HEART FAILURE NURSE RN EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+

1 HEART FAILURE NURSE RN EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ Which of the following patients are MOST at risk for developing heart failure? Correct Answer: -A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction -A 30 year old male with a history of endocarditis and has severe mitral stenosis -A 58 year old female with uncontrolled hypertension and is being treated for influenza -Risk factor for heart failure mnemonic FAILURE: faulty heart valves, arrhythmias, infarction, lineage, uncontrolled hypertension, recreational drug use, evaders (influenza) A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. Which statement is NOT correct about this condition? Correct Answer: This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema (not correct) 2 -This describes right-sided heart failure Which of the following are NOT typical signs and symptoms of right-sided heart failure? SATA Correct Answer: -persistent cough -crackles -orthopnea *these are s/s of LEFT sided heart failure Expected findings of left-sided systolic dysfunction heart failure? Correct Answer: -Echocardiogram shows an ejection fraction of 38% -Patient has frequent episodes of nocturnal paroxysmal dyspnea ejection fraction Correct Answer: measurement of the volume percentage of left ventricular contents ejected with each contraction normal ejection fraction Correct Answer: 55-70% True or False 3 Patients with left sided diastolic dysfunction heart failure usually have a normal ejection fraction Correct Answer: True -however, their SYSTOLIC dysfunction is the main issue because it doesn't CONTRACT efficiently Which of the following statements made by a patient with heart failure indicates the patient may be experiencing heart failure exacerbation? Correct Answer: -I've noticed that I've gained 6 pounds in one week -While I sleep, I have to prop myself up with a pillow so I can breathe Which of the following patients are most are at MOST risk for heart failure exacerbation? Correct Answer: -A 73 year old who reports not taking Amiodarone for one month and is experiencing atrial fibrillation *A fib patients have valves tath do not contract properly* A 74 year old female present to the ER with complaints of dyspnea, persistent cough, unable to sleep at night due to difficult breathing. On assessment, you note crackles 4 throughout the lung fields, RR of 25, and oxygen sat of 90% on room air. Which lab results confirm suspicion of heart failure? Correct Answer: BNP 820 (B type natriuretic peptide) 100 no failure, 100-300 present, 300 mild, 600 moderate, 900 severe Which of the following tests/procedures are NOT used to diagnose heart failure? Correct Answer: Holter monitoring (used to diagnosed patient's rhythm) Which type of HF does this statement describe? The ventricle is unable to fill properly with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience SOB Correct Answer: Left ventricular diastolic dysfunction A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention? Correct Answer: Assist the patient into high fowler's position (make breathing easier due to fluid overload) You're providing diet discharge teaching with a history of heart failure. Which of the following statements made by the patient represents the understood the diet teaching? Correct Answer: "I will limit my consumption of frozen meals." 5 -Patients should limit sodium to 2-3 grams/day, avoid canned vegetables/fish, and avoid sandwhich meat Select all the correct statements about education patient with HF Correct Answer: -It is important that patients notify physician if the gain 2-3 pounds in a day or 5 pounds in a week -Patients with heart failure should receive an annual influenza vaccine and be up-todate with the pneumonia vaccine -HF patients should limit sodium intake to 2-3 grams/day -Heart failure is exacerbated by illness, too much fluid, or sodium intake, and arrythmias -exercise only as tolerated A patient taking digoxin is experiencing severe bradychardia, nausea, and vomitting. A lab draw shows that their digoxin level is 4ng/mL. What medication do you anticipate the physician to order for this patient? Correct Answer: Digibind (antidote for digoxin) Which is a late sign of HF? Correct Answer: Frothy-blood tinged sputum 6 These drugs are used as first-line treatment of HF. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. Correct Answer: Angiotensin converting enzyme inhibitors A patient with HF is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T waves and flat P wave. Which results confirms these finding? Correct Answer: K+ 8.0 Losartan and Spironolactone can both cause and increased potassium level. Losartan is an ARB and Spironolactone is a potassium sparing diuretic. During you morning assessment of a patient with HF, the patient complains of sudden vision changes that include seeing yellowish green halos around the lights. Which of the following medications do you suspect is causing this issue? Correct Answer: Digoxin (toxicity) Select all the correct statements about the pharmacodynamics of beta blockers for the treatment of HF Correct Answer: -A side effect of these drugs include bradychardia 7 -beta blockers are prescribed with ACE or ARBs to treat HF You are assisting a patient up form the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for HF and is taking hydralazine (vasodilator) and Isordil (nitrate). Which of the following is a nursing priority for the patient while assisting them to the bathroom? Correct Answer: Assist the patient up slowly and gradually (most important) These drugs cause orthostatic hypotension A patient is taking digoxin. Prior to administration you check the patient's apical pulse (61bpm). Morning lab values are: K+3.3, digoxin 5ng/mL. Which of the following is the correct nursing action? Correct Answer: Hold the dose and notify physician of digoxin level 2 normal digoxin level common side effect of spironolactone? Correct Answer: hyperkalemia drug is potassium sparing (increases potassium level) 8 The physician's order says to administer Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0 and BUN 10. Which of the following is a nursing priority? Correct Answer: Hold the dose and notify physician about the potassium level