HEART FAILURE

‘Wag kayo magrely dito nakikita kayo ni Papa Jesus. Pero GOODLUCK parin sana
pumasa tayo lahat

NOTE:

- Find the answer not the question!!! Then, analyze the question pinaraphrase
lang kasi nila yung iba
- Be careful sa SATA minsan nakabaligtad yung sa exam

Quizlet:

- https://quizlet.com/124343834/exam-2-cardiac-practice-questions-nclex-flash-cards/
- https://quizlet.com/523204600/practice-questions-for-med-surg-exam-1-cardiac-flash-ca
rds/
- https://quizlet.com/205337662/test-1-medsurg-nclex-review-cardiac-flash-cards/
- https://quizlet.com/260073540/med-surg-2-exam-1-cardiac-flash-cards/

1.A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours
before the procedure and for 48 hours after the procedure?

A. Glipizide
B. Metformin
C. Repaglinide
D. Regular insulin

2. A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a
blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be prescribed?

A. Administer digoxin.
B. Defibrillate the client.
C. Continue to monitor the client.
D. Prepare for transcutaneous pacing.

3. The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops
extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse
immediately asks another nurse to contact the health care provider and prepares to implement which
priority interventions? Select all that apply.

1. Administering oxygen
2. Inserting a Foley catheter
3. Administering furosemide
4. Administering morphine sulfate intravenously
5. Transporting the client to the coronary
care unit
6. Placing the client in a low Fowler’s side-lying
position

4 . A client with myocardial infarction becomes tachycardic, shows signs of air hunger, and begins
coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate when auscultating the
client’s breath sounds?
A. Stridor
B. Crackles
C. Scattered rhonchi
D. Diminished breath sounds

5. A client with myocardial infarction is developing cardiogenic shock. Because of the risk of
myocar- dial ischemia, what condition should the nurse carefully assess the client for?
A. Bradycardia
B. Ventricular dysrhythmias
C. Rising diastolic blood pressure
D. Falling central venous pressure

6. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20mL/hour for 2
hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the
subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45
mg/dL(16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these
findings, the nurse would anticipate that the client is at risk for which problem?
A. Hypovolemia
B, Acute kidney injury
C. Glomerulonephritis
D. Urinary tract infection
7. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PRinterval is 0.16 seconds, and QRScomplexes measure 0.06 seconds. The overall heart
rate is 64 beats/minute. Which action should the nurse take?

A. Check vital sign

B. Check laboratory test results.
C. Notify the health care provider.
D. Continue to monitor for any rhythm change​.

8. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees
no electrocardiographic complexes on the screen. Which is the priority nursing action?
A. Call a code.
B. Call the health care provider.
C. Check the client’s status and lead placement.
D. Press the recorder button on the electrocardiogram console.

9. The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are
no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140
beats/minute. The nurse determines that the client is experiencing which dysrhythmia

A. Sinus tachycardia
 B. Ventricular fibrillation
C. Ventricular tachycardia
D. Premature ventricular contractions

10. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the
nurse be most concerned about with this dysrhythmia?
A. It can develop into ventricular fibrillation at any time.
B. It is almost impossible to convert to a normal rhythm.
C. It is uncomfortable for the client, giving a sense of impending doom.
D. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia.

11. A client is having frequent premature ventricular contractions. The nurse should place priority on
assessment of which item?
A. Sensations of palpitations
B. Causative factors, such as caffeine
C. Blood pressure and oxygen saturation
D. Precipitating factors, such as infection

12. The client has developed atrial fibrillation, with a ventricular rate of 150 beats/minute. The nurse
should assess the client for which associated signs and/or symptoms?
A. Flat neck veins
B. Nausea and vomiting
C. Hypotension and dizziness
D. Hypertension and headache

13. The nurse is watching the cardiac monitor, and a client’s rhythm suddenly changes. There are no
Pwaves; instead, there are fibrillatory waves before each QRScomplex. How should the nurse
correctly interpret the client’s heart rhythm?

