Chapter 29: Management of Patients With Complications from Heart Disease
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. mL
1.25
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) Bibasilar crackles
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) Decrease in renal perfusion
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) Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.
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) Persistent cough
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) Pulmonary congestion
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) Restlessness and confusion
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) Tissue hypoperfusion
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) Bibasilar crackles
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) Dyspnea on exertion
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) Head of the bed elevated at 45 degrees and lower arms supported by pillows
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) Low ejection fraction (EF)
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) Morphine sulfate
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) Potassium level of 2.8 mEq/L
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) Decompensated heart failure with pulmonary edema
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) Heart transplant
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) Leg edema
Which of the following medications is a human brain natriuretic peptide (BNP) preparation? a) Captopril b) Metoprolol c) Natrecor d) Enalapril
c) Natrecor
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) Potassium
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) Slightly reduced
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) peripheral edema.
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's specifically designed for long-term use. b) It never needs batteries. c) It's designed for extremely active patients. d) An LVAD only supports a failing left ventricle.
d) An LVAD only supports a failing left ventricle.
The nurse recognizes which of the following lab tests is a key diagnostic indicator of heart failure? a) Blood urea nitrogen (BUN) b) Complete blood count (CBC) c) Creatinine d) Brain natriuretic peptide (BNP)
d) Brain natriuretic peptide (BNP)
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) Congestion in the peripheral tissues
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) Echocardiogram
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) Fatigue
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) IV
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) It reduces ventricular ejection volume.
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) Left ventricular function
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) Potassium level of 3.1
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) The force of the contraction related to the status of the myocardium
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) Withhold the medication and notify the physician of the heart rate