Chapter 29-Quizleeeet

CHAPTER 29 - QUIZLET
A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and
furosemide 20 mg by mouth twice daily. The nurse should assess the client for what
sign of digoxin toxicity?
● visual disturbances.
While auscultating the heart sounds of a client with heart failure, the nurse hears an
extra heart sound immediately after the second heart sound (S2). How should the nurse
document this sound?
● a third heart sound (S3)
A client with left-sided heart failure reports increasing shortness of breath and is
agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these
findings as signs and symptoms of what condition?
● acute pulmonary edema
When a client has increased difficulty breathing when lying flat, the nurse records that
the client is demonstrating
● orthopnea.
The client with cardiac failure is taught to report which symptom to the physician or
clinic immediately?
● Persistent cough
Which is a characteristic of right-sided heart failure?
● Jugular vein distention
A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows
to look for which assessment finding for this client?
● Pulmonary congestion
A new client has been admitted with right-sided heart failure. When assessing this
client, the nurse knows to look for which finding?
● Jugular venous distention
The nurse is caring for a client with suspected right-sided heart failure. What would the
nurse know that clients with suspected right-sided heart failure may experience?
● Gradual unexplained weight gain
Medical management of cardiac failure uses similar methodology whether it is

right-sided or left-sided. Measures such as dietary modification, lifestyle changes,
medications to reduce dyspnea and relieve anxiety, etc. are all used with one primary
intention. The primary goal in the medical management of heart failure is to reduce:
● cardiac workload.
A client is already being treated for hypertension. The doctor is concerned about the
potential for heart failure, and has the client return for regular check-ups. What does
hypertension have to do with heart failure?
● Hypertension causes the heart's chambers to enlarge and weaken.
The nurse is caring for a client with heart failure. What procedure should the nurse
prepare the client for in order to determine the ejection fraction to measure the
efficiency of the heart as a pump?
● Echocardiogram
A patient is prescribed digitalis preparations. Which of the following conditions should

the nurse closely monitor when caring for the patient?
● Potassium levels
When the client has increased difficulty breathing when lying flat, the nurse records that
● orthopnea.
A nurse caring for a client recently admitted to the ICU observes the client coughing up
large amounts of pink, frothy sputum. Lung auscultation reveals course crackles to
lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is
developing
● decompensated heart failure with pulmonary edema.

The nurse completes an assessment of a client admitted with a diagnosis of right-sided
heart failure. What will be a significant clinical finding related to right-sided heart failure?
● pitting edema
A client has been diagnosed with heart failure. What is the major nursing outcome for
the client?
● Reduce the workload on the heart.
The nurse is teaching a client about medications prescribed for severe volume overload
from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart
failure?
● furosemide
The nurse is administering furosemide to a client with heart failure. What best describes
the therapeutic action of the medication?
● The medication blocks sodium reabsorption in the ascending loop and dilate
renal vessels.
The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is
the primary underlying disorder of pulmonary edema?
● decreased left ventricular pumping
A nurse suspects that a client has digoxin toxicity. The nurse should assess for:
● vision changes.
● acute pulmonary edema.
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
● Echocardiogram
A client with acute pericarditis is exhibiting distended jugular veins, tachycardia,
tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of
what occurrence?
● Excess pericardial fluid compresses the heart and prevents adequate diastolic
filling.
A client is exhibiting digitalis toxicity. Which of the following medications would the nurse
expect to be ordered for this client?
● Digoxin immune FAB
A client has been having cardiac symptoms for several months and is seeing a
cardiologist for diagnostics to determine the cause. How will the client's ejection fraction
be measured?
● echocardiogram
The nurse is obtaining data on an older adult client. What finding may indicate to the
nurse the early symptom of heart failure?
● Dyspnea on exertion
The diagnosis of heart failure is usually confirmed by which of the following?
● Echocardiogram
failure?
● furosemide
A nurse is administering digoxin. What client parameter would cause the nurse to hold
the digoxin and notify the health care prescriber?
● heart rate of 55 beats per minute
A client in the emergency room is in cardiac arrest and exhibiting pulseless electrical
activity (PEA) on the cardiac monitor. What will be the nurse's next action?
● Administer epinephrine.
The nurse is caring for a client with heart failure who is receiving torsemide. What
implementation will help the nurse evaluate the client's response of the medication?
● measuring intake and output
The nurse is assessing a client with crackling breath sounds or pulmonary congestion.
What is the cause of the congestion?
● inadequate cardiac output
A client has been experiencing increasing shortness of breath and fatigue. The health
care provider has ordered a diagnostic test in order to determine what type of heart
failure the client is having. What diagnostic test does the nurse anticipate being
ordered?
● An echocardiogram
Which feature is the hallmark of systolic heart failure?
● Low ejection fraction (EF)
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally;
3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse
obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate
for this client?
● The development of left-sided heart failure
Which is a cerebrovascular manifestation of heart failure?
● Dizziness