A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular fibrillation
D. Ventricular tachycardia

14. The nurse is assisting to defibrillate a client in ventricular fibrillation. After placing the pad on
theclient’schestandbeforedischarge,whichinter- vention is a priority?
A. Ensure that the client has been intubated.
B. Set the defibrillator to the “synchronize” mode.
C. Administer an amiodarone bolus intravenously.
D. Confirm that the rhythm is actually ventricular fibrillation

15. A client in ventricular fibrillation is about to be defibrillated. To convert this rhythm effectively,
the monophasic defibrillator machine should be set at which energy level (in joules, J) for the first
delivery?
A. 50J
B.120J
C.200J
D. 360 J

16. The nurse should evaluate that defibrillation of a client was most successful if which observation
was made?
A. Arousable, sinus rhythm, blood pressure (BP)116/72 mm Hg
B. Nonarousable, sinus rhythm, BP 88/60 mm Hg
C. Arousable, marked bradycardia, BP 86/54 mm Hg
D. Nonarousable, supraventricular tachycardia, BP122/60 mm Hg

17. The nurse is evaluating a client’s response to cardioversion. Which assessment would be the
priority?
A. Blood pressure
B. Status of airway
C. Oxygen flow rate
D. Level of consciousness

18. The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter-defibrillator. The nurse should assess which item based on priority?
A. Anxiety level of the client and family
B. Presence of a MedicAlert card for the client to carry
C. Knowledge of restrictions on post-discharge physical activity
D. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to
deliver

19. A client’s electrocardiogram strip shows atrial and ventricularratesof110beats/minute. The PR

interval is 0.14 seconds, the QRScomplex measures 0.08seconds, and the PP and RR intervals are
regular. How should the nurse correctly interpret this rhythm?
A. Sinus tachycardia
B. Sinus bradycardia
C. Sinus dysrhythmia
D. Normal sinus rhythm

20. The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit
4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes
rednessandedema.Thepedalpulseispalpableand unchanged from admission. How should the nurse
correctly interpret the client’s neurovascular status?
A. The neurovascular status is normal because of increased blood flow through the leg.
B. The neurovascular status is moderately impaired, and the surgeon should be called.
C. The neurovascular status is slightly deteriorating and should be monitored for another hour.
D. The neurovascular status is adequate from an arterial approach, but venous complications are
arising.

21. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac
tamponade. Which observation would indicate that the procedure was effective?

A. Muffled heart sounds

B. A rise in blood pressure
C. Jugular venous distention
 D. Client expressions of dyspnea

22. The nurse is caring for a client who had a resection of an abdominal aortic aneurysm yesterday.
The client has an intravenous (IV) infusion at a rate of 150 mL/hour, unchanged for the last 10 hours.
The client’s urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The
client’s blood urea nitrogen level is 35 mg/dL (12.6 mmol/L) and the serum creatinine level is 1.8
mg/dL (159 mcmol/L), measured this morn- ing. Which nursing action is the priority?
A. Check the urine specific gravity.
B. Call the health care provider (HCP).
C. Put the IVline on a pump so that the infusion rate is sure to stay stable.
D. Check to see if the client had a blood sample for a serum albumin level drawn.

23. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily.
Which statement by the client indicates the need for further teaching?
A. “I should notify my doctor if my feet or legs start to swell.”
B. “My doctor told me to call his office if my pulse rate decreases below 60.”
C. “Avoiding grapefruit juice will definitely be a challenge for me, since I usually drink it every
morning with breakfast.”
D. “My spouse told me that since I have developed this problem, we are going to stop walking in
the mall every morning.”

24. The nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls
on the T wave of the preceding beat. The client’s rhythm suddenly changes to one with no P waves,
no definable QRS complexes, and coarse wavy lines of varying amplitude. How should the nurse
correctly interpret this rhythm?
A. Asystole
B. Atrial fibrillation
C. Ventricular fibrillation
D. Ventricular tachycardia

25. Aclient with atrial fibrillation is receiving a contin- uous heparin infusion at 1000 units/hour. The
nurse determines that the client is receiving the therapeutic effect based on which results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds

26. The nurse provides discharge instructions to a cli- ent who is taking warfarin sodium. Which state-
ment, by the client, reflects the need for further teaching?
1. “I will avoid alcohol consumption.”
2. “I will take my pills every day at the same time.” 3. “I have already called my family to pick up
MedicAlert bracelet.”
4. “I will take coated aspirin for my headaches because it will coat my stomach.”

27. A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and is
complaining of anorexia. The health care provider prescribes a serum digoxin level to be done. The
nurse checks the results and should expect to note which level that is outside of the therapeutic range?
1. 0.3ng/mL
2. 0.5 ng/mL
3. 0.8ng/mL
4. 1.0 ng/mL

28. A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous
administration of the medication, the client com- plains of dizziness. What intervention should the
nurse take first?
1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerin tablets.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client’s apical pulse and obtain a blood pressure.

