Question 1

A patient with altered cardiac function is being assessed by the nurse.When auscultating lung sounds,the nurse will assist this patient into a _____ position.

Accepted Answer

The Fowler's position, or a semi-sitting position with the head of the bed elevated between 45 and 60 degrees, is the best position for a patient with altered cardiac function to facilitate breathing and reduce pressure on the chest. This position allows for better lung expansion and can help to reduce the workload on the heart.

Question 2

Before administering digoxin (Lanoxin),the nurse takes the adult patient's apical pulse for 1 full minute.What additional nursing consideration(s)will be taken before administration of the medication? (Select all that apply.)

Accepted Answer

Before administering digoxin, it is important to review the digoxin blood level to ensure it is within therapeutic range, review serum electrolytes, liver, and kidney function studies to detect any potential issues that could affect digoxin metabolism or excretion, and obtain baseline patient assessment data to monitor for any adverse effects or toxicity signs.

Question 3

Which action(s)will the nurse take when caring for a patient with heart failure? (Select all that apply.)

Accepted Answer

A) Administering diuretics at bedtime is not a general action for all patients with heart failure as the timing and frequency of medication administration depend on the individual patient's needs.
B) Assessing electrolyte levels is important in managing heart failure as certain electrolyte imbalances, such as low potassium or low magnesium, can exacerbate symptoms and lead to cardiac complications.
C) Reporting daily weight fluctuations is crucial in monitoring the progress of heart failure as weight gain may indicate fluid buildup and weight loss may indicate effective treatment.
D) Encouraging sodium intake is not a recommended action for heart failure patients as sodium can increase fluid retention and worsen symptoms.
E) Maintaining skin hygiene is important in preventing infections and skin breakdown, especially in patients with edema or fluid buildup from heart failure.

Question 4

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI).Which symptom(s)would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.)

Accepted Answer

Left ventricular systolic failure often leads to diminished exercise tolerance and shortness of breath with activity due to reduced cardiac output and pulmonary congestion.

Question 5

The nurse is providing education to a patient with altered cardiac function.When instructing this patient the nurse will encourage: (Select all that apply.)

Accepted Answer

The answer of The nurse is providing education to a...

Question 6

The nurse is to administer digoxin to an 18-month-old patient who weighs 16.5 lb.Guidelines for administration read as follows: 0.0075 to 0.010 mg/kg/day.Which is a safe medication dosage?

Accepted Answer

To calculate the safe medication dosage, we need to convert the weight of the patient from pounds to kilograms. 
16.5 lb = 7.5 kg

Then we can calculate the safe medication dosage range: 
0.0075 mg/kg/day x 7.5 kg = 0.05625 mg/day 
0.010 mg/kg/day x 7.5 kg = 0.075 mg/day

Therefore, the safe medication dosage range for this patient is between 0.05625 mg/day and 0.075 mg/day.

Option A (0.05 mg) is lower than the safe medication dosage range. 
Option B (0.12 mg) is higher than the safe medication dosage range. 
Option C (0.074 mg) is within the safe medication dosage range. 
Option D (0.75 mg) is much higher than the safe medication dosage range.

Therefore, the best choice is C.

Question 7

Which drug is used to obtain vasodilation in the treatment of chronic heart failure?

Accepted Answer

ACE inhibitors are commonly used in the treatment of chronic heart failure to achieve vasodilation by inhibiting the production of angiotensin II, a vasoconstrictor. This leads to decreased resistance in blood vessels and improved blood flow, which can alleviate symptoms of heart failure. ACTH, ARBs, and ANB agents are not typically used for vasodilation in heart failure.

Question 8

An older adult male patient with long-term heart failure has presented for an office visit.The nurse obtains information that he has recently begun taking St.John's wort.What results with the use of this herbal supplement?

Accepted Answer

St. John's wort can reduce the therapeutic benefits of digoxin, leading to decreased effectiveness of the medication in treating heart failure. This can lead to worsening symptoms and potential complications. Therefore, it is important to monitor patients taking both medications closely and adjust their treatment plan as needed.

Question 9

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin)for management of heart failure?

Accepted Answer

Nausea and vomiting are common adverse effects of digoxin and should be reported to the healthcare provider.

Answer: B 
 Patients should be instructed to maintain a consistent intake of potassium and not make significant changes without consulting their healthcare provider.

Answer: D 
 Visual disturbances, such as blurry vision or yellow-green halos, are common adverse effects of digoxin and should be reported to the healthcare provider.

Answer: C 
 This instruction is incorrect. Patients should not omit their dose of digoxin without consulting their healthcare provider, even if their pulse is 60 beats/min. Dosage adjustments should only be made under the guidance of a healthcare provider.

