Heart Failure Test Questions And Answers
Verified 100% Correct
An older adult client is admitted with fluid volume excess. Which diagnostic study does
the nurse facilitate as a priority?
a. Echocardiography
b. Chest x-ray
c. T4 and thyroid-stimulating hormone (TSH)
d. Arterial blood gas -
ANSWER: A
Echocardiography is considered the best tool for the diagnosis of heart failure. A chest
x-ray probably will be done, and if the client has dyspnea, an arterial blood gas will be
drawn, but the echocardiogram is the priority. T4 and TSH might be ordered to assess
for a contributing cause of heart failure.
The nurse is caring for a client with severe heart failure. What is the best position in
which to place this client?
a. High Fowler's, pillows under arms
b. Semi-Fowler's, with legs elevated
c. High Fowler's, with legs elevated
d. Semi-Fowler's, on the left side - ANSWER: A
Placing the client in high Fowler's position, with pillows under the arms, allows for
maximum chest expanswerion.
The nurse is instructing a client with heart failure about energy conservation. Which is
the best instruction?
a. "Walk until you become short of breath and then walk back home."
b. "Gather everything you need for a chore before you begin."
c. "Pull rather than push or carry items heavier than 5 pounds."
d. "Take a walk after dinner every day to build up your strength." - ANSWER: B
Gathering all supplies needed for a chore at one time decreases the amount of energy
needed.
A client with heart failure is due to receive enalapril (Vasotec) and has a blood pressure
of 98/50 mm Hg. What is the nurse's best action?
a. Administer the Vasotec.
b. Recheck the blood pressure.
c. Hold the Vasotec.
d. Notify the health care provider. -
ANSWER: A
The nurse should administer the medication. Generally, the health care provider will
,maintain the client's blood pressure between 90 and 110 mm Hg.
A client in severe heart failure has a heparin drip infusing. The health care provider
prescribes nesiritide (Natrecor) to be given intravenously. Which intervention is
essential before administration of this medication? a. Insert a separate IV access.
b. Prepare a test bolus dose.
c. Prepare the piggyback line.
d. Administer furosemide (Lasix) first. - ANSWER: A
Natrecor should be given through a separate IV access because it is incompatible with
many medications, especially heparin. A test bolus is not needed, nor is Lasix. Because
the medication should be given through a separate IV, it is not necessary to prepare a
piggyback line.
The nurse is assessing a client with left-sided heart failure. What conditions does the
nurse assess for? (Select all that apply.) a. Pulmonary crackles
b. Confusion, restlessness
c. Pulmonary hypertension
d. Dependent edema
e. S3/S4 summation gallop
f. Cough worsens at night - ANSWER: A, B, E, F
Left-sided failure occurs with a decrease in contractility of the heart or an increase in
afterload. Most of the signs will be noted in the respiratory system. Right-sided failure
occurs with problems from the pulmonary vasculature onward. Signs will be noted
before the right atrium or ventricle.
The nurse is evaluating the laboratory results for a client with heart failure. What results
does the nurse expect? (Select all that apply.) a. Hematocrit (Hct), 32.8%
b. Serum sodium, 130 mEq/L
c. Serum potassium, 4.0 mEq/L
d. Serum creatinine, 1.0 mg/dL
e. Proteinuria
f. Microalbuminuria - ANSWER: A, B, E, F
The hematocrit is low (should be 42.6%), indicating a dilutional ratio of red blood cells
(RBCs) to fluid. The serum sodium is low because of hemodilution. Microalbuminuria
and proteinuria are present, indicating a decrease in renal filtration. This is an early
warning sign of decreased compliance of the heart.
The nurse prepares to administer digoxin to a client with heart failure and notes the
following information: Temperature: 99.8° F
Pulse: 48 beats/min and irregular
Respirations: 20 breaths/min
Potassium level: 3.2 mEq/L What
action does the nurse take?
a. Give the digoxin; reassess the heart rate in 30 minutes.
b. Give the digoxin; document assessment findings in the medical record.
, c. Hold the digoxin, and obtain a prescription for an additional dose of furosemide.
d. Hold the digoxin, and obtain a prescription for a potassium supplement. - ANSWER:
D Digoxin causes bradycardia; hypokalemia potentiates digoxin. Because digoxin
causes bradycardia, the medication should be held. Furosemide decreases
circulating blood volume and depletes potassium; no indication suggests that the
client has fluid volume excess at this time.