29. The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a
potential adverse complication associated with this medication?

1. The development of complaints of insomnia

2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after 2
doses of the medication
4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/ minute
after 2 doses of the medication

30. A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour
and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows:
activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3.
The nurse should take which action based on the cli- ent’s laboratory results?

1. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and admin-
ister the warfarin sodium as prescribed.
2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and
administer the warfarin sodium as prescribed.
3. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a hep- arin
infusion and the aPTT is within the therapeutic range.
4. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of
dabigatran etexilate in place of warfarin sodium.

31. AclientisdiagnosedwithanSTsegmentelevation myocardial infarction (STEMI) and is receiving a

tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding​.
4. Have heparin sodium available.

32. The nurse is planning to administer hydrochlorothiazide to a client. The nurse should monitor for
which adverse effects related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy

33. Thehomehealthcarenurseisvisitingaclientwith elevated triglyceride levels and a serum choles- terol

level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine and the nurse teaches the client
about the medication. Which statement, by the client, indicates the need for further teaching?
1. “Constipation and bloating might be a problem.”
2. “I’ll continue to watch my diet and reduce my fats.”
3. “Walking a mile each day will help the whole process.”
4. “I’ll continue my nicotinic acid from the health food store.”

34. The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are
characteristic of digoxin toxicity? Select all that apply.
1. Tremors
2. Diarrhea
3. Irritability
4. Blurred vision
5. Nausea and vomiting

35. Prior to administering a client’s daily dose of digoxin,thenursereviewstheclient’slaboratorydata

and notes the following results: serum calci- um, 9.8 mg/dL (2.45 mmol/L); serum magnesium, 1.0
mEq/L (0.5 mmol/L); serum potassium, 4.1 mEq/L (4.1 mmol/L); serum creatinine, 0.9 mg/ dL (79.5
mcmol/L). Which result should alert the nurse that the client is at risk for digoxin toxicity?
1. Serum calcium level
2. Serum potassium level
3. Serum creatinine level
4. Serum magnesium level

36. A client being treated for heart failure is administered intravenous bumetanide. Which outcome
indicates that the medication has achieved the expected effect?
1. Cough becomes productive of frothy pink sputum.
2. Urine output increases from 10 mL/hour to greater than 50 mL hourly​.
3. The serum potassium level changes from 3.8 to 3.1mEq/L(3.8to3.1mmol/L).
4. B-type natriuretic peptide (BNP) factor increases from 200 to 262 pg/mL(200 to 262 ng/L).

37. Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the
nurse ensures that which medication is available on the nursing unit?
1.VitaminK
2. Protamine sulfate
3. Potassium chloride
4. Aminocaproic acid

38. A client receiving thrombolytic therapy with a continuous infusion of alteplase suddenly becomes
extremely anxious and complains of itching. The nurse hears stridor and notes generalized urticaria
and hypotension. Which nursing action is the priority

A. Administer oxygen and protamine sulfate.

B. Cut the infusion rate in half and sit the client up in bed.
C. Stop the infusion and call for the Rapid Response Team (RRT).
D. Administer diphenhydramine and epinephrine and continue the infusion.

39. The nurse should report which assessment finding to the health care provider (HCP) before
initiating thrombolytic therapy in a client with pulmonary embolism?
1. Adventitious breath sounds
2. Temperature of 99.4 °F (37.4 °C) orally
3. Blood pressure of 198/110 mm Hg
4. Respiratory rate of 28 breaths/minute

40.. A client is prescribed nicotinic acid for hyperlipidemia and the nurse provides instructions to the
cli- ent about the medication. Which statement by the client indicates an understanding of the
instructions?
1. “It is not necessary to avoid the use of alcohol.”
2. “The medication should be taken with meals to decrease flushing.”
3. “Clay-colored stools are a common side effect and should not be of concern.”
4. “Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing.”

41. True or False: Endocarditis only affects the atrioventricular and semi-lunar valves in the heart.
FALSE

42. Which of the following patients are MOST at risk for developing endocarditis?
Select-all-that-apply:
A. A 25 year old male who reports using intravenous drugs on a daily basis.
B. A 55 year old male who is post-opt from aortic valve replacement.
C. A 63 year old female who is newly diagnosed with hyperparathyroidism and is taking Aspirin.
D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago
and is having a fever.

