BSN 366 Week 11 Heart Failure Questions With Complete
Solutions
Atrial Dysrhythmias
Question 1 of 3
A patient who is otherwise healthy is experiencing premature
atrial contractions (PACs). The patient asks what could be
causing the PACs. Which is the best response by the nurse?
"Your low-protein diet."
"Your coffee and cigarette use."
"Your family history of diabetes."
"Your sedentary lifestyle and high-fat diet." Correct Answer
"Your coffee and cigarette use."
In a normal heart, a PAC can result from the use of caffeine or
tobacco.
Basic ECG Interpretation:
Question 1 of 4
Match the property of the cardiac conduction system with its
description.
Property of the cell that allows it to accept initiation of
stimulation
Excitability
Property that moves electrical impulse along a membrane
Conductivity
Ability of heart muscle to respond mechanically to an impulse
Contractility
Ability of heart muscle to initiate an impulse, begin stimulation
Automaticity Correct Answer
Diuretics
,Diuretics reduce edema, pulmonary venous pressure, and
preload. Thiazide diuretics (e.g., hydrochlorothiazide) inhibit
sodium reabsorption in the distal tubule, thus promoting
excretion of sodium and water. Loop diuretics such as
furosemide, bumetanide, and torsemide are potent but can cause
hypokalemia and ototoxicity. Spironolactone is a potassium-
sparing diuretic that promotes sodium and water excretion while
retaining potassium and therefore can cause hyperkalemia. In
chronic HF, the lowest effective dose of diuretic should be used.
Correct Answer Angiotensin-Converting Enzyme (ACE)
Inhibitors
ACE inhibitors (e.g., captopril, enalapril) are the primary drugs
of choice for blocking the renin-angiotensin-aldosterone system
in patients with systolic HF. A reduction in systemic vascular
resistance with the use of ACE inhibitors causes a significant
increase in CO. Although BP decreases, tissue perfusion is
maintained or increased as a result of improved CO, and diuresis
is enhanced by the suppression of aldosterone.
Heart Transplantation
Question 1 of 3
A 22-year-old patient is diagnosed with terminal heart failure
and starts the screening process for a heart transplantation. The
patient questions the necessity of testing for a methicillin-
resistant Staphylococcus aureus (MRSA) infection. Which is the
best response by the nurse?
"This is a preventative measure and a part of routine care."
"Any active infection would disqualify you as a donor
recipient."
"If positive, you would need treatment for MRSA infection
before the procedure."
,"There are too many risk factors involved with performing a
transplantation on a person with an active MRSA infection."
Correct Answer "Any active infection would disqualify you as a
donor recipient."
Because an active infection, including MRSA infection, is an
absolute contraindication for a heart transplantation, the nurse's
best response is to explain the necessity of MRSA testing prior
to a heart transplantation.
Junctional Dysrhythmias
Question 1 of 3
Two months after being diagnosed with myocardial infarction, a
patient returns for a checkup. A routine ECG shows a 2:1 then
3:1 ratio (indicating two P waves to one QRS complex, then
three P waves to one QRS complex). The nurse anticipates
educating the patient about which dysrhythmia?
First-degree heart block
Third-degree heart block
Second-degree heart block type I
Second-degree heart block type II Correct Answer Second-
degree heart block type II
In type II second-degree AV block, a certain number of
impulses from the SA node are not conducted to the ventricles.
This occurs in ratios of 2:1, 3:1, and so on (i.e., two P waves to
one QRS complex, three P waves to one QRS complex). It may
occur with varying ratios.
Nitrates
Nitrates (e.g., nitroglycerin) cause vasodilation by acting
directly on the smooth muscle of the vessel wall. Nitrates are of
particular benefit in the management of myocardial ischemia
, related to HF because they promote vasodilation of the coronary
arteries. Correct Answer BiDil
A combination drug containing isosorbide dinitrate and
hydralazine is used for the treatment of HF in African
Americans who are already being treated with standard therapy.
Nursing Management of the Patient with Heart Failure
Question 1 of 4
A patient arrives at the cardiac clinic for a 3-month follow-up.
The questionnaire asks the patient to describe heart failure (HF)
signs and symptoms experienced in the previous 4 weeks.
Which of the signs and symptoms listed by the patient need to
be addressed immediately by the nurse?
Select all that apply.
A 2-lb weight gain
Not taking daily walks
Bruising in the absence of injury
Requiring three pillows to sleep at night
Not having received a TDAP vaccination Correct Answer
Bruising in the absence of injury
Bruising in the absence of injury may occur with internal
bleeding and should be addressed immediately.
Requiring three pillows to sleep at night
Orthopnea, or difficulty breathing while lying flat, is a symptom
of worsening HF and should be addressed immediately.
Overview of Heart Failure
Question 1 of 3
Which statement by the patient indicates the need for further
education concerning the risk factors associated with chronic
heart failure (HF)?