A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse
with this new prescription?
a. Serum sodium level of 135 mEq/L
b. Serum potassium level of 2.8 mEq/L
c. Serum creatinine of 1.0 mg/dL
d. Serum magnesium level of 1.9 mEq/L - ANSWER: B
Clients taking loop diuretics should be monitored for potassium deficiency from diuretic
therapy. A serum sodium level of 135 mEq/L is a normal value. Heart failure may cause
renal insufficiency, but a serum creatinine of 1.0 mg/dL represents a normal value. A
diuretic may deplete magnesium, but a serum magnesium level of 1.9 mEq/L represents
a normal value.
Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? a.
Serum potassium level of 3.2 mEq/L
b. Ejection fraction of 60%
c. B-type natriuretic peptide (BNP) of 760 ng/dL
d. Chest x-ray report showing right middle lobe consolidation - ANSWER: C
BNP is produced and released by the ventricles when the client has fluid overload as a
result of HF; a normal value is less than 100 pg/mL. Hypokalemia may occur in
response to diuretic therapy for HF, but may also occur with other conditions; it is not
specific to HF. Ejection fraction of 60% represents a normal value of 50% to 70%.
Consolidation on chest x-ray may indicate pneumonia.
The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure
(HF). The nurse questions the client about the use of which medication because it
raises an index of suspicion as to the worsening of the client's HF? a. Ibuprofen
(Motrin)
b. Hydrochlorothiazide (HydroDIURIL)
c. NPH insulin
d. Levothyroxine (Synthroid) - ANSWER: A
Long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin)
causes fluid and sodium retention, which can worsen a client's HF. A diuretic may be
used in the treatment of HF and hypertension. Although diabetes may be a risk factor
for cardiovascular disease, it does not directly cause HF. In proper doses, Synthroid
replaces thyroid hormone for those with hypothyroidism; it does not cause HF.
A client begins therapy with lisinopril (Prinivil, Zestril). What does the nurse consider at
the start of therapy with this medication?
Verified 100% Correct
An older adult client is admitted with fluid volume excess. Which diagnostic study does
the nurse facilitate as a priority?
a. Echocardiography
b. Chest x-ray
c. T4 and thyroid-stimulating hormone (TSH)
d. Arterial blood gas -
ANSWER: A
Echocardiography is considered the best tool for the diagnosis of heart failure. A chest
x-ray probably will be done, and if the client has dyspnea, an arterial blood gas will be
drawn, but the echocardiogram is the priority. T4 and TSH might be ordered to assess
for a contributing cause of heart failure.
The nurse is caring for a client with severe heart failure. What is the best position in
which to place this client?
a. High Fowler's, pillows under arms
b. Semi-Fowler's, with legs elevated
c. High Fowler's, with legs elevated
d. Semi-Fowler's, on the left side - ANSWER: A
Placing the client in high Fowler's position, with pillows under the arms, allows for
maximum chest expanswerion.
The nurse is instructing a client with heart failure about energy conservation. Which is
the best instruction?
a. "Walk until you become short of breath and then walk back home."
b. "Gather everything you need for a chore before you begin."
c. "Pull rather than push or carry items heavier than 5 pounds."
d. "Take a walk after dinner every day to build up your strength." - ANSWER: B
Gathering all supplies needed for a chore at one time decreases the amount of energy
needed.
A client with heart failure is due to receive enalapril (Vasotec) and has a blood pressure
of 98/50 mm Hg. What is the nurse's best action?
a. Administer the Vasotec.
b. Recheck the blood pressure.
c. Hold the Vasotec.
d. Notify the health care provider. -
ANSWER: A
The nurse should administer the medication. Generally, the health care provider will
,maintain the client's blood pressure between 90 and 110 mm Hg.
A client in severe heart failure has a heparin drip infusing. The health care provider
prescribes nesiritide (Natrecor) to be given intravenously. Which intervention is
essential before administration of this medication? a. Insert a separate IV access.
b. Prepare a test bolus dose.
c. Prepare the piggyback line.
d. Administer furosemide (Lasix) first. - ANSWER: A
Natrecor should be given through a separate IV access because it is incompatible with
many medications, especially heparin. A test bolus is not needed, nor is Lasix. Because
the medication should be given through a separate IV, it is not necessary to prepare a
piggyback line.
