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Heart Failure Practice Questions With Complete Solutions
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Heart Failure Practice QuestionsWith Complete Solutions
A 54-year-old male patient who had bladder surgery 2 days ago
develops acute decompensated heart failure (ADHF) with severe
dyspnea. Which action by the nurse would be indicated first?
A Perform a bladder scan to assess for urinary retention.
B Restrict the patient's oral fluid intake to 500 mL per day.
C Assist the patient to a sitting position with arms on the
overbed table.
D Instruct the patient to use pursed-lip breathing until the
dyspnea subsides. Correct Answers C Assist the patient to a
sitting position with arms on the overbed table.
The nurse should place the patient with ADHF in a high
Fowler's position with the feet horizontal in the bed or dangling
at the bedside. This position helps decrease venous return
because of the pooling of blood in the extremities. This position
also increases the thoracic capacity, allowing for improved
ventilation. Pursed-lip breathing helps with obstructive air
trapping but not with acute pulmonary edema. Restricting fluids
takes considerable time to have an effect.
A male patient with a long-standing history of heart failure has
recently qualified for hospice care. What measure should the
nurse now prioritize when providing care for this patient?
A Taper the patient off his current medications.
B Continue education for the patient and his family.
C Pursue experimental therapies or surgical options.
,D Choose interventions to promote comfort and prevent
suffering. Correct Answers D Choose interventions to promote
comfort and prevent suffering.
The central focus of hospice care is the promotion of comfort
and the prevention of suffering. Patient education should
continue, but providing comfort is paramount. Medications
should be continued unless they are not tolerated. Experimental
therapies and surgeries are not commonly used in the care of
hospice patients.
A patient admitted with heart failure appears very anxious and
complains of shortness of breath. Which nursing actions would
be appropriate to alleviate this patient's anxiety (select all that
apply)?
A Administer ordered morphine sulfate.
B Position patient in a semi-Fowler's position.
C Position patient on left side with head of bed flat.
D Instruct patient on the use of relaxation techniques.
E Use a calm, reassuring approach while talking to patient.
Correct Answers A Administer ordered morphine sulfate.
B Position patient in a semi-Fowler's position.
D Instruct patient on the use of relaxation techniques.
E Use a calm, reassuring approach while talking to patient.
Morphine sulfate reduces anxiety and may assist in reducing
dyspnea. The patient should be positioned in semi-Fowler's
position to improve ventilation that will reduce anxiety.
Relaxation techniques and a calm reassuring approach will also
serve to reduce anxiety.
,A patient with a diagnosis of heart failure has been started on a
nitroglycerin patch by his primary care provider. What should
this patient be taught to avoid?
A High-potassium foods
B Drugs to treat erectile dysfunction
C Nonsteroidal antiinflammatory drugs
D Over-the-counter H2 -receptor blockers Correct Answers B
Drugs to treat erectile dysfunction
The use of erectile drugs concurrent with nitrates creates a risk
of severe hypotension and possibly death. High-potassium
foods, NSAIDs, and H2-receptor blockers do not pose a risk in
combination with nitrates.
A patient with a recent diagnosis of heart failure has been
prescribed furosemide in an effort to physiologically do what for
the patient?
A Reduce preload.
B Decrease afterload.
C Increase contractility.
D Promote vasodilation. Correct Answers A Reduce preload.
Diuretics such as furosemide are used in the treatment of HF to
mobilize edematous fluid, reduce pulmonary venous pressure,
and reduce preload. They do not directly influence afterload,
contractility, or vessel tone.
A70-year-old woman with chronic heart failure and atrial
fibrillation asks the nurse why warfarin has been prescribed for
, her to continue at home. Which response by the nurse is
accurate?
A "The medication prevents blood clots from forming in your
heart."
B "The medication dissolves clots that develop in your coronary
arteries."
C "The medication reduces clotting by decreasing serum
potassium levels."
D "The medication increases your heart rate so that clots do not
form in your heart." Correct Answers A "The medication
prevents blood clots from forming in your heart."
Chronic heart failure causes enlargement of the chambers of the
heart and an altered electrical pathway, especially in the atria.
When numerous sites in the atria fire spontaneously and rapidly,
atrial fibrillation occurs. Atrial fibrillation promotes thrombus
formation within the atria with an increased risk of stroke and
requires treatment with cardioversion, antidysrhythmics, and/or
anticoagulants. Warfarin is an anticoagulant that interferes with
hepatic synthesis of vitamin K-dependent clotting factors.
At a clinic visit, the nurse provides dietary teaching for a 56-
year-old woman who was recently hospitalized with an
exacerbation of chronic heart failure. The nurse determines that
teaching is successful if the patient makes which statement?
A "I will limit the amount of milk and cheese in my diet."
B "I can add salt when cooking foods but not at the table."
C "I will take an extra diuretic pill when I eat a lot of salt."
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