Angiotensin-converting-
enzyme (ACE) inhibitors
are a central part of the
treatment of heart
failure because they
have more than one
action to address the
pathological changes in
this disorder. Which of
the following
pathological changes in
heart failure is NOT
addressed by ACE
inhibitors?
1. Changes in the
1. structure of the left
ventricle so that it dilates,
hypertrophies, and uses
energy less efficiently.
2. Reduced formation of
cross-bridges so that
contractile force
decreases.
3. Activation of the
sympathetic nervous
system that increases
heart rate and preload.
4. Decreased renal blood
flow that decreases
oxygen supply to the
kidneys.
2. One of the three types of
heart failure involves
systolic dysfunction.
Potential causes of this
most common form of
heart failure include:
1. Myocardial ischemia
and injury secondary to
myocardial infarction
2. Inadequate relaxation
and loss of muscle fiber
secondary to valvular
dysfunction
, 3. Increased demands of
the heart beyond its
ability to adapt
secondary to anemia
4. Slower filling rate and
elevated systolic
pressures secondary to
uncontrolled
hypertension
The American Heart
Association and the
American College of
Cardiology have devised
a classification system
for heart failure that can
be used to direct
3. treatment. Patients with
symptoms and
underlying disease are
classified as stage:
1. A
2. B
3. C
4. D
4. Diagnosis of heart failure
cannot be made by
symptoms alone because
many disorders share the
same symptoms. The
most specific and
sensitive diagnostic test
for heart failure is:
1. Chest x-rays that show
cephalization and
measure heart size
2. Two-dimensional
echocardiograms that
identify structural
anomalies and cardiac
dysfunction
3. Complete blood count,
blood urea nitrogen, and
serum electrolytes that
, facilitate staging for end-
organ damage
4. Measurement of brain
natriuretic peptide to
distinguish between
systolic and diastolic
dysfunction
Treatments for heart
failure, including drug
therapy, are based on
the stages developed by
the ACC/AHA. Stage A
patients are treated
with:
1. Drugs for hypertension
and hyperlipidemia, if
they exist
5.
2. Lifestyle management
including diet, exercise,
and smoking cessation
only
3. Angiotensin-converting
enzyme (ACE) inhibitors
to directly affect the
heart failure only
4. No drugs are used in
this early stage
6. Class I recommendations
for stage A heart failure
include:
1. Aerobic exercise within
tolerance levels to
prevent the development
of heart failure
2. Reduction of sodium
intake to less than 2,000
mg/day to prevent fluid
retention
3. Beta blockers for all
patients regardless of
cardiac history
4. Treatment of thyroid
disorders, especially if
, they are associated with
tachyarrhythmias
Stage B patients should
have beta blockers
added to their heart
failure treatment
regimen when:
7. 1. They have an ejection
fraction less than 40%
2. They have had a recent
MI
3. Both 1 and 2
4. Neither 1 nor 2
Increased life expectancy
for patients with heart
failure has been
associated with the use
of:
1. ACE inhibitors,
especially when started
8.
early in the disease
process
2. All beta blockers
regardless of selectivity
3. Thiazide and loop
diuretics
4. Cardiac glycosides
9. Stage C patients usually
require a combination of
three to four drugs to
manage their heart
failure. In addition to
ACE inhibitors and beta
blockers, diuretics may
be added. Which of the
following statements
about diuretics is NOT
true?
1. Diuretics reduce
preload associated with
fluid retention.
2. Diuretics can be used
earlier than stage C when
enzyme (ACE) inhibitors
are a central part of the
treatment of heart
failure because they
have more than one
action to address the
pathological changes in
this disorder. Which of
the following
pathological changes in
heart failure is NOT
addressed by ACE
inhibitors?
1. Changes in the
1. structure of the left
ventricle so that it dilates,
hypertrophies, and uses
energy less efficiently.
2. Reduced formation of
cross-bridges so that
contractile force
decreases.
3. Activation of the
sympathetic nervous
system that increases
heart rate and preload.
4. Decreased renal blood
flow that decreases
oxygen supply to the
kidneys.
2. One of the three types of
heart failure involves
systolic dysfunction.
Potential causes of this
most common form of
heart failure include:
1. Myocardial ischemia
and injury secondary to
myocardial infarction
2. Inadequate relaxation
and loss of muscle fiber
secondary to valvular
dysfunction
, 3. Increased demands of
the heart beyond its
ability to adapt
secondary to anemia
4. Slower filling rate and
elevated systolic
pressures secondary to
uncontrolled
hypertension
The American Heart
Association and the
American College of
Cardiology have devised
a classification system
for heart failure that can
be used to direct
3. treatment. Patients with
symptoms and
underlying disease are
classified as stage:
1. A
2. B
3. C
4. D
4. Diagnosis of heart failure
cannot be made by
symptoms alone because
many disorders share the
same symptoms. The
most specific and
sensitive diagnostic test
for heart failure is:
1. Chest x-rays that show
cephalization and
measure heart size
2. Two-dimensional
echocardiograms that
identify structural
anomalies and cardiac
dysfunction
3. Complete blood count,
blood urea nitrogen, and
serum electrolytes that
, facilitate staging for end-
organ damage
4. Measurement of brain
natriuretic peptide to
distinguish between
systolic and diastolic
dysfunction
Treatments for heart
failure, including drug
therapy, are based on
the stages developed by
the ACC/AHA. Stage A
patients are treated
with:
1. Drugs for hypertension
and hyperlipidemia, if
they exist
5.
2. Lifestyle management
including diet, exercise,
and smoking cessation
only
3. Angiotensin-converting
enzyme (ACE) inhibitors
to directly affect the
heart failure only
4. No drugs are used in
this early stage
6. Class I recommendations
for stage A heart failure
include:
1. Aerobic exercise within
tolerance levels to
prevent the development
of heart failure
2. Reduction of sodium
intake to less than 2,000
mg/day to prevent fluid
retention
3. Beta blockers for all
patients regardless of
cardiac history
4. Treatment of thyroid
disorders, especially if
, they are associated with
tachyarrhythmias
Stage B patients should
have beta blockers
added to their heart
failure treatment
regimen when:
7. 1. They have an ejection
fraction less than 40%
2. They have had a recent
MI
3. Both 1 and 2
4. Neither 1 nor 2
Increased life expectancy
for patients with heart
failure has been
associated with the use
of:
1. ACE inhibitors,
especially when started
8.
early in the disease
process
2. All beta blockers
regardless of selectivity
3. Thiazide and loop
diuretics
4. Cardiac glycosides
9. Stage C patients usually
require a combination of
three to four drugs to
manage their heart
failure. In addition to
ACE inhibitors and beta
blockers, diuretics may
be added. Which of the
following statements
about diuretics is NOT
true?
1. Diuretics reduce
preload associated with
fluid retention.
2. Diuretics can be used
earlier than stage C when
