Prone with legs elevated on pillows d) Supine with arms elevated on pillows above the level of the heart
B
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? a) Supine with arms elevated on pillows above the level of the heart b) Head of the bed elevated at 45 degrees and lower arms supported by pillows c) Prone with legs elevated on pillows d) Head of the bed elevated at 30 degrees and legs elevated on pillows
B
A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity? a) Magnesium level of 2.5 mg/dl b) Potassium level of 2.8 mEq/L c) Sodium level of 152 mEq/L d) Calcium level of 7.5 mg/dl
B
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? a) Angel food cake b) Canned peas c) Dried peas d) Ready-to-eat cereals
B
The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following? a) Right atrial function b) Left ventricular function c) Left atrial function d) Right ventricular function
B
The nurse is addressing exercise and physical activity during discharge education with a patient diagnosed with HF. What should the nurse teach this patient about exercise? A) "Do not exercise unsupervised." B) "Eventually aim to work up to 30 minutes of exercise each day." C) "Slow down if you get dizzy or short of breath." D) "Start your exercise program with high-impact activities."
B
The nurse is assessing a patient who is known to have right-sided HF. What assessment finding is most consistent with this patient's diagnosis? A) Pulmonary edema B) Distended neck veins C) Dry cough D) Orthopnea
B
The nurse is caring for a 68-year-old patient the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment datum? A) Skin turgor B) Potassium level C) White blood cell count D) Peripheral pulses
B
The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure? a) Hypotension b) Dyspnea on exertion c) Tachycardia d) Decreased urinary output
B
The nurse overseeing care in the ICU reviews the shift report on four patients. The nurse recognizes which patient to be at greatest risk for the development of cardiogenic shock? A) The patient admitted with acute renal failure B) The patient admitted following an MI C) The patient admitted with malignant hypertension D) The patient admitted following a stroke
B
The nurse's comprehensive assessment of a patient who has HF includes evaluation of the patient's hepatojugular reflux. What action should the nurse perform during this assessment? A) Elevate the patient's head to 90 degrees. B) Press the right upper abdomen. C) Press above the patient's symphysis pubis. D) Lay the patient flat in bed.
B
The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? a) Increased appetite b) Persistent cough c) Weight loss d) Ability to sleep through the night
B
Which assessment would be most appropriate for a patient who is receiving a loop diuretic for HF? A) Monitor liver function studies B) Monitor for hypotension C) Assess the patient's vitamin D intake D) Assess the patient for hyperkalemia
B
Which of the following is the hallmark of systolic heart failure? a) Basilar crackles b) Low ejection fraction (EF) c) Limitation of activities of daily living (ADLs) d) Pulmonary congestion
B
The critical care nurse is caring for a patient who is in cardiogenic shock. What assessments must the nurse perform on this patient? Select all that apply. A) Platelet level B) Fluid status C) Cardiac rhythm D) Action of medications E) Sputum volume
BCD
A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.) a) Jugular vein distention b) Cough c) Pulmonary crackles d) Ascites e) Dyspnea
BCE
A client is receiving captopril (Capoten) for heart failure. The nurse should notify the physician that the medication therapy is ineffective if an assessment reveals: a) postural hypotension. b) skin rash. c) peripheral edema. d) dry cough.
C
A client with pulmonary edema has been admitted to the ICU. What would be the standard care for this client? a) Intubation of the airway b) Insertion of a central venous catheter c) BP and pulse measurements every 15 to 30 minutes d) Hourly administration of a fluid bolus
C
The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach this patient to do to assess her fluid balance in the home setting? A) Monitor her blood pressure daily B) Assess her radial pulses daily C) Monitor her weight daily D) Monitor her bowel movements
C
The nurse recognizes which of the following symptoms as a classic sign of cardiogenic shock? a) Hyperactive bowel sounds b) High blood pressure c) Restlessness and confusion d) Increased urinary output
C
Which of the following therapies are for patient who have advanced heart failure (HF) after all other therapies have failed? a) Cardiac resynchronization therapy b) Ventricular access device c) Heart transplant d) Implantable cardiac defibrillator (ICD)
C
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? a) Summon the nurse-manager. b) Administer potassium. c) Call the physician. d) Check the client's potassium level.
