Question 1

Which is a potent vasodilator produced by vascular endothelial cells?
A)Nitric oxide
B)Endothelin
C)Tumor necrosis factor-alpha
D)Digitalis

Accepted Answer

Nitric oxide is a potent vasodilator produced by vascular endothelial cells, playing a crucial role in regulating blood vessel tone and blood pressure.

Question 2

Which statement best differentiates cardiac afterload from cardiac preload?
A)Cardiac afterload is the volume of blood in the heart at the end of diastole.
B)Cardiac afterload is the amount of resistance that the ventricle must overcome.
C)Cardiac afterload is the factor that affects cardiac output.
D)Cardiac afterload is the amount of blood that enters the right atrium.

Accepted Answer

Cardiac afterload refers to the resistance that the left ventricle must overcome to circulate blood, while preload refers to the volume of blood in the ventricles at the end of diastole.

Question 3

In which way does the nurse define oncotic pressure?
A)A pressure reading within the inferior vena cava
B)A force that attempts to pull fluid from the interstitial and intracellular spaces
C)A force that attempts to push fluid out of the capillary pores into interstitial and intracellular spaces
D)A pressure reading upon inflation of the balloon on the tip of the Swan-Ganz catheter

Accepted Answer

Oncotic pressure is defined as the force exerted by proteins, particularly albumin, in the blood plasma that tends to pull water into the circulatory system from the interstitial and intracellular spaces. This helps in maintaining the fluid balance between the blood vessels and the tissues.

Question 4

How is high-output failure different from low-output failure?
A)In high-output failure, the heart can weaken and the ventricle can fail.
B)In high-output failure, the heart is unable to fill with adequate amounts of blood.
C)In high-output failure, there is a lack of delivery of adequate oxygen to the tissues.
D)In high-output failure, there is a lack of sufficient blood to recirculate through the heart.

Accepted Answer

In high-output failure, the heart can weaken and the ventricle can fail due to the increased demand and workload on the heart, which is different from low-output failure where the heart's pumping capacity is diminished, leading to inadequate circulation of blood.

Question 5

The nurse is reviewing instructions with a client being discharged home after experiencing heart failure. When reviewing medications, the client asks about the addition of captopril to the previous medication regimen. Which action of captopril will the nurse explain to the client?
A)Captopril lowers resistance against the left ventricle.
B)Captopril is considered a potassium-sparing diuretic.
C)Captopril decreases blood volume and sodium retention.
D)Captopril inhibits peripheral vasoconstriction.

Accepted Answer

Captopril is an ACE inhibitor that lowers resistance against the left ventricle by reducing afterload, which helps improve cardiac output in heart failure patients.

Question 6

The registered nurse is reviewing information with coronary staff nurses about the renin-angiotensin-aldosterone system (RAAS). Which statement made by an attending nurse indicates understanding?
A)"RAAS is a mechanism that regulates arterial blood pressure."
B)"RAAS is a mechanism that decreases blood pressure."
C)"RAAS is a mechanism that increases blood volume in response to increased renal perfusion."
D)"RAAS is a mechanism with detrimental effects that decrease workload for the left ventricle."

Accepted Answer

The renin-angiotensin-aldosterone system (RAAS) is a hormone system that regulates blood pressure and fluid balance. When blood volume is low, RAAS is activated to increase arterial blood pressure by vasoconstriction and by increasing sodium and water reabsorption in the kidneys.

Question 7

In which manner does the heart function when a client is diagnosed with heart failure?
A)The decrease in preload causes high blood volume, filling the ventricle.
B)The ventricular muscle pumps out the excess blood.
C)The stroke volume decreases when the ventricle ejects its blood.
D)The contractility and stroke volume decrease.

Accepted Answer

In heart failure, the heart's ability to pump blood effectively is compromised, leading to decreased contractility (the heart's pumping strength) and stroke volume (the amount of blood pumped out of the ventricle with each heartbeat).

Question 8

The nurse is assessing a client after cardiac testing. One test result indicates a cardiac output of 4,500 mL per minute. Using the calculation to determine normal cardiac output, which conclusion does the nurse draw?
A)The client's cardiac output is normal.
B)The client's cardiac output is slightly higher than normal.
C)The client's cardiac output is lower than normal.
D)The client's cardiac output is grossly higher than normal.

