NURS 6201 Exam 2 Content: Heart Failure and
Dysrhythmias (Assessment data, medications, teaching
points, complications, and more regarding heart failure)
Questions With Complete Solutions
A client has developed atrial fibrillation with a ventricular rate
of 150 beats per minute. A nurse assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins Correct Answers A. Hypotension and
dizziness
Reasoning: Hypotension and dizziness are common signs and
symptoms of reduced CO, which is a common problem with
Atrial fibrillation
A nurse is caring for a patient with suspected heart failure d/t
prolonged hypertension. She notices that the provider has
ordered a chest x-ray.
Is this a useful diagnostic test for heart failure?
If the patient has heart failure, what would we expect to see and
why? Correct Answers Chest X-rays are useful diagnostic tests
for heart failure. We may be able to see an enlargement of the
heart (hypertrophy).
We might also see fluid in the lungs if this is left-sided heart
failure.
A nurse is educating a patient placed on Lasix and Digoxin to
manage their HF symptoms. What teaching might the nurse give
the patient to reduce their risk for serious adverse effects?
,Correct Answers 1. Eat potassium-rich foods such as bananas,
avocados, and coconut water.
2. Contact your provider if you are experiencing muscle
cramps/spasms, extreme fatigue, and/or numbness and tingling
(s/s of hypokalemia)
3. Contact your provider if you experience nausea, vomiting,
and vision changes such as chromatopsias (s/s of digoxin
toxicity)
A nurse is educating a patient with newly diagnosed heart failure
on daily weights. What recommendations should the nurse make
to the patient regarding daily weights? Correct Answers The
patient should weigh themselves at the same time each day,
wearing the same clothes if possible. Morning is usually the best
time for patients to weigh themselves.
A nurse is teaching a patient on potential adverse effects of beta-
blockers for the treatment of heart failure. Which of the
following points should the nurse include? (Select all that apply)
A. Worsening of HF symptoms
B. Fatigue
C. Bradycardia
D. Hypotension Correct Answers A-D are correct. These are all
potential adverse effects of beta-blocker therapy. Recall that
beta-blockers block SNS stimulation of the heart. This reduces
HR and contractility, which may actually worsen symptoms of
HF if the patient is fluid overloaded.
For D, just remember that practically all chronic HF drugs cause
hypotension.
, A patient is 4 hours post-operative after a femoral cardiac
catheterization. When you enter the patient's room, they tell you
that they feel like they need to poop. What is the nurse's priority
action?
A. Assess the patient's mental status.
B. Assist the patient to semi-Fowler's position.
C. Help the patient ambulate to the bathroom.
D. Check the patient's lumbar area for ecchymosis. Correct
Answers D. Check the patient's lumbar area for ecchymosis.
Patients who are post-op from femoral catheterization should
have no need to poop. If they feel the urge to defecate, it's a sign
of a retroperitoneal bleed. In this case, you should check the
patient's back for ecchymosis.
If you suspect a retroperitoneal bleed, call the physician.
A patient is scheduled to received cardioversion for treatment of
atrial fibrillation which has been present for longer than 24
hours.
Which diagnostic test should be performed before
cardioversion?
Why? Correct Answers A TEE (TransEsophageal
Echocardiogram) should be performed prior to cardioversion for
any patient who has been in afib for >24 hrs.
The reason is that clots formed during afib may be ejected into
circulation after rhythm correction during cardioversion. This
dramatically increases the risk for stroke, MI, and other
complications. The TEE will allow us to see any clots.
A patient placed on Losartan for treatment of heart failure
requires education regarding adverse effects of this medication.
Dysrhythmias (Assessment data, medications, teaching
points, complications, and more regarding heart failure)
Questions With Complete Solutions
A client has developed atrial fibrillation with a ventricular rate
of 150 beats per minute. A nurse assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins Correct Answers A. Hypotension and
dizziness
Reasoning: Hypotension and dizziness are common signs and
symptoms of reduced CO, which is a common problem with
Atrial fibrillation
A nurse is caring for a patient with suspected heart failure d/t
prolonged hypertension. She notices that the provider has
ordered a chest x-ray.
Is this a useful diagnostic test for heart failure?
If the patient has heart failure, what would we expect to see and
why? Correct Answers Chest X-rays are useful diagnostic tests
for heart failure. We may be able to see an enlargement of the
heart (hypertrophy).
We might also see fluid in the lungs if this is left-sided heart
failure.
A nurse is educating a patient placed on Lasix and Digoxin to
manage their HF symptoms. What teaching might the nurse give
the patient to reduce their risk for serious adverse effects?
,Correct Answers 1. Eat potassium-rich foods such as bananas,
avocados, and coconut water.
2. Contact your provider if you are experiencing muscle
cramps/spasms, extreme fatigue, and/or numbness and tingling
(s/s of hypokalemia)
3. Contact your provider if you experience nausea, vomiting,
and vision changes such as chromatopsias (s/s of digoxin
toxicity)
A nurse is educating a patient with newly diagnosed heart failure
on daily weights. What recommendations should the nurse make
to the patient regarding daily weights? Correct Answers The
patient should weigh themselves at the same time each day,
wearing the same clothes if possible. Morning is usually the best
time for patients to weigh themselves.
A nurse is teaching a patient on potential adverse effects of beta-
blockers for the treatment of heart failure. Which of the
following points should the nurse include? (Select all that apply)
A. Worsening of HF symptoms
B. Fatigue
C. Bradycardia
D. Hypotension Correct Answers A-D are correct. These are all
potential adverse effects of beta-blocker therapy. Recall that
beta-blockers block SNS stimulation of the heart. This reduces
HR and contractility, which may actually worsen symptoms of
HF if the patient is fluid overloaded.
For D, just remember that practically all chronic HF drugs cause
hypotension.
, A patient is 4 hours post-operative after a femoral cardiac
catheterization. When you enter the patient's room, they tell you
that they feel like they need to poop. What is the nurse's priority
action?
A. Assess the patient's mental status.
B. Assist the patient to semi-Fowler's position.
C. Help the patient ambulate to the bathroom.
D. Check the patient's lumbar area for ecchymosis. Correct
Answers D. Check the patient's lumbar area for ecchymosis.
Patients who are post-op from femoral catheterization should
have no need to poop. If they feel the urge to defecate, it's a sign
of a retroperitoneal bleed. In this case, you should check the
patient's back for ecchymosis.
If you suspect a retroperitoneal bleed, call the physician.
A patient is scheduled to received cardioversion for treatment of
atrial fibrillation which has been present for longer than 24
hours.
Which diagnostic test should be performed before
cardioversion?
Why? Correct Answers A TEE (TransEsophageal
Echocardiogram) should be performed prior to cardioversion for
any patient who has been in afib for >24 hrs.
The reason is that clots formed during afib may be ejected into
circulation after rhythm correction during cardioversion. This
dramatically increases the risk for stroke, MI, and other
complications. The TEE will allow us to see any clots.
A patient placed on Losartan for treatment of heart failure
requires education regarding adverse effects of this medication.
