TEST BANK
Chapter 103: Heart Failure
Buttaro: Primary Care: A Collaborative Practice, 6th Edition
MULTIPLE CHOICE
1. A patient experiencing heart failure with reduced ejection fraction will have which symptoms?
a. Dyspnea and fatigue without volume overload
b. Impairment of ventricular filling and relaxation
c. Mild, exertionally related dyspnea
d. Pump failure from left ventricular systolic dysfunction
ANS: D
Heart failure with reduced ejection fraction results in pump failure from ventricular systolic
dysfunction. Heart failure with preserved ejection fraction may have milder symptoms and is
associated with impairment of ventricular filling and relaxation.
2. A patient who has been diagnosed with heart failure for over a year reports being comfortable
while at rest but experiences palpitations and dyspnea when walking to the bathroom. Which
classification of heart failure is appropriate based on these symptoms?
a. Class I
b. Class II
c. Class III
d. Class IV
ANS: B
Patients with Class II heart failure (HF) will have slight limitation of activity and will be
comfortable at rest with symptomsNURoccurring
SINGTBwith.COordinary
M physical activity. Patients with
Class I HF do not have limitations and ordinary physical activity does not produce symptoms.
With Class III HF, less than usual activity will produce symptoms. With Class IV HF,
symptoms are present even at rest and all physical activity worsens symptoms.
3. A patient who has Class II heart failure is taking an ACE inhibitor and reports a recurrent
cough that does not interfere with sleep or activity. What will the provider do initially to
manage this patient?
a. Assess serum potassium and sodium immediately
b. Discontinue the ACE inhibitor and prescribe an ARB
c. Provide reassurance that this is a benign side effect
d. Withhold the drug and evaluate renal and pulmonary function
ANS: C
Cough occurs in about 20% of patients who take ACE inhibitors and is not dangerous. The
patient should be reassured that this is the case. If the cough is annoying, alternate therapy
with an ARB may be considered. It is not necessary to evaluate electrolytes, renal function, or
pulmonary function.
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