NURS 5463 Module 6-Heart Failure
NURS 5463 Module 6: Heart Failure
Study online at https://quizlet.com/_c410hx
1. A 65-year-old man with heart failure has pillow or- C. Class III
thopnea and SOB while walking around his house. Heart failure symptoms with min-
He is comfortable only at rest. What New York imal amounts of exertion
Heart Association heart failure class symptoms
does he have?
A. Class I
B. Class II
C. Class III
D. Class IV
2. A 45-year-old man presents with dyspnea on ex- B. Assess for CAD with a stress test
ertion and four-pillow orthopnea. Jugular venous of cardiac catheterization
pressure is elevated, and you hear an S3 on exam. An ischemic evaluation is essen-
ECG is normal sinus rhythm without Q waves, ST, tial in a patient presenting with
or T wave changes. Echocardiography shows glob- recent-onset heart failure since
al left ventricular hypokinesis and an EF of 30% the most common cause of car-
with no valvular abnormalities. What is the next diomyopathy in the US is is-
best step in diagnosis or management? chemic heart disease
A. Order a chest CT for a coronary calcium score
B. Assess for coronary artery disease with a stress
test or cardiac catheterization
C. Implant a biventricular implantable cardiovert-
er defibrillator
D. Order a multigated acquisition scan to better
assess cardiac function
3. A 75-year-old man with chronic systolic heart fail- C. Implantable cardioverter de-
ure presents to your clinic with class III symptoms. fibrillator
His most recent echo showed an EF of 25%. He While digoxin, dietary recom-
takes losartan, metoprolol, aspirin, and aldactone. mendations, and cardiac rehab
Which of the following interventions will decrease can improve symptoms and de-
his mortality? crease readmission in heart fail-
, NURS 5463 Module 6-Heart Failure
NURS 5463 Module 6: Heart Failure
Study online at https://quizlet.com/_c410hx
A. Digoxin ure, only an ICD has been shown
B. Low-salt diet and fluid restriction to 1.5 L/day to decrease mortality
C. Implantable cardioverter defibrillator
D. Cardiac rehabilitation
4. A 55-year-old man complains of increasing dysp- B. IV furosemide
nea on exertion and orthopnea. His physical ex- Indicated in this patient with
amination reveals an S3 heart sound, pulmonary decompensated heart failure. IV
rales, jugular venous distention, and lower ex- dosing results in more rapid drug
tremity edema. He is normotensive, and his ex- delivery and effect than PO. BB
tremities are warm to touch. An echocardiogram initiation or titration is not ad-
confirms an ejection fraction of 25% and a dilated visable in patients with acute-
left ventricle. What is the most appropriate next ly decompensated HF. Nitroglyc-
step in management? erin may cause some venodila-
A. Oral furosemide tion, which may reduce preload,
B. IV furosemide but it will not affect this patient's
C. Oral BB volume overload
D. Sublingual nitroglycerin
5. Signs of low perfusion on physical exam include all C. Presence of the third heart
of the following exept? sound
A. Cool skin A third heart sound is a marker of
B. Narrow pulse pressure LV volume overload. Cool extrem-
C. Absence of the third heart sound ities, narrow pulse pressure, and
D. Faint pulses faint pulses are markers of poor
distal perfusion
6. Which of the following lab values is most helpful in B. BNP < 100
ruling out HF as a cause of dyspnea? Has a very high negative predic-
A. Troponin T <0.1 tive value for HF whereas BNP ex-
B. BNP <100 ceeding 400 is highly suggestive
of HF. A troponin level is used
NURS 5463 Module 6: Heart Failure
Study online at https://quizlet.com/_c410hx
1. A 65-year-old man with heart failure has pillow or- C. Class III
thopnea and SOB while walking around his house. Heart failure symptoms with min-
He is comfortable only at rest. What New York imal amounts of exertion
Heart Association heart failure class symptoms
does he have?
A. Class I
B. Class II
C. Class III
D. Class IV
2. A 45-year-old man presents with dyspnea on ex- B. Assess for CAD with a stress test
ertion and four-pillow orthopnea. Jugular venous of cardiac catheterization
pressure is elevated, and you hear an S3 on exam. An ischemic evaluation is essen-
ECG is normal sinus rhythm without Q waves, ST, tial in a patient presenting with
or T wave changes. Echocardiography shows glob- recent-onset heart failure since
al left ventricular hypokinesis and an EF of 30% the most common cause of car-
with no valvular abnormalities. What is the next diomyopathy in the US is is-
best step in diagnosis or management? chemic heart disease
A. Order a chest CT for a coronary calcium score
B. Assess for coronary artery disease with a stress
test or cardiac catheterization
C. Implant a biventricular implantable cardiovert-
er defibrillator
D. Order a multigated acquisition scan to better
assess cardiac function
3. A 75-year-old man with chronic systolic heart fail- C. Implantable cardioverter de-
ure presents to your clinic with class III symptoms. fibrillator
His most recent echo showed an EF of 25%. He While digoxin, dietary recom-
takes losartan, metoprolol, aspirin, and aldactone. mendations, and cardiac rehab
Which of the following interventions will decrease can improve symptoms and de-
his mortality? crease readmission in heart fail-
, NURS 5463 Module 6-Heart Failure
NURS 5463 Module 6: Heart Failure
Study online at https://quizlet.com/_c410hx
A. Digoxin ure, only an ICD has been shown
B. Low-salt diet and fluid restriction to 1.5 L/day to decrease mortality
C. Implantable cardioverter defibrillator
D. Cardiac rehabilitation
4. A 55-year-old man complains of increasing dysp- B. IV furosemide
nea on exertion and orthopnea. His physical ex- Indicated in this patient with
amination reveals an S3 heart sound, pulmonary decompensated heart failure. IV
rales, jugular venous distention, and lower ex- dosing results in more rapid drug
tremity edema. He is normotensive, and his ex- delivery and effect than PO. BB
tremities are warm to touch. An echocardiogram initiation or titration is not ad-
confirms an ejection fraction of 25% and a dilated visable in patients with acute-
left ventricle. What is the most appropriate next ly decompensated HF. Nitroglyc-
step in management? erin may cause some venodila-
A. Oral furosemide tion, which may reduce preload,
B. IV furosemide but it will not affect this patient's
C. Oral BB volume overload
D. Sublingual nitroglycerin
5. Signs of low perfusion on physical exam include all C. Presence of the third heart
of the following exept? sound
A. Cool skin A third heart sound is a marker of
B. Narrow pulse pressure LV volume overload. Cool extrem-
C. Absence of the third heart sound ities, narrow pulse pressure, and
D. Faint pulses faint pulses are markers of poor
distal perfusion
6. Which of the following lab values is most helpful in B. BNP < 100
ruling out HF as a cause of dyspnea? Has a very high negative predic-
A. Troponin T <0.1 tive value for HF whereas BNP ex-
B. BNP <100 ceeding 400 is highly suggestive
of HF. A troponin level is used