Solutions
Atrial Dysrhythmias
Question 1 of 3
A patient who is otherwise healthy is experiencing premature
atrial contractions (PACs). The patient asks what could be
causing the PACs. Which is the best response by the nurse?
"Your low-protein diet."
"Your coffee and cigarette use."
"Your family history of diabetes."
"Your sedentary lifestyle and high-fat diet." Correct Answer
"Your coffee and cigarette use."
In a normal heart, a PAC can result from the use of caffeine or
tobacco.
Basic ECG Interpretation:
Question 1 of 4
Match the property of the cardiac conduction system with its
description.
Property of the cell that allows it to accept initiation of
stimulation
Excitability
Property that moves electrical impulse along a membrane
Conductivity
Ability of heart muscle to respond mechanically to an impulse
Contractility
Ability of heart muscle to initiate an impulse, begin stimulation
Automaticity Correct Answer
Diuretics
,Diuretics reduce edema, pulmonary venous pressure, and
preload. Thiazide diuretics (e.g., hydrochlorothiazide) inhibit
sodium reabsorption in the distal tubule, thus promoting
excretion of sodium and water. Loop diuretics such as
furosemide, bumetanide, and torsemide are potent but can cause
hypokalemia and ototoxicity. Spironolactone is a potassium-
sparing diuretic that promotes sodium and water excretion while
retaining potassium and therefore can cause hyperkalemia. In
chronic HF, the lowest effective dose of diuretic should be used.
Correct Answer Angiotensin-Converting Enzyme (ACE)
Inhibitors
ACE inhibitors (e.g., captopril, enalapril) are the primary drugs
of choice for blocking the renin-angiotensin-aldosterone system
in patients with systolic HF. A reduction in systemic vascular
resistance with the use of ACE inhibitors causes a significant
increase in CO. Although BP decreases, tissue perfusion is
maintained or increased as a result of improved CO, and diuresis
is enhanced by the suppression of aldosterone.
Heart Transplantation
Question 1 of 3
A 22-year-old patient is diagnosed with terminal heart failure
and starts the screening process for a heart transplantation. The
patient questions the necessity of testing for a methicillin-
resistant Staphylococcus aureus (MRSA) infection. Which is the
best response by the nurse?
"This is a preventative measure and a part of routine care."
"Any active infection would disqualify you as a donor
recipient."
"If positive, you would need treatment for MRSA infection
before the procedure."
,"There are too many risk factors involved with performing a
transplantation on a person with an active MRSA infection."
Correct Answer "Any active infection would disqualify you as a
donor recipient."
Because an active infection, including MRSA infection, is an
absolute contraindication for a heart transplantation, the nurse's
best response is to explain the necessity of MRSA testing prior
to a heart transplantation.
Junctional Dysrhythmias
Question 1 of 3
Two months after being diagnosed with myocardial infarction, a
patient returns for a checkup. A routine ECG shows a 2:1 then
3:1 ratio (indicating two P waves to one QRS complex, then
three P waves to one QRS complex). The nurse anticipates
educating the patient about which dysrhythmia?
First-degree heart block
Third-degree heart block
Second-degree heart block type I
Second-degree heart block type II Correct Answer Second-
degree heart block type II
In type II second-degree AV block, a certain number of
impulses from the SA node are not conducted to the ventricles.
This occurs in ratios of 2:1, 3:1, and so on (i.e., two P waves to
one QRS complex, three P waves to one QRS complex). It may
occur with varying ratios.
Nitrates
Nitrates (e.g., nitroglycerin) cause vasodilation by acting
directly on the smooth muscle of the vessel wall. Nitrates are of
particular benefit in the management of myocardial ischemia
, related to HF because they promote vasodilation of the coronary
arteries. Correct Answer BiDil
A combination drug containing isosorbide dinitrate and
hydralazine is used for the treatment of HF in African
Americans who are already being treated with standard therapy.
Nursing Management of the Patient with Heart Failure
Question 1 of 4
A patient arrives at the cardiac clinic for a 3-month follow-up.
The questionnaire asks the patient to describe heart failure (HF)
signs and symptoms experienced in the previous 4 weeks.
Which of the signs and symptoms listed by the patient need to
be addressed immediately by the nurse?
Select all that apply.
A 2-lb weight gain
Not taking daily walks
Bruising in the absence of injury
Requiring three pillows to sleep at night
Not having received a TDAP vaccination Correct Answer
Bruising in the absence of injury
Bruising in the absence of injury may occur with internal
bleeding and should be addressed immediately.
Requiring three pillows to sleep at night
Orthopnea, or difficulty breathing while lying flat, is a symptom
of worsening HF and should be addressed immediately.
Overview of Heart Failure
Question 1 of 3
Which statement by the patient indicates the need for further
education concerning the risk factors associated with chronic
heart failure (HF)?