D
A client has been symptomatic for several months and is seeing a cardiologist for diagnostics to determine the cause of his cardiac symptoms. You review the diagnostic procedures the cardiologist will perform. How will the client's ejection fraction be measured? a) Cardiac ultrasound b) Cardiac catheterization c) Electrocardiogram d) Echocardiogram
D
An older adult patient with HF is being discharged home on an ACE inhibitor and a loop diuretic. The patient's most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this patient's subsequent care, what nursing diagnosis should be identified? A) Risk for ineffective tissue perfusion related to dysrhythmia B) Risk for fluid volume excess related to medication regimen C) Risk for ineffective breathing pattern related to hypoxia D) Risk for falls related to hypotension
D
Cardiogenic shock is pump failure that primarily occurs because of which of the following? a) Coronary artery stenosis b) Right atrial flutter c) Myocardial ischemia d) Inadequate tissue perfusion
D
The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following? a) Right ventricular function b) Right atrial function c) Left atrial function d) Left ventricular function
D
The nurse has entered a patient's room and found the patient unresponsive and not breathing. What is the nurse's next appropriate action? A) Palpate the patient's carotid pulse. B) Illuminate the patient's call light. C) Begin performing chest compressions. D) Activate the Emergency Response System (ERS).
D
The nurse hears the alarm sound on the telemetry monitor and observes a flat line. The patient is found unresponsive, without a pulse, and no respiratory effort. What is the first action by the nurse? a) Administer epinephrine 1:10,000 10 mL IV push. b) Deliver breaths with a bag-valve mask. c) Defibrillate the patient with 360 joules. d) Call for help and begin chest compressions.
D
The nurse identifies which of the following symptoms as a manifestation of right-sided heart failure (HF)? a) Reduction in cardiac output b) Reduction in forward flow c) Accumulation of blood in the lungs d) Congestion in the peripheral tissues
D
The nurse is assessing an older adult patient with numerous health problems. What assessment datum indicates an increase in the patient's risk for heart failure (HF)? A) The patient takes Lasix (furosemide) 20 mg/day. B) The patient's potassium level is 4.7 mEq/L. C) The patient is an African American man. D) The patient's age is greater than 65.
D
What is the typical percentage of blood a healthy heart ejects? a) 45% b) 50% c) 40% d) 55%
D
Which drug is most commonly used to treat cardiogenic shock? a) Metoprolol (Lopressor) b) Furosemide (Lasix) c) Enalapril (Vasotec) d) Dopamine (Intropin)
D
Which of the following symptoms should the nurse expect to find as an early symptom of chronic heart failure? a) Pedal edema b) Nocturia c) Irregular pulse d) Fatigue
D
You are caring for a client with left-sided heart failure. When you go in to do your shift assessment, you find your client is wheezing, restless, tachycardic, and has severe apprehension. You know that these are symptoms of what? a) Progressive heart failure b) Cardiogenic shock c) Pulmonary hypertension d) Acute pulmonary edema
D
A cardiac patient's resistance to left ventricular filling has caused blood to back up into the patient's circulatory system. What health problem is likely to result? A) Acute pulmonary edema B) Right-sided HF C) Right ventricular hypertrophy D) Left-sided HF
A
A cardiovascular patient with a previous history of pulmonary embolism (PE) is experiencing a sudden onset of dyspnea, rapid breathing, and chest pain. The nurse recognizes the characteristic signs and symptoms of a PE. What is the nurse's best action? A) Rapidly assess the patient's cardiopulmonary status. B) Arrange for an ECG. C) Increase the height of the patient's bed. D) Manage the patient's anxiety.
A
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? a) Bibasilar crackles b) Right upper quadrant pain c) Dependent edema d) Jugular vein distention
A
A nurse in the CCU is caring for a patient with HF who has developed an intracardiac thrombus. This creates a high risk for what sequela? A) Stroke B) Myocardial infarction (MI) C) Hemorrhage D) Peripheral edema
A
A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic balloon pump (IABP). What does the nurse understand is the mechanism of action of the balloon pump? a) The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart. b) The balloon delivers an electrical impulse to correct dysrhythmias the patient experiences. c) The balloon keeps the vessels open so that blood will adequately deliver to the myocardium. d) The balloon will inflate at the beginning of systole and deflate before diastole to provide a long-term solution to a failing myocardium.