43. A patient is receiving treatment for infective endocarditis. The patient has a history of intravenous
drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a
transesophageal echocardiogram tomorrow. On assessment, you find tender, red lesions on the
patient’s hands and feet. You know that this is a common finding in patients with infective
endocarditis and is known as?
A. Janeway Lesions
B. Roth Spots
C. Osler’s Nodes
D. Trousseau’s Sign

44. A 30 year old female is being treated for infective endocarditis with IV antibiotics. At the
beginning of the hospitalization, the patient’s symptoms were severe and sudden with a high fever but
are now controlled. She has no significant health history other than 2 cesarean sections in the past.
She is being prepped for a central line placement so she can be discharged home with home health to
continue the 4 week antibiotic regime. What type of infective endocarditis is this classified as based
on the information listed?
A. Acute Infective Endocarditis
B. Subacute Infective Endocarditis
C. Non-infective endocarditis
D. Pericarditis

45. A patient is admitted with sepsis. The patient has a temperature of 104.2 ‘F and is experiencing
chills. On assessment, you note a mitral murmur which the patient states they’ve never had before,
and dark, small lines on the patient’s fingernails. The patient has a history of IV drug use in the past.
However, the patient states they are no longer using drugs. The physician suspects possible infective
endocarditis. What diagnostic test do you expect the physician to order in order to confirm the
presence of infective endocarditis?
A. Abdominal ultrasound
B. Heart catheterization
C. Transesophageal echocardiogram
D. White blood cell count

46. Select-all-that-apply: What are the typical signs and symptoms of infective endocarditis?
A. Hyperthermia
B. S4 gallop
C. Enlarged Spleen
D. Hyperkalemia
E. Substernal pain that radiates to the back
F. Heart failure
G. Cardiac Murmur

47. You’re providing discharge teaching to a patient being treated for endocarditis. Which statement
by the patient demonstrated they understood your teaching about this condition?
A. “I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic resistance.”
B. “I will only wash my hands with soap and water.”
C. “I will inform my dentist about my history of endocarditis prior to any invasive procedures.”
D. “I will avoid eating fish and organ meats.”

48. A patient being treated for infective endocarditis is complaining of very sharp radiating abdominal
pain that goes to the left shoulder and back. As the nurse familiar with complications of infective
endocarditis, what do you suspect is the cause of this patient finding?
A. Renal embolic event
B. Pulmonary embolic event
C. Central nervous system embolic event
D. Splenic embolic event

49. A patient with endocarditis has listed in their medical history “Roth Spots”. You know that this is
a complication of infective endocarditis and presents as?
A. Non-tender spots found on the feet and hands
B. Red and tender lesions found in the eyes
C. Retinal hemorrhages with white centers
D. Purplish spots found on the forearms and groin

50. Which of the following patients are MOST at risk for developing heart failure?
Select-all-that-apply:
 A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial
infarction.

B. A 55 year old female with a health history of asthma and hypoparathyroidism.

C. A 30 year old male with a history of endocarditis and has severe mitral stenosis.
D. A 45 year old female with lung cancer stage 2.
E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

51. A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. As
the nurse providing discharge teaching to the patient, which statement is NOT a correct statement
about this condition?

A. “Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough,
difficulty breathing while lying down, and weight gain.”

B. “It is important to monitor your daily weights, fluid and salt intake.”
C. “Left-sided heart failure can lead to right-sided heart failure, if left untreated.”
D. “This type of heart failure can build up pressure in the hepatic veins and cause them to
become congested with fluid which leads to peripheral edema.”

52. Which of the following are NOT typical signs and symptoms of right-sided heart failure?
Select-all-that-apply:
A. Jugular venous distention
B. Persistent cough
C. Weight gain
D. Crackles
E. Nocturia
F. Orthopnea

53. A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following
are expected findings with this condition?
A. Echocardiogram shows an ejection fraction of 38%.
B. Heart catheterization shows an ejection fraction of 65%.
C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
D. Options A and C are both expected findings with left sided systolic dysfunction heart failure​.

