Chapter 38. Heart Failure
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure
because they have more than one action to address the pathological changes in this disorder. Which
of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?
1. Changes in the structure of the left ventricle so that it dilates, hypertrophies, and
uses energy less efficiently.
2. Reduced formation of cross-bridges so that contractile force decreases.
3. Activation of the sympathetic nervous system that increases heart rate and preload.
4. Decreased renal blood flow that decreases oxygen supply to the kidneys.
2. One of the three types of heart failure involves systolic dysfunction. Potential causes of this most
common form of heart failure include:
1. Myocardial ischemia and injury secondary to myocardial infarction
2. Inadequate relaxation and loss of muscle fiber secondary to valvular dysfunction
3. Increased demands of the heart beyond its ability to adapt secondary to anemia
4. Slower filling rate and elevated systolic pressures secondary to uncontrolled
hypertension
3. The American Heart Association and the American College of Cardiology have devised a
classification system for heart failure that can be used to direct treatment. Patients with
symptoms and underlying disease are classified as stage:
, 1. A
2. B
3. C
4. D
4. Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the
same symptoms. The most specific and sensitive diagnostic test for heart failure is:
1. Chest x-rays that show cephalization and measure heart size
2. Two-dimensional echocardiograms that identify structural anomalies and cardiac
dysfunction
3. Complete blood count, blood urea nitrogen, and serum electrolytes that facilitate
staging for end-organ damage
4. Measurement of brain natriuretic peptide to distinguish between systolic and
diastolic dysfunction
5. Treatments for heart failure, including drug therapy, are based on the stages developed by the
ACC/AHA. Stage A patients are treated with:
1. Drugs for hypertension and hyperlipidemia, if they exist
2. Lifestyle management including diet, exercise, and smoking cessation only
3. Angiotensin-converting enzyme (ACE) inhibitors to directly affect the heart failure
only
4. No drugs are used in this early stage
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Angiotensin-converting-enzyme (ACE) inhibitors are a central part of the treatment of heart failure
because they have more than one action to address the pathological changes in this disorder. Which
of the following pathological changes in heart failure is NOT addressed by ACE inhibitors?
1. Changes in the structure of the left ventricle so that it dilates, hypertrophies, and
uses energy less efficiently.
2. Reduced formation of cross-bridges so that contractile force decreases.
3. Activation of the sympathetic nervous system that increases heart rate and preload.
4. Decreased renal blood flow that decreases oxygen supply to the kidneys.
2. One of the three types of heart failure involves systolic dysfunction. Potential causes of this most
common form of heart failure include:
1. Myocardial ischemia and injury secondary to myocardial infarction
2. Inadequate relaxation and loss of muscle fiber secondary to valvular dysfunction
3. Increased demands of the heart beyond its ability to adapt secondary to anemia
4. Slower filling rate and elevated systolic pressures secondary to uncontrolled
hypertension
3. The American Heart Association and the American College of Cardiology have devised a
classification system for heart failure that can be used to direct treatment. Patients with
symptoms and underlying disease are classified as stage:
, 1. A
2. B
3. C
4. D
4. Diagnosis of heart failure cannot be made by symptoms alone because many disorders share the
same symptoms. The most specific and sensitive diagnostic test for heart failure is:
1. Chest x-rays that show cephalization and measure heart size
2. Two-dimensional echocardiograms that identify structural anomalies and cardiac
dysfunction
3. Complete blood count, blood urea nitrogen, and serum electrolytes that facilitate
staging for end-organ damage
4. Measurement of brain natriuretic peptide to distinguish between systolic and
diastolic dysfunction
5. Treatments for heart failure, including drug therapy, are based on the stages developed by the
ACC/AHA. Stage A patients are treated with:
1. Drugs for hypertension and hyperlipidemia, if they exist
2. Lifestyle management including diet, exercise, and smoking cessation only
3. Angiotensin-converting enzyme (ACE) inhibitors to directly affect the heart failure
only
4. No drugs are used in this early stage