A
A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which of the following indicates that cardiac tamponade has been relieved? a) Decrease in central venous pressure (CVP) b) Decrease in blood pressure c) Increase in CVP d) Absence of cough
A
A patient who is at high risk for developing intracardiac thrombi has been placed on long-term anticoagulation. What aspect of the patient's health history creates a heightened risk of intracardiac thrombi? A) Atrial fibrillation B) Infective endocarditis C) Recurrent pneumonia D) Recent surgery
A
A patient with HF has met with his primary care provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the patient begins treatment, the nurse should prioritize what assessment? A) Blood pressure B) Level of consciousness (LOC) C) Assessment for nausea D) Oxygen saturation
A
A patient with a diagnosis of HF is started on a beta-blocker. What is the nurse's priority role during gradual increases in the patient's dose? A) Educating the patient that symptom relief may not occur for several weeks B) Stressing that symptom relief may take up to 4 months to occur C) Making adjustments to each day's dose based on the blood pressure trends D) Educating the patient about the potential changes in LOC that may result from the drug
A
Which of the following is a key diagnostic indicator of heart failure (HF)? a) Brain natriuretic peptide (BNP) b) Creatinine c) Complete blood count (CBC) d) Blood urea nitrogen (BUN)
A
Which of the following is the hallmark of systolic heart failure? a) Low ejection fraction (EF) b) Basilar crackles c) Limitation of activities of daily living (ADLs) d) Pulmonary congestion
A
The triage nurse in the ED is assessing a patient with chronic HF who has presented with worsening symptoms. In reviewing the patient's medical history, what is a potential primary cause of the patient's heart failure? A) Endocarditis B) Pleural effusion C) Atherosclerosis D) Atrial-septal defect
C
Which of the following medications is a human brain natriuretic peptide (BNP) preparation? a) Captopril b) Metoprolol c) Natrecor d) Enalapril
C
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? a) Pulmonary congestion b) Jugular venous distention c) Nausea d) Pedal edema
A
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? a) Bibasilar crackles b) Dependent edema c) Jugular vein distention d) Right upper quadrant pain
A
A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient? A) In a high Fowler's position B) On the left side-lying position C) In a flat, supine position D) In the Trendelenburg position
A
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 a) Excess pericardial fluid compresses the heart and prevents adequate diastolic filling. b) Fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating generalized myocardial dysfunction. c) The pericardial space is eliminated with scar tissue and thickened pericardium. d) The parietal and visceral pericardial membranes adhere to each other, preventing normal myocardial contraction.
A
Cardiopulmonary resuscitation has been initiated on a patient who was found unresponsive. When performing chest compressions, the nurse should do which of the following? A) Perform at least 100 chest compressions per minute. B) Pause to allow a colleague to provide a breath every 10 compressions. C) Pause chest compressions to allow for vital signs monitoring every 4 to 5 minutes. D) Perform high-quality chest compressions as rapidly as possible.
A
The nurse is caring for a patient with severe left ventricular dysfunction who has been identified as being at risk for sudden cardiac death. What medical intervention can be performed that may extend the survival of the patient? A) Insertion of an implantable cardioverter defibrillator B) Insertion of an implantable pacemaker C) Administration of a calcium channel blocker D) Administration of a beta-blocker
A
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient for adverse effects, the nurse should assess for which of the following signs and symptoms? A) Confusion and bradycardia B) Uncontrolled diuresis and tachycardia C) Numbness and tingling in the extremities D) Chest pain and shortness of breath
A
The nurse is performing a physical assessment on a patient suspected of having HF. The presence of what sound would signal the possibility of impending HF? A) An S3 heart sound B) Pleural friction rub C) Faint breath sounds D) A heart murmur
A
The nurse is performing an initial assessment of a client diagnosed with HF. The nurse also assesses the patient's sensorium and LOC. Why is the assessment of the patient's sensorium and LOC important in patients with HF? A) HF ultimately affects oxygen transportation to the brain. B) Patients with HF are susceptible to overstimulation of the sympathetic nervous system. C) Decreased LOC causes an exacerbation of the signs and symptoms of HF. D) The most significant adverse effect of medications used for HF treatment is altered LOC.
