Heart Failure (med-surg) Exam 3 Practice Questions With
Complete Solutions
A 66-year-old client has been in the hospital for care and
management of heart failure. There are orders for discharge and
the nurse is reviewing discharge instructions with the client.
Which of the following information would be included as part of
discharge information for this client?
The client should not eat more than 2,000 mg of sodium each
day
The client should restrict fluid intake to less than 4,000 mL per
day
The client should not have more than 3 alcoholic beverages per
day
The client should take non-steroidal anti-inflammatory drugs
(NSAIDs) for pain control and not acetaminophen Correct
Answers A
Excess sodium intake can cause changes in circulatory volume,
potentially increasing fluid and contributing to buildup. Many
clients with heart failure are restricted in their dietary sodium to
2,000 mg a day, although in some cases, the provider may allow
for more or less, depending on the client's condition.
While a client with heart failure may drink alcohol, it must be
done in moderation. Three alcoholic beverages per day is too
much alcohol, and would be considered moderate to heavy
drinking. A client with heart failure should be counseled not to
drink more than one alcoholic beverage in a day, and to avoid
drinking alcohol every day.
,NSAIDS may worsen heart failure and should be avoided.
Heart failure can cause an increase in fluid in the circulatory
system. Most heart failure clients are instructed to restrict fluid
to 1,000 to 2,000 mL per day.
A 69-year-old female has a history of heart failure. She is
admitted to the emergency department with heart failure
complicated by pulmonary edema. On admission of this client,
which of the following should the nurse assess first?
a) Blood pressure
b) Skin breakdown
c) Serum potassium level
d) Urine output Correct Answers ANSWER: A
Rationale: It is a priority to assess blood pressure first because
people with pulmonary edema typically experience severe
hypertension that requires early intervention. The client
probably does not have skin breakdown on admission; however,
when the client is stable, the nurse should inspect the skin.
Potassium levels are not the first priority. The nurse should
monitor urine output after the client is stable.
A client has a history of heart failure and has been taking several
medications, including furosemide (Lasix), digoxin (Lanoxin)
and potassium chloride. The client has nausea, blurred vision,
headache, and weakness. The nurse notes that the client is
confused. The telemetry strip shows first degree atrioventricular
block. The
nurse should assess the client for signs of which condition?
a) Hyperkalemia
b) Digoxin toxicity
,c) Fluid deficit
d) Pulmonary edema Correct Answers ANSWER: B
Rationale: Early symptoms of digoxin toxicity include anorexia,
nausea, and vomiting. Visual disturbances can also occur,
including double or blurred vision and visual halos.
Hypokalemia is a common cause of digoxin toxicity associated
with arrhythmias because low serum potassium can enhance
ectopic pacemaker activity. Although vomiting can lead to fluid
deficit, given the client's history, the vomiting is likely due to
the adverse effects of digoxin toxicity. Pulmonary edema is
manifested by dyspnea and coughing.
A client receiving a loop diuretic should be encouraged to eat
which of the following foods? Select all that apply.
a) Angel food cake
b) Banana
c) Dried fruit
d) Orange juice
e) Peppers Correct Answers ANSWER: B, C, D
Rationale: Hypokalemia is a side effect of loop diuretics.
Bananas, dried fruits, and oranges are examples of food high in
potassium. Angel food cake, yellow cake, and peppers are listed
by the National Kidney Foundation as low in potassium.
A client with chronic heart failure has atrial fibrillation and a left
ventricular ejection fraction of 15%. The
client is taking warfarin (Coumadin). The expected outcome of
this drug is to:
a) Decrease circulatory overload
b) Improve the myocardial workload
c) Prevent thrombus formation
, d) Regulate cardiac rhythm Correct Answers ANSWER: C
Rationale: Coumadin is an anticoagulant, which is used in the
treatment of atrial fibrillation and decreased left
ventricular ejection fraction (less than 20%) to prevent thrombus
formation and release of emboli into the circulation. The client
may also take other medication as needed to manage the heart
failure. Coumadin does not reduce circulatory load or improve
myocardial workload. Coumadin does not affect cardiac rhythm.
A client with heart failure is receiving digoxin intravenously.
The nurse should determine the effectiveness of the drug by
assessing which of the following?
a) Dilated coronary arteries
b) Increased myocardial contractility
c) Decreased cardiac arrhythmias
d) Decreased electrical conductivity in the heart Correct
Answers ANSWER: B
Rationale: Digoxin is a cardiac glycoside with positive inotropic
activity. This inotropic activity causes increased strength of
myocardial contractions and thereby increases output of blood
from the left ventricle. Digoxin does not dilate coronary arteries.
Although digoxin can be used to treat arrhythmias and does
decrease the electrical conductivity of the myocardium, these are
not primary reasons for its use in clients with heart failure and
pulmonary edema.