Accepted Answer

The answer of The nurse is assessing a client after...

Question 9

In which way is chronic heart failure different from acute heart failure?
A)Chronic heart failure is the rapid, sudden development of heart failure.
B)Chronic heart failure gradually develops over a long period.
C)Chronic heart failure is caused by substantial ventricular muscle injury.
D)Chronic heart failure is referred to as cardiogenic shock.

Accepted Answer

Chronic heart failure develops gradually over time, often due to long-term conditions affecting the heart, such as hypertension or coronary artery disease, rather than sudden cardiac events.

Question 10

The registered nurse is teaching nursing staff about ischemic cardiomyopathy. Which statement made by one of the attending nurses indicates effective learning?
A)"There is scarring of the heart muscle caused by coronary artery insufficiency."
B)"There is enlargement and hypertrophy of the left or right ventricles."
C)"It is a disorder that restricts the ventricle's ability to fully expand."
D)"It is a genetic predisposition for the muscular enlargement of the interventricular septal wall."

Accepted Answer

Ischemic cardiomyopathy is primarily caused by coronary artery disease leading to reduced blood flow to the heart muscle, which can result in scarring and impaired heart function.

Question 11

Which pathology is a cause specifically for right ventricle failure (RVF)?
A)Pulmonary emboli
B)Endocarditis
C)Myocarditis
D)Rheumatic fever

Accepted Answer

Pulmonary emboli can lead to increased pulmonary artery pressure, which directly strains the right ventricle as it tries to pump blood into the lungs. This increased strain can lead to right ventricle failure (RVF).

Question 12

The registered nurse is teaching nursing staff about the normal level for central venous pressure. Which statement made by one of the attending nurses indicates effective learning?
A)"The normal range for central venous pressure is 4 to 13 mm Hg."
B)"The normal range for central venous pressure is 60 to 80 mm Hg."
C)"The normal range for central venous pressure is 12 to 15 mm Hg."
D)"The normal range for central venous pressure is 1 to 5 mm Hg."

Accepted Answer

The answer of The registered nurse is teaching nursing staff...

Question 13

A middle-aged adult is diagnosed with Class III (moderate) heart failure. In which way is Class III heart failure different from other classes of heart failure in the client, according to the New York Association of Classification of Heart Failure?
A)The client with Class III (moderate) heart failure will feel comfortable with ordinary physical activity.
B)The client with Class III (moderate) heart failure will feel fatigue and palpitations but only with ordinary activity.
C)The client with Class III (moderate) heart failure will have fatigue, palpitations, or dyspnea while doing less-than-normal physical activities.
D)The client with Class III (moderate) heart failure will be unable to carry out physical activities comfortably.

Accepted Answer

Class III heart failure is characterized by marked limitation of physical activity. Patients are comfortable at rest, but less-than-ordinary activity causes fatigue, palpitations, or dyspnea.

Question 14

A nurse is caring for four clients with heart disease in the intensive care unit. One of the clients has been diagnosed with decreased calcium availability. Which client is administered a drug to increase calcium availability? Client 1
Client 2
Client 3
Client 4
Drugs
Dobutamine
Digoxin
Milrinone
Angiotensin-converting enzyme inhibitors
A)Client 1
B)Client 2
C)Client 3
D)Client 4

Accepted Answer

Milrinone is a phosphodiesterase inhibitor that increases calcium availability in the heart muscle, improving cardiac contractility.

Question 15

Heart failure is classified into four different stages by the American College of Cardiology/American Heart Association. In which way is the condition of a client in stage B different from the condition of clients in other stages?
A)The client in stage B is supported by a mechanical circulatory assist device.
B)The client in stage B is undergoing treatment for prior symptoms of heart failure.
C)The client in stage B has a history of a previous myocardial infarction.
D)The client in stage B has diabetes mellitus and a family history of cardiomyopathy.

Accepted Answer

Stage B heart failure includes clients who have a structural heart disease but have never shown symptoms of heart failure. A history of a previous myocardial infarction is an example of such structural heart disease.