A
The nurse is providing patient education prior to a patient's discharge home after treatment for HF. The nurse gives the patient a home care checklist as part of the discharge teaching. What should be included on this checklist? A) Know how to recognize and prevent orthostatic hypotension. B) Weigh yourself weekly at a consistent time of day. C) Measure everything you eat and drink until otherwise instructed. D) Limit physical activity to only those tasks that are absolutely necessary.
A
The nurse is reviewing the medication administration record of a patient diagnosed with systolic HF. What medication should the nurse anticipate administering to this patient? A) A beta-adrenergic blocker B) An antiplatelet aggregator C) A calcium channel blocker D) A nonsteroidal anti-inflammatory drug (NSAID)
A
The nurse recognizes which of the following symptoms as a classic sign of cardiogenic shock? a) Restlessness and confusion b) Increased urinary output c) High blood pressure d) Hyperactive bowel sounds
A
The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? a) Persistent cough b) Ability to sleep through the night c) Increased appetite d) Weight loss
A
Which of the following body system responses correlates with systolic heart failure (HF)? a) Decrease in renal perfusion b) Increased blood volume ejected from ventricle c) Vasodilation of skin d) Dehydration
A
Which of the following is a classic sign of cardiogenic shock? a) Tissue hypoperfusion b) Increased urinary output c) High blood pressure d) Hyperactive bowel sounds
A
A 78-year-old client has been diagnosed with right-sided heart failure from her symptomology. Her cardiologist will confirm his suspicions through diagnostics. Which of the following diagnostics are used to reveal right ventricular enlargement? Select all that apply. a) Chest radiograph b) Echocardiography c) Pulmonary arteriography d) Electrocardiogram
ABD
The nurse is creating a care plan for a patient diagnosed with HF. When addressing the problem of anxiety, what interventions should the nurse include in the care plan? Select all that apply. A) Facilitate the presence of friends and family whenever possible. B) Teach the patient about the harmful effects of anxiety on cardiac function. C) Provide supplemental oxygen, as needed. D) Provide validation of the patient's expressions of anxiety. E) Administer benzodiazepines two to three times daily.
ACD
The nurse is planning the care of a patient with HF. The nurse should identify what overall goals of this patient's care? Select all that applies A) Improve functional status B) Prevent endocarditis. C) Extend survival. D) Limit physical activity. E) Relieve patient symptoms.
ACE
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? a) Dopamine (Intropin) b) Morphine sulfate c) Nitroglycerin d) Furosemide (Lasix)
B
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? a) Dependent edema b) Bibasilar crackles c) Right upper quadrant pain d) Jugular vein distention
B
A client with heart failure must be monitored closely after starting diuretic therapy. The best indicator for the nurse to monitor is: a) urine specific gravity. b) weight. c) vital signs. d) fluid intake and output.
B
The nurse is educating an 80-year-old patient diagnosed with HF about his medication regimen. What should the nurse to teach this patient about the use of oral diuretics? A) Avoid drinking fluids for 2 hours after taking the diuretic. B) Take the diuretic in the morning to avoid interfering with sleep. C) Avoid taking the medication within 2 hours consuming dairy products. D) Take the diuretic only on days when experiencing shortness of breath.
B
A client is awaiting the availability of a heart for transplant. What option may be available to the client as a bridge to transplant? a) Implanted cardioverter-defibrillator (ICD) b) Pacemaker c) Ventricularassistdevice (VAD) d) Intra-aortic balloon pump (IABP)
C
A client is receiving captopril (Capoten) for heart failure. The nurse should notify the physician that the medication therapy is ineffective if an assessment reveals: a) postural hypotension. b) dry cough. c) peripheral edema. d) skin rash.
