WGU D027 UPDATED FINAL EXAMS ACTUAL
QUESTIONS AND ANSWERS SURE A+
✔✔Stage B HF co-morbidities - ✔✔previous MI, LV remodeling with LV hypertrophy and
low EF, asymptomatic valvular disease
✔✔Therapy goals of Stage B HF - ✔✔Meds: ACEI or ARB, Beta-blockers, inplantable
defibrillators
✔✔Stage C heart failure - ✔✔structural heart disease with prior or current symptoms of
HF
✔✔Presentation of Stage C HF - ✔✔known structural heart disease and shortness of
breath and fatigue, reduced exercise tolerance
✔✔Therapy for Stage C HF - ✔✔dietary salt restriction, MEDS: diuretic, ACEI, beta
blockers. Some patients: aldosterone antagonist, ARBs, digitalis, hydralazine/nitrates,
biventricular pacing, inplantable defibrillators
✔✔Stage D heart failure - ✔✔refractory HF requiring specialized interventions
, ✔✔Presentation of Stage D HF - ✔✔marked symptoms at rest despite maximal medical
therapy (recurrently hospitalized or cannot be safely discharged without specialized
interventions)
✔✔Therapy goals for Stage D HF - ✔✔compassionate end-of-life care/hospice,
extraordinary measures ,heart transplant, chronic inotropes, permanent mechanical
support, experimental drugs or surgery
✔✔Ischemic heart Disease (CAD, MI) presentation - ✔✔chest discomfort, pain in
neck/jaw/chest (crushing, squeezing, sharp), pain worse with exertion (demand
requirement is higher), abnormal heart sounds, hypoxia, arrhythmias (afib, ST elevation)
✔✔Stable angina goal - ✔✔decrease cardiac oxygen demand
✔✔Meds for stable angina - ✔✔nitro first choice, then beta blockers (beta blockers if
angina occurs with effort)
✔✔nitroglycerine dose - ✔✔sublingual, acts within 5 minutes, max of 3 doses
✔✔Cardiac glycosides (Digoxin) - ✔✔Increased myocardial contractile force (increases
output), used in ED, exerts positive inotropic action, can cause severe dysrhythmias
✔✔Digoxin Dosing - ✔✔therapeutic - 0.5-0.8 ng/ml. ASSESS apical pulse before
administering, If lethargic and not acting right, see patient FIRST
✔✔Goal of Anticoagulant and Antiplatelet Drugs - ✔✔inactivate and suppress formation
of thrombin
✔✔Warfarin (coumadin) - ✔✔PO to prevent blood clots; start with half a dose
✔✔Anticoagulants - ✔✔Warfarin, heparin, lovenox; Caution about hemorrhage, any
patients with risks for bleeding
✔✔Pneumonia Patho - ✔✔pathogen reaches airway and overwhelms defenses causing
inflammatory cascade; fluid forms, blocking diffusion (gas exchange) causing hypoxia,
ultimately leads to respiratory failure
✔✔Diagnosing pneumonia - ✔✔Chest X-ray: viral - diffuse widespread whitening;
bacterial - patchy, consolidated, lobar
✔✔Emphysema - ✔✔destruction of alveolar walls; air goes into lungs, can't get out;
leads to hyperinflation
✔✔Bronchitis - ✔✔excess mucus production, smooth muscle hypertrophy
QUESTIONS AND ANSWERS SURE A+
✔✔Stage B HF co-morbidities - ✔✔previous MI, LV remodeling with LV hypertrophy and
low EF, asymptomatic valvular disease
✔✔Therapy goals of Stage B HF - ✔✔Meds: ACEI or ARB, Beta-blockers, inplantable
defibrillators
✔✔Stage C heart failure - ✔✔structural heart disease with prior or current symptoms of
HF
✔✔Presentation of Stage C HF - ✔✔known structural heart disease and shortness of
breath and fatigue, reduced exercise tolerance
✔✔Therapy for Stage C HF - ✔✔dietary salt restriction, MEDS: diuretic, ACEI, beta
blockers. Some patients: aldosterone antagonist, ARBs, digitalis, hydralazine/nitrates,
biventricular pacing, inplantable defibrillators
✔✔Stage D heart failure - ✔✔refractory HF requiring specialized interventions
, ✔✔Presentation of Stage D HF - ✔✔marked symptoms at rest despite maximal medical
therapy (recurrently hospitalized or cannot be safely discharged without specialized
interventions)
✔✔Therapy goals for Stage D HF - ✔✔compassionate end-of-life care/hospice,
extraordinary measures ,heart transplant, chronic inotropes, permanent mechanical
support, experimental drugs or surgery
✔✔Ischemic heart Disease (CAD, MI) presentation - ✔✔chest discomfort, pain in
neck/jaw/chest (crushing, squeezing, sharp), pain worse with exertion (demand
requirement is higher), abnormal heart sounds, hypoxia, arrhythmias (afib, ST elevation)
✔✔Stable angina goal - ✔✔decrease cardiac oxygen demand
✔✔Meds for stable angina - ✔✔nitro first choice, then beta blockers (beta blockers if
angina occurs with effort)
✔✔nitroglycerine dose - ✔✔sublingual, acts within 5 minutes, max of 3 doses
✔✔Cardiac glycosides (Digoxin) - ✔✔Increased myocardial contractile force (increases
output), used in ED, exerts positive inotropic action, can cause severe dysrhythmias
✔✔Digoxin Dosing - ✔✔therapeutic - 0.5-0.8 ng/ml. ASSESS apical pulse before
administering, If lethargic and not acting right, see patient FIRST
✔✔Goal of Anticoagulant and Antiplatelet Drugs - ✔✔inactivate and suppress formation
of thrombin
✔✔Warfarin (coumadin) - ✔✔PO to prevent blood clots; start with half a dose
✔✔Anticoagulants - ✔✔Warfarin, heparin, lovenox; Caution about hemorrhage, any
patients with risks for bleeding
✔✔Pneumonia Patho - ✔✔pathogen reaches airway and overwhelms defenses causing
inflammatory cascade; fluid forms, blocking diffusion (gas exchange) causing hypoxia,
ultimately leads to respiratory failure
✔✔Diagnosing pneumonia - ✔✔Chest X-ray: viral - diffuse widespread whitening;
bacterial - patchy, consolidated, lobar
✔✔Emphysema - ✔✔destruction of alveolar walls; air goes into lungs, can't get out;
leads to hyperinflation
✔✔Bronchitis - ✔✔excess mucus production, smooth muscle hypertrophy
