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Caring for Clients With Heart Failure| 2022 | Exam with Answers

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A procedure known as surgical ventricular restoration (SVR) decreases the size of the heart to a near normal size and shape by removing dysfunctional heart muscle that does not contract properly. Once the adynamic (nonfunctioning) area is removed, the ventricle is repaired with a patch. In the cases that were studied, 91% were free of congestive heart failure after surgery with an ejection fraction that increased from 30% to 40%. A cardiomyoplasty, placement of an external pacemaker, or a ventricular assist device are not considered curative for heart failure. 7. 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) BP and pulse measurements every 15 to 30 minutes C) Insertion of a central venous catheter D) Hourly administration of a fluid bolus Ans: B Feedback: Bedside ECG monitoring is standard, as are continuous pulse oximetry, automatic BP, and pulse measurements approximately every 15 to 30 minutes. 8. The nurse documents pitting edema in the bilateral lower extremities of the client. What does this documentation mean? A) There is excess fluid volume in the interstitial space in areas affected by gravity. B) There is excess fluid volume in the venous system of the lower extremities. C) There is excess fluid volume in the arterial system of the lower extremities. D) There is excess fluid volume in the hepatic system. Ans: A Feedback: Dependent pitting edema (excess fluid volume in the interstitial space in body areas affected by gravity) in the feet and ankles can be observed. This type of edema may seem to disappear overnight but really is temporarily redistributed by gravity to other tissues, such as the sacral area. Options B, C, and D are not descriptive of pitting edema.

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The nurse is preparing a client
for a multiple gated acquisition
(MUGA) scan. What would be an
1.
important instruction for the
nurse to give a client who is to
undergo a MUGA scan?
Avoid any activity at least 2
A)
hours before the test.
Drink plenty of fluids during the
B)
test.
Avoid dairy products a day before
C)
and a day after the test.
Lie very still at intermittent times
D)
during the test.
Ans: D
Feedback:
The nurse should instruct the
client, who is to undergo a MUGA
scan, to lie very still at
intermittent times during the 45-
minute test. The client need not
to drink plenty of fluids, avoid
activities before or after the test,
or avoid dairy products during
the test.


You are caring for a client with
suspected right-sided heart
failure. What would you know
2.
that clients with suspected right-
sided heart failure may
experience?
A) Increased urine output
B) Gradual unexplained weight gain
C) Increased perspiration
D) Sleeping in a chair or recliner
Ans: B
Feedback:
Clients with right-sided heart
failure may have a history of
gradual, unexplained weight gain
from fluid retention. Left-sided
heart failure produces
paroxysmal nocturnal dyspnea,

, which may prompt the client to
use several pillows in bed or to
sleep in a chair or recliner. Right-
sided heart failure does not
cause increased perspiration or
increased urine output.


A client with left-sided heart
failure is in danger of impaired
3. renal perfusion. How would the
nurse assess this client for
impaired renal perfusion?
A) Assess for reduced urine output.
Assess for reduced blood sodium
B)
levels.
Assess for elevated blood
C)
potassium levels.
Assess for elevated blood urea
D)
nitrogen levels.
Ans: D
Feedback:
Elevated blood urea nitrogen
indicates impaired renal
perfusion in a client with left-
sided heart failure. Serum
sodium levels may be elevated.
Reduced urine output or elevated
blood potassium levels do not
indicate impaired renal perfusion
in a client with left-sided heart
failure.


The student nurse is caring for a
client with heart failure. Diuretics
have been ordered. What method
4. might be used with a debilitated
patient to help the nurse
evaluate the client's response to
diuretics?
A) Using mechanical ventilation
B) Using a urinary catheter
Using a pulmonary artery
C)
catheter

, D) Using a biventricular pacemaker
Ans: B
Feedback:
To evaluate response to diuretics,
a urinary catheter is used.
Mechanical ventilation helps
maintain a normal breathing
pattern. A pulmonary artery
catheter helps estimate cardiac
output. A biventricular
pacemaker is used to sustain life.


You are working in a long-term
care facility with a group of older
adults with cardiac disorders.
Why would it be important for
5.
you to closely monitor an older
adult receiving digitalis
preparations for cardiac
disorders?
Older adults are at increased risk
A)
for toxicity.
Older adults are at increased risk
B)
for cardiac arrests.
Older adults are at increased risk
C)
for hyperthyroidism.
Older adults are at increased risk
D)
for asthma.
Ans: A
Feedback:
Older adults receiving digitalis
preparations are at increased risk
for toxicity because of the
decreased ability of the kidneys
to excrete the drug due to age-
related changes. The margin
between a therapeutic and toxic
effect of digitalis preparations is
narrow. Using digitalis
preparations does not increase
the risk of cardiac arrests,
hyperthyroidism, or asthma.

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