A nurse in the CCU is caring for a patient with heart failure who
has developed an intracardiac thrombus. What is the most
common complication of thromboembolic problems among HF
patients?
a) Pulmonary embolism
Complete Solutions
A 66-year-old client has been in the hospital for care and
management of heart failure. There are orders for discharge and
the nurse is reviewing discharge instructions with the client.
Which of the following information would be included as part of
discharge information for this client?
The client should not eat more than 2,000 mg of sodium each
day
The client should restrict fluid intake to less than 4,000 mL per
day
The client should not have more than 3 alcoholic beverages per
day
The client should take non-steroidal anti-inflammatory drugs
(NSAIDs) for pain control and not acetaminophen Correct
Answers A
Excess sodium intake can cause changes in circulatory volume,
potentially increasing fluid and contributing to buildup. Many
clients with heart failure are restricted in their dietary sodium to
2,000 mg a day, although in some cases, the provider may allow
for more or less, depending on the client's condition.
While a client with heart failure may drink alcohol, it must be
done in moderation. Three alcoholic beverages per day is too
much alcohol, and would be considered moderate to heavy
drinking. A client with heart failure should be counseled not to
drink more than one alcoholic beverage in a day, and to avoid
drinking alcohol every day.
,NSAIDS may worsen heart failure and should be avoided.
Heart failure can cause an increase in fluid in the circulatory
system. Most heart failure clients are instructed to restrict fluid
to 1,000 to 2,000 mL per day.
A 69-year-old female has a history of heart failure. She is
admitted to the emergency department with heart failure
complicated by pulmonary edema. On admission of this client,
which of the following should the nurse assess first?
a) Blood pressure
b) Skin breakdown
c) Serum potassium level
d) Urine output Correct Answers ANSWER: A
Rationale: It is a priority to assess blood pressure first because
people with pulmonary edema typically experience severe
hypertension that requires early intervention. The client
probably does not have skin breakdown on admission; however,
when the client is stable, the nurse should inspect the skin.
Potassium levels are not the first priority. The nurse should
monitor urine output after the client is stable.
A client has a history of heart failure and has been taking several
medications, including furosemide (Lasix), digoxin (Lanoxin)
and potassium chloride. The client has nausea, blurred vision,
headache, and weakness. The nurse notes that the client is
confused. The telemetry strip shows first degree atrioventricular
block. The
nurse should assess the client for signs of which condition?
a) Hyperkalemia
b) Digoxin toxicity
,c) Fluid deficit
d) Pulmonary edema Correct Answers ANSWER: B
Rationale: Early symptoms of digoxin toxicity include anorexia,
nausea, and vomiting. Visual disturbances can also occur,
including double or blurred vision and visual halos.
Hypokalemia is a common cause of digoxin toxicity associated
with arrhythmias because low serum potassium can enhance
ectopic pacemaker activity. Although vomiting can lead to fluid
deficit, given the client's history, the vomiting is likely due to
the adverse effects of digoxin toxicity. Pulmonary edema is
manifested by dyspnea and coughing.
A client receiving a loop diuretic should be encouraged to eat
which of the following foods? Select all that apply.
a) Angel food cake
b) Banana
c) Dried fruit
d) Orange juice
e) Peppers Correct Answers ANSWER: B, C, D
Rationale: Hypokalemia is a side effect of loop diuretics.
Bananas, dried fruits, and oranges are examples of food high in
potassium. Angel food cake, yellow cake, and peppers are listed
by the National Kidney Foundation as low in potassium.
A client with chronic heart failure has atrial fibrillation and a left
ventricular ejection fraction of 15%. The
client is taking warfarin (Coumadin). The expected outcome of
this drug is to:
a) Decrease circulatory overload
b) Improve the myocardial workload
c) Prevent thrombus formation
, d) Regulate cardiac rhythm Correct Answers ANSWER: C
Rationale: Coumadin is an anticoagulant, which is used in the
treatment of atrial fibrillation and decreased left
ventricular ejection fraction (less than 20%) to prevent thrombus
formation and release of emboli into the circulation. The client
may also take other medication as needed to manage the heart
failure. Coumadin does not reduce circulatory load or improve
myocardial workload. Coumadin does not affect cardiac rhythm.
A client with heart failure is receiving digoxin intravenously.
The nurse should determine the effectiveness of the drug by
assessing which of the following?
a) Dilated coronary arteries
b) Increased myocardial contractility
c) Decreased cardiac arrhythmias
d) Decreased electrical conductivity in the heart Correct
Answers ANSWER: B
Rationale: Digoxin is a cardiac glycoside with positive inotropic
activity. This inotropic activity causes increased strength of
myocardial contractions and thereby increases output of blood
from the left ventricle. Digoxin does not dilate coronary arteries.
Although digoxin can be used to treat arrhythmias and does
decrease the electrical conductivity of the myocardium, these are
not primary reasons for its use in clients with heart failure and
pulmonary edema.
A nurse in the CCU is caring for a patient with heart failure who
has developed an intracardiac thrombus. What is the most
common complication of thromboembolic problems among HF
patients?
a) Pulmonary embolism
