Self assessment quiz on heart failure PDF

Preview

Summary

HF quiz ...

Description

Self-Assessment Quiz: Heart Failure 1. Which of the following clinical manifestations indicates to the nurse that the patient’s left-sided heart failure has progressed to include the right side of the heart? a. b. c. d.

fatique pink, frothy sputum weak peripheral pulses, easily obliterated distended neck veins in the sitting position

2. Which of the following clinical manifestations in a patient with heart failure indicates that his condition is worsening? a. b. c. d.

the patient requires two pillows for dyspnea. crackles have increased from bases to mid-lungs. urine output has increased from 20ml to 80ml per hour. physician’s note states that patient’s activity has increased.

3. Which nursing diagnosis would be a priority for a patient with heart failure? a. b. c. d.

fatigue decreased cardiac output impaired physical mobility altered urinary elimination

4. Drug therapy for severe heart failure frequently focuses on inhibiting systemic vasoconstriction, rather than on increasing myocardial contraction. How does inhibiting vasoconstriction improve cardiac function? a. b. c. d.

increasing afterload, increasing cardiac output decreasing afterload, increasing cardiac output increasing afterload, decreasing cardiac output decreasing afterload, decreasing cardiac output

5. Which statement made by family members to a home health care nurse indicates a possible worsening of the patient’s mild heart failure? a. “He says that he is always cold; even in the summer he prefers to wear a light sweater.” b. “When he first wakes up in the morning, he seems to know what’s going on, but as the day progresses, he gets confused.” c. “His heart rate seems to be faster the hour after a meal as compared to the hour before a meal.” d. “That diuretic he takes in the morning makes him urinate almost every hour during the day.” 6. A patient with acute heart failure has been admitted to your unit. Which of the following orders should be carried out first? a. b. c. d.

insertion of IV placement of foley catheter delivery of oxygen via nasal cannula application of thromboembolic stockings

7. Which of the following assessment data obtained by the home health care nurse suggest that an elderly patient on diuretic therapy for heart failure may be dehydrated? a. Tenting of skin on back of the hand b. The presence of dry skin on the patient’s extremities c. The patient states that he gets up three or more times during the night to urinate. d. The patient states that his heart pounds and he feels light-headed when he gets out of bed or stands up. 8. A patient taking diuretic therapy would be educated to have which of the following laboratory tests to monitor for potential cardiac problems and Digoxin toxicity? a. b. c. d.

complete blood counts BUN and creatinine levels Serum potassium levels Prothrombin time and INR

9. Which of the following is an outcome for the collaborative problem, “Potential for Pulmonary Edema”? a. b. c. d.

No dysrhythmias Clear lung sounds Less fatigue No disorientation

10. In addition to oxygen and a diuretic, which of the following drugs is commonly administered to relieve dyspnea resulting from pulmonary edema? a. b. c. d.

Beta blockers Dopamine Morphine sulfate Digoxin

11. The best way for a nurse to assess for orthopnea is to ask the client about which of the following? a. b. c. d.

Number of times the client voids at night Dry hacking cough The use of two or more pillows to sleep Sudden awakening with a feeling of breathlessness at night

12. Indicate which of the following medications are used to reduce afterload. SELECT ALL THAT APPLY: a. b. c. d.

Digoxin Human B-type natriuretic peptides ACE inhibitors Beta blockers

13. Discharge planning for the patient with heart failure includes which of the following? a. Teaching the patient to take diuretics at bedtime to enhance the effect on increased renal perfusion. b. Demonstrating to the patient how to monitor an apical pulse and what symptoms to report to the physician. c. Determining whether the patient has a bathroom scale to monitor weight to facilitate reporting a gain of more than 1-2 pounds. d. Providing the patient with dietary exchange list of foods allowed on a low-potassium diet. 14. Which of the following statements indicates that the patient needs more teaching regarding a treatment regimen for heart failure? a. “I should weigh myself once a week and watch for fluid retention.” b. “If my heart feels like it is racing, I should call the doctor.” c. “I need to consider my activities for the day and rest as needed.” d. “I need to take my medications as ordered by the physician and make sure to keep my appointments.” 15. A patient with a history of heart failure and hypertension is hospitalized following abdominal surgery. Vital signs have been stable, and D5 ½ NS is infusing at 80ml/hr. The patient awakens in the middle of the night complaining of trouble breathing. Which assessment by the nurse should take priority at this time? a. b. c. d.

review intake and output record assess extremities for edema count apical heart rate auscultate lung fields

16. A patient on a telemetry unit with a diagnosis of heart failure and atrial fibrillation has an order for Digoxin. The patient’s pulse is 112 and irregular. The nurse should: a. b. c. d.

give the dose as ordered. hold the dose and call the physician. closely assess the patient’s apical pulse for pulse deficit. give the dose and monitor vital signs every 15 minutes....