Heart Failure Nursing Certification Questions With
Complete Solutions
-Timing of initiation in ACE-I and ARBs in naïve patients:
Correct Answers -avoid initiation when hypotensive or
hypovolemic
-Avoid initiation when renal function is declining
-Optimize does prior to discharge and identify and communicate
target does to outpatient provider*
-Consider hydralazine/dinitrate combination as alternative if
ACE-I/ARB intolerant, or added, if African-American
" upstream" planning for ICD deactivation: deactivation
information should be provided at the time of the insertion,
including Correct Answers -consideration, the future
deactivation of defibrillator feature may be desired
-Reasons for deactivation
-Process for deactivation of defibrillator features
-Discussions about defibrillator deactivation should be revisited
BEFORE marked reductions in prognosis or functional status
occur
-ICD deactivation preferences in code status should be clearly
documented and communicated to the healthcare team
-If ICD defibrillation features are deactivated, pacing, and
resynchronization pacing features should be maintained to
prevent clinical deterioration and worsening of symptoms
" upstream" planning for ICD deactivation: ICD pre-
implantation counseling should include: Correct Answers -
Information about individual cardiac prognosis
-risk of sudden and non-sudden death
,-Benefits, safety, risk of ICD therapy
-Risk associated with ICD shots, including pain, anxiety, risk of
inappropriate shocks, site problems
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: education for an acute care HF hospitalization should
only include essential education Correct Answers -assist
patient in understanding the cause of HF, its treatment, and post
discharge medication and follow up regimen
-Education during hospitalization should be supplemented and
reinforced within 1-2 weeks following discharge and continued
for 3-6 months; reassessing periodically
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: education, focused on improving decision-making
abilities may improve outcomes Correct Answers -improving
adherence includes engaging patient to undertake a greater
personal role in managing their HF
-use once daily medication dosing whenever possible
-Tailor medication's to patient daily schedules
-Consider providing weekly pill dispensers
-Pill bottle should be labeled in large print with drug name and
dosing regimen
-Provide updated medication list and written instructions for
medication changes of every visit
-Ask about over-the-counter meds
-Ask the patient is tolerating their medication; do not assume
they're taking them as prescribed. ASK PTS HOW MANY
,TIMES IN A SPACE OF WEEK OR MONTH DO THEY
THINK THEY ARE MISSING THEIR MED
-Assist with social and financial concerns
-Follow up with patients by phone or email regarding self care
-provide educational materials on diet, activity, and medication'
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: patients with advanced HF, or with persistent difficulty
adhering to recommended regimen, require the most education
and counseling Correct Answers -patient should be offered a
variety of options for learning according to their preference
-Repeated exposure to material is recommended
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: recommended prior to discharge for all patients with
HF Correct Answers -exacerbating factors addressed
-Optima fluid status and pharmacological therapy achieved
-Transition from IV to oral diuretics successfully completed
-patient and family education completed
-Educational session should begin with an assessment of
patient's current HF knowledge
-Issues about which the patient wants to learn should be
discussed
-Review the patient's perceived barriers to change
1 kg increase in weight reflects how many liters of fluid
retention? Correct Answers 1L
, 12 lead EKG Correct Answers Looking for ischemic changes,
arrhythmias, LV, hypertrophy, monitoring drug side effects, or
electrolyte imbalances
2013 ACCF/AHA, heart failure, guideline recommendations on
inpatient and outpatient transition of care include: Correct
Answers 1. Use of performance improvement systems, and/or
evidence based systems of care is recommended in the hospital
in early post discharge setting to identify HF patientsfor GDMT
2. Before discharge, at the first post discharge visit, and all
subsequent visits, the following should be addressed:
-Initiation of GMT, if not done or contraindicated
-Causes of HF, barriers to care, and limitations of social support
-Assessment of volume status and blood pressure with
adjustments of HF medical therapy
-Optimization of chronic oral HF therapy
-Renal function and electrolytes
-Management of comorbid conditions
-HF education, self-care, emergency, plans, and adherence
-Palliative or hospice care
3. HF patients at high risk for hospital readmission should be
referred to and followed by an interdisciplinary HF disease
management program
-The literature Chalmette programs for specialist, followed by
an interdisciplinary team, decrease all cars, hospitalizations and
mortality
4. Afollow up visit within 7 to 14 days and/or a telephone follow
up call within three days of hospital discharge
Complete Solutions