The nurse is assessing a client with left-sided heart failure. What conditions does the
nurse assess for? (Select all that apply.) a. Pulmonary crackles
b. Confusion, restlessness
c. Pulmonary hypertension
d. Dependent edema
e. S3/S4 summation gallop
f. Cough worsens at night - ANSWER: A, B, E, F
Left-sided failure occurs with a decrease in contractility of the heart or an increase in
afterload. Most of the signs will be noted in the respiratory system. Right-sided failure
occurs with problems from the pulmonary vasculature onward. Signs will be noted
before the right atrium or ventricle.
The nurse is evaluating the laboratory results for a client with heart failure. What results
does the nurse expect? (Select all that apply.) a. Hematocrit (Hct), 32.8%
b. Serum sodium, 130 mEq/L
c. Serum potassium, 4.0 mEq/L
d. Serum creatinine, 1.0 mg/dL
e. Proteinuria
f. Microalbuminuria - ANSWER: A, B, E, F
The hematocrit is low (should be 42.6%), indicating a dilutional ratio of red blood cells
(RBCs) to fluid. The serum sodium is low because of hemodilution. Microalbuminuria
and proteinuria are present, indicating a decrease in renal filtration. This is an early
warning sign of decreased compliance of the heart.
The nurse prepares to administer digoxin to a client with heart failure and notes the
following information: Temperature: 99.8° F
Pulse: 48 beats/min and irregular
Respirations: 20 breaths/min
Potassium level: 3.2 mEq/L What
action does the nurse take?
a. Give the digoxin; reassess the heart rate in 30 minutes.
b. Give the digoxin; document assessment findings in the medical record.
, c. Hold the digoxin, and obtain a prescription for an additional dose of furosemide.
d. Hold the digoxin, and obtain a prescription for a potassium supplement. - ANSWER:
D Digoxin causes bradycardia; hypokalemia potentiates digoxin. Because digoxin
causes bradycardia, the medication should be held. Furosemide decreases
circulating blood volume and depletes potassium; no indication suggests that the
client has fluid volume excess at this time.
A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse
with this new prescription?
a. Serum sodium level of 135 mEq/L
b. Serum potassium level of 2.8 mEq/L
c. Serum creatinine of 1.0 mg/dL
d. Serum magnesium level of 1.9 mEq/L - ANSWER: B
Clients taking loop diuretics should be monitored for potassium deficiency from diuretic
therapy. A serum sodium level of 135 mEq/L is a normal value. Heart failure may cause
renal insufficiency, but a serum creatinine of 1.0 mg/dL represents a normal value. A
diuretic may deplete magnesium, but a serum magnesium level of 1.9 mEq/L represents
a normal value.
Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? a.
Serum potassium level of 3.2 mEq/L
b. Ejection fraction of 60%
c. B-type natriuretic peptide (BNP) of 760 ng/dL
d. Chest x-ray report showing right middle lobe consolidation - ANSWER: C
BNP is produced and released by the ventricles when the client has fluid overload as a
result of HF; a normal value is less than 100 pg/mL. Hypokalemia may occur in
response to diuretic therapy for HF, but may also occur with other conditions; it is not
specific to HF. Ejection fraction of 60% represents a normal value of 50% to 70%.
Consolidation on chest x-ray may indicate pneumonia.
The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure
(HF). The nurse questions the client about the use of which medication because it
raises an index of suspicion as to the worsening of the client's HF? a. Ibuprofen
(Motrin)
b. Hydrochlorothiazide (HydroDIURIL)
c. NPH insulin
d. Levothyroxine (Synthroid) - ANSWER: A
Long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin)
causes fluid and sodium retention, which can worsen a client's HF. A diuretic may be
used in the treatment of HF and hypertension. Although diabetes may be a risk factor
for cardiovascular disease, it does not directly cause HF. In proper doses, Synthroid
replaces thyroid hormone for those with hypothyroidism; it does not cause HF.
A client begins therapy with lisinopril (Prinivil, Zestril). What does the nurse consider at
the start of therapy with this medication?
