HEART FAILURE NCLEX EXAM 3 LATEST VERSIONS (VERSION A,
B AND C) 2023 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
define what heart fialure is - ANSWER: when the heart is unable to pump enough
blood to meet the body's needs
what can cause heart failure? - ANSWER: impaired cardiac function. CAD. MI.
ischemia, valve disease, congenital defects, cardiomyopathies
OR
excess work: from HTN or pulm HTN, fluid overlaod, anemia, thyrotoxicosis
describe myocardial hypertrophy: - ANSWER: results from increased work, but heart
outgrows its blood supply
describe myocardial dialation: - ANSWER: this results from increased PRELOAD, but
overstretches and weakens; becomes more spherical
when overstretching ______ is released and this leads to _____ - ANSWER: BNP;
increased sodium excretion
what are the two types of HEart failure? - ANSWER: 1) heart failure with reduced
ejection fraction
2) heart with preserved ejection fraction
describe heart failure with reduced ejection fraction - ANSWER: this would have
reduced contractility and an ejection fraction of less than 40% (MI would affect this)
describe heart failure with preserved ejection fraction - ANSWER: this would have
impaired cardiac relaxation and impaired ventricular filling; ventricles do NOT relax
and fill well/poor stretch; WORSE PROGNOSIS
(Lupus would affect this)
what symptoms will we see with right sides heart failure? - ANSWER: JVD, edema,
ascites, increased CVP and RAP
what symptoms will we see with left sided heart failure? - ANSWER: pulmonary
symptoms -- crackles, decreased O2 sats, increased RR, increased PA pressure,
pulmonay edema, orthopena
what causes Biventricular failure? - ANSWER: left and right ventricular MI or severe
left sided left untreated
what assessments will we want to do with patients in heart failure? - ANSWER: -
gather a history of symptoms and activites
, - physical assessments
- weight
- labs
- ecg
- echo
- CXR
- hemodynamic monitoring
- ABGS
what is significant with weight assessments in heart failure? - ANSWER: increases of
more than 2 pounds a day or 5 pounds in a week are SIGNIFICANT
what labs would we want to observe for heart failure? - ANSWER: BNP,
Creatinine/BUN, CBC, cardiac enzymes & proteins, electrolytes
what does the echo look at in heart failure? - ANSWER: used to check the wall
motion, ejection fraction, valves
why is a CXR benefical in heart failure? - ANSWER: - checks for pulmonary edema
- checks the size of the heart (cardiac silhouette size)
what will hemodynamics present like in heart failure? - ANSWER: DEC: CO/CI
INC: CVP, RV, SVR, PAOP, HR
what are the goals for acute heart failure? - ANSWER: - to reduce ventricular
modeling
- improve tissue perfusion
- improve quality of life
- reduce morality and comps
what two oxygegnation ways can we provide if the patient needs severe help? -
ANSWER: BIPAP or VENT
what is the nursing care for BIPAP? - ANSWER: - **Critical*** LOC assessments
- skin breakdown
- fitting of the mask
we can give _____ to help manage acute HF and with this we would want to monitor
____ hourly - ANSWER: diuretics; urine output
when would we want to give IV fluids for managment of acute HF? - ANSWER: if
there is dec volume form over-diuresis or dehydration
what do we wnat to monitor while giving fluids? - ANSWER: monitor BP
what will inotropes help with in acute heart fialure? - ANSWER: they will increase
contractility and O2 demands
B AND C) 2023 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
define what heart fialure is - ANSWER: when the heart is unable to pump enough
blood to meet the body's needs
what can cause heart failure? - ANSWER: impaired cardiac function. CAD. MI.
ischemia, valve disease, congenital defects, cardiomyopathies
OR
excess work: from HTN or pulm HTN, fluid overlaod, anemia, thyrotoxicosis
describe myocardial hypertrophy: - ANSWER: results from increased work, but heart
outgrows its blood supply
describe myocardial dialation: - ANSWER: this results from increased PRELOAD, but
overstretches and weakens; becomes more spherical
when overstretching ______ is released and this leads to _____ - ANSWER: BNP;
increased sodium excretion
what are the two types of HEart failure? - ANSWER: 1) heart failure with reduced
ejection fraction
2) heart with preserved ejection fraction
describe heart failure with reduced ejection fraction - ANSWER: this would have
reduced contractility and an ejection fraction of less than 40% (MI would affect this)
describe heart failure with preserved ejection fraction - ANSWER: this would have
impaired cardiac relaxation and impaired ventricular filling; ventricles do NOT relax
and fill well/poor stretch; WORSE PROGNOSIS
(Lupus would affect this)
what symptoms will we see with right sides heart failure? - ANSWER: JVD, edema,
ascites, increased CVP and RAP
what symptoms will we see with left sided heart failure? - ANSWER: pulmonary
symptoms -- crackles, decreased O2 sats, increased RR, increased PA pressure,
pulmonay edema, orthopena
what causes Biventricular failure? - ANSWER: left and right ventricular MI or severe
left sided left untreated
what assessments will we want to do with patients in heart failure? - ANSWER: -
gather a history of symptoms and activites
, - physical assessments
- weight
- labs
- ecg
- echo
- CXR
- hemodynamic monitoring
- ABGS
what is significant with weight assessments in heart failure? - ANSWER: increases of
more than 2 pounds a day or 5 pounds in a week are SIGNIFICANT
what labs would we want to observe for heart failure? - ANSWER: BNP,
Creatinine/BUN, CBC, cardiac enzymes & proteins, electrolytes
what does the echo look at in heart failure? - ANSWER: used to check the wall
motion, ejection fraction, valves
why is a CXR benefical in heart failure? - ANSWER: - checks for pulmonary edema
- checks the size of the heart (cardiac silhouette size)
what will hemodynamics present like in heart failure? - ANSWER: DEC: CO/CI
INC: CVP, RV, SVR, PAOP, HR
what are the goals for acute heart failure? - ANSWER: - to reduce ventricular
modeling
- improve tissue perfusion
- improve quality of life
- reduce morality and comps
what two oxygegnation ways can we provide if the patient needs severe help? -
ANSWER: BIPAP or VENT
what is the nursing care for BIPAP? - ANSWER: - **Critical*** LOC assessments
- skin breakdown
- fitting of the mask
we can give _____ to help manage acute HF and with this we would want to monitor
____ hourly - ANSWER: diuretics; urine output
when would we want to give IV fluids for managment of acute HF? - ANSWER: if
there is dec volume form over-diuresis or dehydration
what do we wnat to monitor while giving fluids? - ANSWER: monitor BP
what will inotropes help with in acute heart fialure? - ANSWER: they will increase
contractility and O2 demands
