AAHFN RN CERTIFICATION ALREADY
PASSED
Each 1% increase in A1C is associated with an _____% increase in risk of hospitalization or HF death -
=8%
Most costly expense for Medicare, nearly 1/3 of all HF patients, 40% of these are preventable - =HF
Admissions
True or False: patients going home on continuous inotrope support must have an ICD? - =True
Nearly 1/3 of all patients with HF are readmitted within this time frame - =30 days
True or False: inotropes can be administered intermittently - =False
Where is an S3 gallop best heard? Best heard with the diaphragm or bell? - =5th ICS mid-clavicular line
(mitral area/cardiac apex); It is best heard with the BELL of the stethoscope
HF and renal dysfunction; is renal dysfunction an independent risk factor for morbidity and mortality? -
=YES, it is an independent risk factor for morbidity and mortality
This is designed to emphasize preventability in HF; 4 stages to help define goals of tx and specific
therapy; reflects structural changes/stages - =ACC/AHA Stages of HF A-D
Which of the following is an AICD FDA approved for?
-Persistent NYHA Class IV symptoms
-Cardiogenic shock
-CABG or Perc. intervention within the last 3 months
-Enzyme positive MI within the last 40 days
,-Prior cardiac arrest 2/2 VF or sustained VT
-Clinical symptoms that make pt candidate for coronary revascularization
-Pt with less than one year survival rate - =-Prior cardiac arrest 2/2 VF or sustained VT
All HF patients must be on WHAT in order to become a candidate for ICD placement? - =GDMT with
appropriate medications
ventricular remodeling causes _____ ventricular contraction - =Dyssynchronous
Dyssynchronous contraction causes an increase or decrease in ventricular contractile force - =Decrease
Dyssynchronous contraction causes an increase or decrease in severity of mitral regurgitation -
=Increase
Dyssynchronous contraction causes optimal or suboptimal ventricular filling - =Suboptimal
PQRST related to HF assessment stands for what - =P=precipitating factors Q=quality
(characteristics/location) R=radiation S=severity and scale T= timing (onset, duration, frequency)
Angiotensin II is a vasoconstrictor or vasodilator - =Potent vasoconstrictor
Describe angiotensin II - =A peptide hormone that stimulates constriction of precapillary arterioles and
increases reabsorption of NaCl and water by the proximal tubules of the kidney, increasing blood
pressure and volume; it also stimulates aldosterone
Describe the role of Aldosterone in HF - =Hormone that stimulates the kidneys to retain sodium ions and
water while stimulating potassium excretion and directly promoting myocardial fibrosis
Chronic activation of SNS increases or decreases oxygen demands - =Increases O2 demands
, Angiotensin II is transformed from ________ by ___________ - =Angiotensin I by angiotensin converting
enzyme (ACE)
Is BNP higher or lower in obesity? - =May be Lower
Is BNP higher or lower in women, elderly, and those with renal failure? - =May be Higher
A BNP of 300-595 is indicative of __________ HF - =Mild HF
A BNP >900 is indicative of __________ HF - =Severe HF
Does Vasopressin (antidiuretic hormone, ADH) increase or decrease peripheral vascular resistance,
arterial BP, and central venous pressure - =Increases PVR, Arterial BP, and CVP 2/2 vasoconstriction
Increased levels of vasopressin lead to hyponatremia or hypernatremia - =HYPOnatremia and congestion
Describe Endothelin (ET) - =Vasocontrictor peptide expressed by myocardium and synthesized in
vascular endothelial cells
Increased levels of Endothelin will lead to ____ _____ dysfunction and ______ hypertension - =Left
ventricular dysfunction and pulmonary hypertension
With neurohormonal activation, you would expect to see the following EXCEPT:
A. Elevated catecholamine release
B. Increased concentrations of renin, angiotensin II, and aldosterone
C. Decreased myocardial oxygen demand
D. Release of vasopressin - =C. Decreased myocardial oxygen demand
Which of the following is involved in the neurohormonal imbalance that occurs in HF:
A. Reduced vascular impedance
PASSED
Each 1% increase in A1C is associated with an _____% increase in risk of hospitalization or HF death -
=8%
Most costly expense for Medicare, nearly 1/3 of all HF patients, 40% of these are preventable - =HF
Admissions
True or False: patients going home on continuous inotrope support must have an ICD? - =True
Nearly 1/3 of all patients with HF are readmitted within this time frame - =30 days
True or False: inotropes can be administered intermittently - =False
Where is an S3 gallop best heard? Best heard with the diaphragm or bell? - =5th ICS mid-clavicular line
(mitral area/cardiac apex); It is best heard with the BELL of the stethoscope
HF and renal dysfunction; is renal dysfunction an independent risk factor for morbidity and mortality? -
=YES, it is an independent risk factor for morbidity and mortality
This is designed to emphasize preventability in HF; 4 stages to help define goals of tx and specific
therapy; reflects structural changes/stages - =ACC/AHA Stages of HF A-D
Which of the following is an AICD FDA approved for?
