Chapter 17 Quiz- Left and Right Heart Failure

A patient with severe pulmonary issues develops right-side heart failure due to these issues. What is an appropriate term for the nurse to use?

Cor pulmon Rationale: Cor pulmaleonale develops when pulmonary disorders cause right ventricle failure.

A patient has severe hypertension and enlargement and distention of the left ventricle making filling very difficult. What type of heart failure may the patient display ?

Diastolic heart failure Rationale: Diastolic heart failure manifests when the heart cannot be filled properly.

In left ventricular failure, which factors may be reduced? Select all that apply.

Ejection fraction Rationale: If the left ventricle is failing, then ejection fraction is reduced. Blood pressure Rationale: In heart failure, the left ventricle can not maintain blood pressure.

Which of the following are backward effects of right ventricular failure? Select all that apply.

Jugular vein distention Rationale: Jugular vein distension occurs in right-side heart failure as fluid backs up into the veins. Hepatomegaly Rationale: If the right side of the heart fails, then fluid may back up in the liver, causing hepatomegaly.

A nurse is reviewing high-output heart failure. Which of the following is the correct association?

May occur in conditions such as thyrotoxicosis Rationale: High-output failure results from extreme demands on the heart. This can occur with hormones released in thyrotoxicosis.

A patient is experiencing a decrease in blood pressure with myocardial infarction. What type of heart failure is exemplified by this scenario?

Systolic heart failure Rationale: The patient is unable to maintain blood pressure due to the heart's inability to contract effectively.

Digitalis is known as a positive inotropic and negative chronotropic medication. How would the nurse interpret this information?

The medication decreases heart rate and increases contractility. Rationale: Digitalis increases heart contractility (inotropic) while decreasing heart rate (chronotropic).

A patient states that, ever since he has had heart failure and was given a medication, he has to "pee more." Which of the following is a correct explanation from the nurse?

The medication increases your urine output to reduce the fluid load on your heart. Rationale: A diuretic will increase urination because it reduces fluid overload on the heart.

A nurse is reviewing how decreased perfusion to the kidneys can result in increased blood volume. Please place the following steps in order.

1. Juxtaglomerular cells secrete renin. 2. Renin activates angiotensinogen. 3. Angiotensin I is converted to angiotensin II. 4. Aldosterone is released. 5. Sodium and water reabsorption is increased. Rationale: With decreased renal perfusion, the juxtaglomerular cells will secrete renin. Renin will stimulate angiotensinogen. Angiotensin I will be converted to angiotensin II, which will stimulated aldosterone release. Aldosterone will increase sodium and water reabsorption, increasing blood volume and blood pressure.

A patient is given an angiotensin-converting enzyme (ACE) inhibitor medication. Which of the following steps does this medication work on?

Angiotensin I to angiotensin II Rationale: ACE stands for angiotensin-converting enzyme, which converts angiotensin I to angiotensin II.

The level of brain natriuretic peptide (BNP) is often measured in states of congestive heart failure. A patient asks a nurse why this factor is released during congestive heart failure. What is the appropriate association for the nurse to make?

BNP helps to alleviate the fluid overload on the heart. Rationale: BNP increases urine output, reducing fluid load on the heart.

Which of the following has likely occurred that led to this image?

Backward effects of left heart failure Rationale: The image shows pulmonary congestion, more common with left ventricular failure.

In the following image, what is this test measuring?

Backward effects of right-side heart failure Rationale: The image shows jugular vein distention, which is a backwards effect of right-side heart failure.

A patient is displaying increased pulmonary capillary wedge pressure due to coronary issues. What else may the nurse expect to see?

Paroxysmal nocturnal dyspnea Rationale: Increased pulmonary capillary wedge pressure indicates left-side heart failure. This may also cause paroxysmal nocturnal dyspnea.

A patient is to receive digitalis. Which of the following laboratory serum values should a nurse be concerned about?

Potassium Rationale: Digitalis toxicity can develop with low potassium levels.