Question 16

An older adult client presents with swollen ankles and fingers, and reports that low-level activity causes fatigue and heart palpitations. The client is diagnosed with heart failure. Which symptom indicates the client's condition is considered to be a Class III, moderate heart failure?
A)Dyspnea
B)Confusion
C)Cold, pale extremities
D)Inability sleep

Accepted Answer

Dyspnea, or shortness of breath, especially during low-level activity, is a symptom of Class III, moderate heart failure, indicating significant limitation in physical activity.

Question 17

How is stage C heart failure different from other stages of heart failure, according to the American College of Cardiology/American Heart Association classification?
A)Clients will have unidentifiable structural or functional heart abnormalities.
B)Clients may develop structural heart disease associated with heart failure.
C)Clients may have current or prior symptoms of heart failure.
D)Clients may have advanced structural heart disease.

Accepted Answer

Stage C heart failure is characterized by patients having current or prior symptoms of heart failure, which differentiates it from other stages where symptoms may not yet be present or are more advanced.

Question 18

Which condition according to the Framingham Criteria for Diagnosis of Congestive Heart Failure is caused by nighttime cough?
A)Paroxysmal nocturnal dyspnea
B)Jugular vein distension
C)Pulmonary crackles
D)Cardiomegaly

Accepted Answer

The answer of Which condition according to the Framingham Criteria...

Question 19

Which condition is the initial cause of an afterload increase in the right ventricle?
A)Cirrhosis of the liver
B)Pulmonary hypertension
C)Elevated systolic pressure
D)Blocked coronary arteries

Accepted Answer

Pulmonary hypertension is the initial cause of an afterload increase in the right ventricle because it directly increases the resistance against which the right ventricle must pump blood to the lungs.

Question 20

The registered nurse is reviewing cardiac output with nursing staff. Which statement by an attending nurse indicates understanding?
A)"Cardiac output is the amount of blood that the heart pumps out of the left ventricle."
B)"Cardiac output is increased in heart failure."
C)"Cardiac output is unvaried by body size."
D)"Adrenergic stimulation slows heart rate, and cholinergic stimulation raises heart rate."

Accepted Answer

Cardiac output is defined as the volume of blood pumped by the left ventricle in one minute. It is a key parameter in assessing heart function and is influenced by heart rate and stroke volume.

Quiz 17: Heart Failure

Which is a potent vasodilator produced by vascular endothelial cells?

Which statement best differentiates cardiac afterload from cardiac preload?

In which way does the nurse define oncotic pressure?

How is high-output failure different from low-output failure?

The nurse is reviewing instructions with a client being discharged home after experiencing heart failure. When reviewing medications, the client asks about the addition of captopril to the previous medication regimen. Which action of captopril will the nurse explain to the client?

The registered nurse is reviewing information with coronary staff nurses about the renin-angiotensin-aldosterone system (RAAS) . Which statement made by an attending nurse indicates understanding?

In which manner does the heart function when a client is diagnosed with heart failure?

The nurse is assessing a client after cardiac testing. One test result indicates a cardiac output of 4,500 mL per minute. Using the calculation to determine normal cardiac output, which conclusion does the nurse draw?

In which way is chronic heart failure different from acute heart failure?

The registered nurse is teaching nursing staff about ischemic cardiomyopathy. Which statement made by one of the attending nurses indicates effective learning?

Which pathology is a cause specifically for right ventricle failure (RVF) ?

The registered nurse is teaching nursing staff about the normal level for central venous pressure. Which statement made by one of the attending nurses indicates effective learning?

A middle-aged adult is diagnosed with Class III (moderate) heart failure. In which way is Class III heart failure different from other classes of heart failure in the client, according to the New York Association of Classification of Heart Failure?

Heart failure is classified into four different stages by the American College of Cardiology/American Heart Association. In which way is the condition of a client in stage B different from the condition of clients in other stages?

An older adult client presents with swollen ankles and fingers, and reports that low-level activity causes fatigue and heart palpitations. The client is diagnosed with heart failure. Which symptom indicates the client's condition is considered to be a Class III, moderate heart failure?

How is stage C heart failure different from other stages of heart failure, according to the American College of Cardiology/American Heart Association classification?

Which condition according to the Framingham Criteria for Diagnosis of Congestive Heart Failure is caused by nighttime cough?

Which condition is the initial cause of an afterload increase in the right ventricle?

The registered nurse is reviewing cardiac output with nursing staff. Which statement by an attending nurse indicates understanding?