-Persistent NYHA Class IV symptoms
-Cardiogenic shock
-CABG or Perc. intervention within the last 3 months
-Enzyme positive MI within the last 40 days
,-Prior cardiac arrest 2/2 VF or sustained VT
-Clinical symptoms that make pt candidate for coronary revascularization
-Pt with less than one year survival rate - =-Prior cardiac arrest 2/2 VF or sustained VT
All HF patients must be on WHAT in order to become a candidate for ICD placement? - =GDMT with
appropriate medications
ventricular remodeling causes _____ ventricular contraction - =Dyssynchronous
Dyssynchronous contraction causes an increase or decrease in ventricular contractile force - =Decrease
Dyssynchronous contraction causes an increase or decrease in severity of mitral regurgitation -
=Increase
Dyssynchronous contraction causes optimal or suboptimal ventricular filling - =Suboptimal
PQRST related to HF assessment stands for what - =P=precipitating factors Q=quality
(characteristics/location) R=radiation S=severity and scale T= timing (onset, duration, frequency)
Angiotensin II is a vasoconstrictor or vasodilator - =Potent vasoconstrictor
Describe angiotensin II - =A peptide hormone that stimulates constriction of precapillary arterioles and
increases reabsorption of NaCl and water by the proximal tubules of the kidney, increasing blood
pressure and volume; it also stimulates aldosterone
Describe the role of Aldosterone in HF - =Hormone that stimulates the kidneys to retain sodium ions and
water while stimulating potassium excretion and directly promoting myocardial fibrosis
Chronic activation of SNS increases or decreases oxygen demands - =Increases O2 demands
, Angiotensin II is transformed from ________ by ___________ - =Angiotensin I by angiotensin converting
enzyme (ACE)
Is BNP higher or lower in obesity? - =May be Lower
Is BNP higher or lower in women, elderly, and those with renal failure? - =May be Higher
A BNP of 300-595 is indicative of __________ HF - =Mild HF
A BNP >900 is indicative of __________ HF - =Severe HF
Does Vasopressin (antidiuretic hormone, ADH) increase or decrease peripheral vascular resistance,
arterial BP, and central venous pressure - =Increases PVR, Arterial BP, and CVP 2/2 vasoconstriction
Increased levels of vasopressin lead to hyponatremia or hypernatremia - =HYPOnatremia and congestion
Describe Endothelin (ET) - =Vasocontrictor peptide expressed by myocardium and synthesized in
vascular endothelial cells
Increased levels of Endothelin will lead to ____ _____ dysfunction and ______ hypertension - =Left
ventricular dysfunction and pulmonary hypertension
With neurohormonal activation, you would expect to see the following EXCEPT:
A. Elevated catecholamine release
B. Increased concentrations of renin, angiotensin II, and aldosterone
C. Decreased myocardial oxygen demand
D. Release of vasopressin - =C. Decreased myocardial oxygen demand
Which of the following is involved in the neurohormonal imbalance that occurs in HF:
A. Reduced vascular impedance