Question 10

Which is the initial manifestation of digoxin toxicity in children?

Accepted Answer

Atrial dysrhythmia is the initial manifestation of digoxin toxicity in children. Hallucinations and weakness are not typically seen as early signs of digoxin toxicity, and diuresis is not a symptom of toxicity but rather a potential therapeutic effect of digoxin.

Question 11

A patient with heart failure has been prescribed nesiritide (Natrecor).Which statement(s)is/are true regarding this medication? (Select all that apply.)

Accepted Answer

Nesiritide is a recombinant form of B-type natriuretic peptide (BNP), which is secreted by cardiac ventricles in response to fluid overload (B). It suppresses the renin-angiotensin-aldosterone system, thereby reducing aldosterone levels (C). It causes vasodilation, which helps reduce preload and afterload in heart failure patients (E).

Question 12

The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?

Accepted Answer

Furosemide can increase the risk of digoxin toxicity by decreasing potassium levels, which can lead to enhanced digoxin effects on the heart. The other options do not have a significant interaction with digoxin.

Question 13

Which action of ACE inhibitors results in effective treatment of heart failure?

Accepted Answer

ACE inhibitors help in the treatment of heart failure primarily by decreasing afterload and preload, which indirectly leads to an increase in cardiac output. This improvement in cardiac output is crucial for treating heart failure, as it enhances the heart's ability to pump blood more efficiently.

Question 14

Which contributing factor(s)to heart failure is/are modifiable? (Select all that apply.)

Accepted Answer

Hypertension, addiction to smoking, and exercise tolerance are modifiable risk factors for heart failure. Managing blood pressure, quitting smoking, and improving physical activity can help reduce the risk of developing heart failure. Genetic history and age are non-modifiable factors.

Question 15

Which agents stimulate the heart to increase the force of contractions,thereby increasing cardiac output?

Accepted Answer

Inotropic agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output. Chronotropic agents, on the other hand, affect heart rate. Isotonic refers to a type of muscular contraction, and isopropyl is a type of alcohol.

Question 16

The nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure.The nurse will schedule this medication:

Accepted Answer

Diuretics are best taken in the morning to avoid disrupting the patient's sleep by causing increased urination during the night. Additionally, taking a diuretic in the morning helps to reduce fluid buildup throughout the day.

Question 17

Which nursing assessment is most important to determine fluid status for a patient with heart failure?

Accepted Answer

Daily weights are the most important assessment to determine fluid status for a patient with heart failure. Daily weights can identify subtle changes in fluid balance, and are the most accurate and sensitive measure of fluid status. Auscultation of the lungs, intake and output measurements, and abdominal girth measurements are also important assessments for patients with heart failure, but they are not as sensitive as daily weights for detecting changes in fluid status.

Question 18

The nurse is caring for a 3-year-old girl who has a congenital heart anomaly.The patient's current medications include digoxin and furosemide (Lasix).The apical pulse rate is 100 beats/min.Which action will the nurse take?

Accepted Answer

For a 3-year-old child, an apical pulse rate of 100 beats/min is within the normal range. Therefore, it is safe to administer medications like digoxin and furosemide as prescribed.

Question 19

The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine,a calcium channel blocker.Which statement by the nurse is accurate?

Accepted Answer

Nifedipine is a calcium channel blocker that reduces the resistance that the heart has to pump against, making it easier for the heart to pump blood out to the body. It does not dilate coronary arteries or help the kidneys get rid of fluid. It may indirectly reduce volume returning to the heart by reducing the afterload, but this is not the primary mechanism of action.

Question 20

Which drug will be administered to a patient being admitted with severe digoxin intoxication?

Accepted Answer

Digoxin immune Fab (Digibind) is a specific antidote for digoxin toxicity and is the recommended treatment for severe intoxication. Amiodarone is an antiarrhythmic medication and spironolactone is a potassium-sparing diuretic, neither of which are appropriate for treating digoxin toxicity. Digitalis glycosides is another term for digoxin, so administering more of the same drug would exacerbate the toxicity.

Quiz 27: Drugs Used to Treat Heart Failure

A patient with altered cardiac function is being assessed by the nurse.When auscultating lung sounds,the nurse will assist this patient into a _____ position.

Before administering digoxin (Lanoxin) ,the nurse takes the adult patient's apical pulse for 1 full minute.What additional nursing consideration(s) will be taken before administration of the medication? (Select all that apply.)

Which action(s) will the nurse take when caring for a patient with heart failure? (Select all that apply.)

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI) .Which symptom(s) would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.)