Meds
This type of medication is used to remove excess fluid in clients with chronic heart failure. What is it?
Answer: Furosemide
Rationale:
Loop diuretics remove excess fluid by increasing urine output = decrease pulmonary congestion and edema.
What is the best position for a client with shortness of breath?
Answer: High fowler's
Rationale:
Improve lung expansion and oxygenation.
What is the purpose of the cardiac stress test?
A. Measures BNP
B. Evaluate heart function during activity
C. Detect fluid overload
D. Measure oxygen sat
Answer: B
Evaluate heart function during activity
Rationale:
A cardiac stress evaluates how the heart functions under increased workload to detect problems like decreased blood flow or ischemia that may not appear at rest.
This condition involves narrowing of coronary arteries, reducing blood flow to the myocardium and is the primary cause of heart failure.
Answer: Coronary artery disease
#1 cause of Heart Failure
What diet is recommended for a client with chronic heart failure?
Answer: low sodium & fluid restriction
Rationale:
Sodium causes fluid retention = worsening heart failure symptoms.
The healthcare provider writes an order for a client to receive an angiotensin ll receptor blocker for treatment of heart failure. What medication does the nurse administer?
A. Digoxin
B. Metolarzone
C. Carvedilol
D. Valsartan
Answer: Valsartan
Rational: Valsartan is an ARB. The other medications belong to different drug classes.
Restlessness and confusion indicate this priority problem.
Hypoxia
Rationale:
Confusion/restlessness are early signs of decreased oxygenation, especially in older adults.
The diagnosis of heart failure is usually confirmed by which of the following diagnostic tests?
Answer: Echocardiogram
Rationale:
This test measures EF
A client with heart failure is at risk for blood clots. Which assessment finding suggests a complication?
A. Warm extremities
B. Sudden SOB
C. Increased appetite
D. Stable weight
Answer: B
Sudden SOB
Rationale:
Sudden SOB may indicate a PE, a serious complication requiring immediate action.
A nurse is providing discharge teaching after a cardiac catheterization. Which statement indicate the client understands the teaching? Select all that apply.
A. " I will report any bleeding at the insertion site"
B. " I will avoid heavy lifting for a few days"
C. " I will increase fluid intake as instructed"
D. " I will bend the affected leg frequently"
E. " I will call for help if I feel sudden warmth or wetness at the site"
Answer: A, B, C, E
Rationale:
Reporting bleeding or sudden feeling of warmth or wetness is important because it may indicate hemorrhage at the insertion site. Avoiding heavy lifting helps prevent strain and reduces the risk of bleeding. Increasing fluid intake helps flush the contrast dye from the body and protects kidney function.
A client with chronic heart failure is prescribed a beta-blocker. The nurse should hold the medication if the heart rate is below what value?
Metoprolol
Rationale:
Beta-blockers slow heart rate and decrease cardiac workload. Giving it with bradycardia can cause severe hypotension or heart block.
A client with chronic heart failure presents with crackles, bounding pulse, and peripheral edema. What condition is the nurse most concerned about?
Fluid volume overload
Rationale:
Fluid overload increases circulating volume → produces strong, bounding pulses along with edema and crackles.
Which finding on a chest XR are consistent with heart failure? Select all that apply
A. Cardiomegaly
B. Pulmonary edema
C. Pleural effusions
D. Hyperinflated lungs
Answer: A, B, C
Rationale:
Hyperinflated lungs is incorrect = that's more associated with COPD not HF
Which condition leads to heart failure by increasing afterload and forcing the heart to work harder overtime?
Answer: HTN
Rationale:
increased afterload = heart strain = HF
A nurse is educating a client at risk for pulmonary edema due to left sided heart failure. Select all that apply.
A. "I will sit upright if I feel SOB"
B. " I will report pink, frothy sputum"
C. " I will lie flat to improve breathing"
D. " I will avoid excessive physical exertion"
E. " I will wait to see if symptoms improve before calling for help"
Answer: A,B,D
Rational:
Sitting upright helps breathing by reducing fluid in lungs. Reporting pink, frothy sputum is critical because it signals pulmonary edema, requiring immediate attention. Avoiding excessive exertion helps prevent worsening symptoms.
This medication combination increases risk for life-threatening potassium retention.
ACE inhibitor + spironolactone
Rationale:
Both medications increase potassium levels → combined use significantly raises risk of hyperkalemia → fatal arrhythmias.
Which patient requires immediate assessment?
A. Weight gain 1 lb
B. Crackles + SpO₂ 88%
C. BP 150/90
D. Mild edema
B
Rationale:
This indicates impaired oxygenation, which is always the priority over stable vital signs or mild symptoms.
Which conditions can be diagnosed with cardiac catheterization?
A. CAD
B. Valve abnormalities
C. Heart failure severity
D. Pulmonary embolism
E. Congenital heart defects
Answer: A, B, C, E
Rationale:
Cardiac Cath visualizes coronary arteries and measures pressure/flow in the heart, so it can diagnose blockages, valve issues, heart function, and defects. It does not diagnose pulmonary embolism.
Which finding suggest cardiac tamponade in a client with heart failure?
A. Bounding pulses
B. Hypotension and muffled heart sounds
C. Increased urine output
D. Warm extremities
Answer: B
Hypotension and muffled heart sounds
Rationale:
Fluid around the heart prevents proper filling, leading to decreased cardiac output and hypotension.
Which findings indicate worsening fluid overload?
Select all that apply:
A. Weight gain of 2lbs in one day
B. Decreased edema
C. Crackles in lungs
D. Increased urine output
E. SOB
Answers: A, C, E
Rationale:
Fluid overload = lungs + weight gain
The patient is on digoxin. Which finding indicates toxicity?
A. HR 88
B. Yellow Halo
C. BP 140/90
D. K+ 4.0
Yellow Halo
classic digoxin toxicity = visual changes + dysrhythmias
Rationale:
Visual changes (yellow halos), Bradycardia, Nausea, Low potassium increases risk of toxicity.
A client with chronic heart failure has RR 28, SpO₂ 86%, and pink frothy sputum. What condition is the nurse most concerned about.
Acute pulmonary edema
Rationale:
Pink frothy sputum + hypoxia + tachypnea = fluid in alveoli, a life-threatening emergency requiring rapid intervention.
Match each lab value with what it indicates in a patient with chronic heart disease.
A. BNP
B. Troponin
C. Creatinine
D. Potassium
1. indicates kidney function
2. indicates heart failure
3. risk for dysrhythmias
4. indicates cardiac muscle damage
Answer:
A. BNP = indicates heart failure
B. Troponin = indicates cardiac muscle damage
C. Creatinine = indicates kidney function
D. Potassium = risk for dysrhythmias
After cardiac catheterization, which finding is MOST concerning?
A. Small bruise at site
B. Oozing blood
C. Sudden swelling and firmness at insertion site
D. Mild discomfort
Answer: C
Sudden swelling and firmness at insertion site
Rationale:
May indicate internal bleeding or hematoma formation.
Which nursing interventions are appropriate for a client with chronic heart failure? Select all that apply
A. Daily weights
B. High sodium diet
C. Elevate HOB
D. Monitor potassium
E. Encourage excess fluids
A, C, D
Rationale:
YES: Daily weights = monitor fluid
YES: Elevate HOB = improve breathing
YES: Monitor potassium = prevent arrhythmias
NO: High sodium = worsens HF
NO: Excess fluids = overload