54. True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal
ejection fraction.
TRUE

55. A patient has a history of heart failure. Which of the following statements by the patient indicates
the patient may be experiencing heart failure exacerbation?
A. “I’ve noticed that I’ve gain 6 lbs in one week.”
B. “While I sleep I have to prop myself up with a pillow so I can breathe.”
C. “I haven’t noticed any swelling in my feet or hands lately.”
D. Options B and C are correct.
E. Options A and B are correct.
F. Options A, B, and C are all correct.
56. Patients with heart failure can experience episodes of exacerbation. All of the patients below have
a history of heart failure. Which of the following patients are at MOST risk for heart failure
exacerbation?
A. A 55 year old female who limits sodium and fluid intake regularly.
B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing
atrial fibrillation.
C. A 67 year old female who is being discharged home from heart valve replacement surgery.
D. A 78 year old male who has a health history of eczema and cystic fibrosis.

57. A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable
to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung
fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following
lab results confirm your suspicions of heart failure?
A. K+ 5.6
B. BNP 820
C. BUN 9
D. Troponin <0.02

58 Which of the following tests/procedures are NOT used to diagnose heart failure?
A. Echocardiogram
B. Brain natriuretic peptide blood test
C. Nuclear stress test
D. Holter monitoring

59. What type of heart failure does this statement describe? The ventricle is unable to properly fill
with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to
experience shortness of breath.
A. Left ventricular systolic dysfunction
B. Left ventricular ride-sided dysfunction
C. Right ventricular diastolic dysfunction
D. Left ventricular diastolic dysfunction

60. A patient with left-sided heart failure is having difficulty breathing. Which of the following is the
most appropriate nursing intervention?
A. Encourage the patient to cough and deep breathe.
B. Place the patient in Semi-Fowler’s position.
C. Assist the patient into High Fowler’s position​.
D. Perform chest percussion therapy.

61. You’re providing diet discharge teaching to a patient with a history of heart failure. Which of the
following statements made by the patient represents they understood the diet teaching?

A. “I will limit my sodium intake to 5-6 grams a day.”

B. “I will be sure to incorporate canned vegetables and fish into my diet.”

C. “I’m glad I can still eat sandwiches because I love bologna and cheese sandwiches.”
D. “I will limit my consumption of frozen meals.”
62 Select all the correct statements about educating the patient with heart failure:
A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a
day or 10 pounds in a week.
B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with
the pneumonia vaccine.”
C. Heart failure patients should limit sodium intake to 2-3 grams per day.
D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias.
E. Patients with heart failure should limit exercise because of the risks.

63. A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw
shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order
for this patient?
A. Narcan
B. Aminophylline
C. Digibind/ Digifab
D. No medication because this is a normal Digoxin level.

64. Which of the following is a late sign of heart failure?

A. Shortness of breath
B. Orthopnea
C. Edema
D. Frothy-blood tinged sputum

64. These drugs are used as first-line treatment of heart failure. They work by allowing more blood to
flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium.
However, some patients can develop a nagging cough with these types of drugs. This description
describes?
A. Beta-blockers
B. Vasodilators
C. Angiotensin II receptor blockers
D. Angiotensin-converting-enzyme inhibitors

65. A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG
changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results
confirms these findings?
A. Na+ 135
B. BNP 560
C. K+ 8.0
D. K+ 1.5

66. During your morning assessment of a patient with heart failure, the patient complains of sudden
vision changes that include seeing yellowish-green halos around the lights. Which of the following
medications do you suspect is causing this issue?
A. Lisinopril
B. Losartan
C. Lasix
D. Digoxin
67. Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of
heart failure:
A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction.
B. A side effect of these drugs include bradycardia.
C. These drugs are most commonly prescribed for patients with heart failure who have COPD.
D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.

68. You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet
and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil.
Which of the following is a nursing priority for this patient while assisting them to the bathroom?
A. Measure and record the urine voided.
B. Assist the patient up slowing and gradually.
C. Place the call light in the patient’s reach while in the bathroom.
D. Provide privacy for the patient.

69. A patient is taking Digoxin. Prior to administration you check the patient’s apical pulse and find it
to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of
the following is the correct nursing action?
A. Hold this dose and administer the second dose at 1800.
B. Administer the dose as ordered.
C. Hold the dose and notify the physician of the Digoxin level.
D. Hold this dose until the patient’s potassium level is normal.

70. Which of the following is a common side effect of Spironolactone?

A. Renal failure
B. Hyperkalemia
C. Hypokalemia
D. Dry cough

71. The physician’s order says to administered Lasix 40 mg IV twice a day. The patient has the
following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a
nursing priority?
A. Administer the Lasix as ordered
B. Notify the physician of the BNP level
C. Assess the patient for edema
D. Hold the dose and notify the physician about the potassium level