-Timing of initiation in ACE-I and ARBs in naïve patients:
Correct Answers -avoid initiation when hypotensive or
hypovolemic
-Avoid initiation when renal function is declining
-Optimize does prior to discharge and identify and communicate
target does to outpatient provider*
-Consider hydralazine/dinitrate combination as alternative if
ACE-I/ARB intolerant, or added, if African-American
" upstream" planning for ICD deactivation: deactivation
information should be provided at the time of the insertion,
including Correct Answers -consideration, the future
deactivation of defibrillator feature may be desired
-Reasons for deactivation
-Process for deactivation of defibrillator features
-Discussions about defibrillator deactivation should be revisited
BEFORE marked reductions in prognosis or functional status
occur
-ICD deactivation preferences in code status should be clearly
documented and communicated to the healthcare team
-If ICD defibrillation features are deactivated, pacing, and
resynchronization pacing features should be maintained to
prevent clinical deterioration and worsening of symptoms
" upstream" planning for ICD deactivation: ICD pre-
implantation counseling should include: Correct Answers -
Information about individual cardiac prognosis
-risk of sudden and non-sudden death
,-Benefits, safety, risk of ICD therapy
-Risk associated with ICD shots, including pain, anxiety, risk of
inappropriate shocks, site problems
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: education for an acute care HF hospitalization should
only include essential education Correct Answers -assist
patient in understanding the cause of HF, its treatment, and post
discharge medication and follow up regimen
-Education during hospitalization should be supplemented and
reinforced within 1-2 weeks following discharge and continued
for 3-6 months; reassessing periodically
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: education, focused on improving decision-making
abilities may improve outcomes Correct Answers -improving
adherence includes engaging patient to undertake a greater
personal role in managing their HF
-use once daily medication dosing whenever possible
-Tailor medication's to patient daily schedules
-Consider providing weekly pill dispensers
-Pill bottle should be labeled in large print with drug name and
dosing regimen
-Provide updated medication list and written instructions for
medication changes of every visit
-Ask about over-the-counter meds
-Ask the patient is tolerating their medication; do not assume
they're taking them as prescribed. ASK PTS HOW MANY
,TIMES IN A SPACE OF WEEK OR MONTH DO THEY
THINK THEY ARE MISSING THEIR MED
-Assist with social and financial concerns
-Follow up with patients by phone or email regarding self care
-provide educational materials on diet, activity, and medication'
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: patients with advanced HF, or with persistent difficulty
adhering to recommended regimen, require the most education
and counseling Correct Answers -patient should be offered a
variety of options for learning according to their preference
-Repeated exposure to material is recommended
***Heart failure, society of America 2010 practice guidelines on
discharge criteria for hospitalized acute decompensated HF
patients: recommended prior to discharge for all patients with
HF Correct Answers -exacerbating factors addressed
-Optima fluid status and pharmacological therapy achieved
-Transition from IV to oral diuretics successfully completed
-patient and family education completed
-Educational session should begin with an assessment of
patient's current HF knowledge
-Issues about which the patient wants to learn should be
discussed
-Review the patient's perceived barriers to change
1 kg increase in weight reflects how many liters of fluid
retention? Correct Answers 1L
, 12 lead EKG Correct Answers Looking for ischemic changes,
arrhythmias, LV, hypertrophy, monitoring drug side effects, or
electrolyte imbalances
2013 ACCF/AHA, heart failure, guideline recommendations on
inpatient and outpatient transition of care include: Correct
Answers 1. Use of performance improvement systems, and/or
evidence based systems of care is recommended in the hospital
in early post discharge setting to identify HF patientsfor GDMT
2. Before discharge, at the first post discharge visit, and all
subsequent visits, the following should be addressed:
-Initiation of GMT, if not done or contraindicated
-Causes of HF, barriers to care, and limitations of social support
-Assessment of volume status and blood pressure with
adjustments of HF medical therapy
-Optimization of chronic oral HF therapy
-Renal function and electrolytes
-Management of comorbid conditions
-HF education, self-care, emergency, plans, and adherence
-Palliative or hospice care
3. HF patients at high risk for hospital readmission should be
referred to and followed by an interdisciplinary HF disease
management program
-The literature Chalmette programs for specialist, followed by
an interdisciplinary team, decrease all cars, hospitalizations and
mortality
4. Afollow up visit within 7 to 14 days and/or a telephone follow
up call within three days of hospital discharge