C
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? a) White blood cell (WBC) count b) Calcium c) Potassium d) Platelet count
C
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? a) Bilateral pneumonia b) Acute exacerbation of chronic obstructive pulmonary disease c) Decompensated heart failure with pulmonary edema d) Tuberculosis
C
A patient has been diagnosed with systolic heart failure. The nurse would expect the patient's ejection fraction to be at which level? a) Normal b) High c) Slightly reduced d) Severely reduced
C
A patient has missed 2 doses of digitalis (Digoxin). What laboratory results would indicate to the nurse that the patient is within therapeutic range? a) 4.0 mg/mL b) 0.25 mg/mL c) 2.0 mg/mL d) 3.2 mg/mL
C
Diagnostic imaging reveals that the quantity of fluid in a client's pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication? A) Pulmonary edema B) Pericardiocentesis C) Cardiac tamponade D) Pericarditis
C
In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure? a) Productive cough b) Cyanosis of the lips c) Leg edema d) Bilateral crackles
C
The nurse does an assessment on a patient who is admitted with a diagnosis of right-sided heart failure. The nurse knows that a significant sign is which of the following? a) Decreased O2 saturation levels b) Oliguria c) Pitting edema d) S3 ventricular gallop sign
C
The nurse is caring for a patient who has developed obvious signs of pulmonary edema. What is the priority nursing action? A) Lay the patient flat. B) Notify the family of the patient's critical state. C) Stay with the patient. D) Update the physician.
C
The nurse is caring for a patient with systolic HF whose previous adverse reactions preclude the safe use of ACE inhibitors. The nurse should anticipate that the prescriber may choose what combination of drugs? A) Loop diuretic and antiplatelet aggregator B) Loop diuretic and calcium channel blocker C) Combination of hydralazine and isosorbide dinitrate D) Combination of digoxin and normal saline
C
The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal hernia repair. The OR report indicates that the patient received large volumes of IV fluids during surgery and the nurse recognizes that the patient is at risk for left-sided heart failure. What signs and symptoms would indicate left-sided heart failure? A) Jugular vein distention B) Right upper quadrant pain C) Bibasilar fine crackles D) Dependent edema
C
The nurse notes that a patient has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem? A) Pericarditis B) Cardiomyopathy C) Pulmonary edema D) Right ventricular hypertrophy
C
A client in the hospital informs the nurse he ?"feels like his heart is racing and can''t catch his breath." ?What does the nurse understand occurs as a result of a tachydysrhythmia? a) It increases preload. b) It increases afterload. c) It causes a loss of elasticity in the myocardium. d) It reduces ventricular ejection volume.
D
A nurse is administering lanoxin, which she knows increases contractility as well as cardiac output. Contractility refers to which of the following? a) Fluid overload and tissue perfusion status b) The amount of blood presented to the ventricles just before systole c) The amount of resistance to the ejection of blood from the ventricles d) The force of the contraction related to the status of the myocardium
D
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? a) It never needs batteries. b) It's designed for extremely active patients. c) It's specifically designed for long-term use. d) An LVAD only supports a failing left ventricle.
D
The cardiac monitor alarm alerts the critical care nurse that the patient is showing no cardiac rhythm on the monitor. The nurse's rapid assessment suggests cardiac arrest. In providing cardiac resuscitation documentation, how will the nurse describe this initial absence of cardiac rhythm? A) Pulseless electrical activity (PEA) B) Ventricular fibrillation C) Ventricular tachycardia D) Asystole
D
The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse? a) Administer the medication and inform the charge nurse about the rate. b) Administer atropine to speed the heart rate and then administer the digoxin. c) Administer the medications and then notify the physician. d) Withhold the medication and notify the physician of the heart rate
D
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? a) Sodium level of 135 b) BNP of 100 c) Hemoglobin of 12 d) Potassium level of 3.1
D
The nurse is reviewing a newly admitted patient's electronic health record, which notes a history of orthopnea? What nursing action is most clearly indicated? A) Teach the patient deep breathing and coughing exercises. B) Administer supplemental oxygen at all times. C) Limit the patient's activity level. D) Avoid positioning the patient supine.
D
The triage nurse in the ED is performing a rapid assessment of a man with complaints of severe chest pain and shortness of breath. The patient is diaphoretic, pale, and weak. When the patient collapses, what should the nurse do first? A) Check for a carotid pulse. B) Apply supplemental oxygen. C) Give two full breaths. D) Gently shake and shout, "Are you OK?"
D
Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest? a) III b) II c) I d) IV
D