what occurrence?
filling.
The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart
failure (HF). By applying this correlation, the nurse notes that the degree of shock is
proportional to which of the following?
● Left ventricular function
A client has had an echocardiogram to measure ejection fraction. The nurse explains
that ejection fraction is the percentage of blood the left ventricle ejects upon contraction.
What is the typical percentage of blood a healthy heart ejects?
● 55%
be measured?
● echocardiogram
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What

medication can the nurse administer with physician orders that will relieve anxiety and
slow respiratory rate?
● Morphine sulfate
A client with congestive heart failure is admitted to the hospital after reporting shortness
of breath. How should the nurse position the client in order to decrease preload?
● Head of the bed elevated 45 degrees and lower arms supported by pillows
The nurse understands that a client with which cardiac arrhythmia is most at risk for
developing heart failure?
● Atrial fibrillation

A nurse is caring for a client with heart failure. The nurse knows that the client has
left-sided heart failure when the client makes which statement?
● I sleep on 3 pillows each night
be measured?
● Echocardiogram
The nurse is preparing to administer hydralazine and isosorbide dinitrate. When

obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the
priority action by the nurse?
● Hold the medication and call the healty care provider
Lowers systemic vascular resistance and left ventricular afterload. If these medications
lead to severe hypotension, the nurse should hold the medication and call the health
care provider.
● Hydralazine
The nurse is performing a respiratory assessment for a patient in left-sided heart failure.
What does the nurse understand is the best determinant of the patient's ventilation and
oxygenation status?
● ABG
A patient is seen in the emergency department (ED) with heart failure secondary to
dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine
the severity of the patient's heart failure?
● BNP
The BNP level is a key diagnostic indicator of HF; high levels are a sign of
● high cardiac filling pressure and can aid in both the diagnosis and management
of HF
An echocardiogram is usually performed to determine the
● ejection fraction, identify anatomic features such as structural abnormalities and

valve malfunction, and confirm the diagnosis of HF.
developing
● Decomponsated heart failure with pulmonary edema
A client with heart failure is having a decrease in cardiac output. What indication does
the nurse have that this is occurring?
● BP 80/46 mm Hg
A client with chronic heart failure is able to continue with his regular physical activity and
does not have any limitations as to what he can do. According to the New York Heart
Association (NYHA), what classification of chronic heart failure does this client have?
● Class I
Classification of HF Class II
● is when the client is comfortable at rest, but ordinary physical activity results in
fatigue, heart palpitations, or dyspnea.
Classification of HF Class III
● is when there is marked limitation of physical activity. The client is comfortable at

rest, but less than ordinary activity causes fatigue, heart palpitations, or dyspnea.
Classification of HF Class IV
● client is unable to carry out any physical activity without discomfort. Symptoms of
cardiac insufficiency occur at rest. Discomfort is increased if any physical activity
is undertaken.
A client has had an echocardiogram to measure ejection fracton. The nurse explains
● 55%
Which of the following therapies are for patient who have advanced heart failure (HF)
after all other therapies have failed?
● Heart transplant
A patient has been diagnosed with systolic heart failure. The nurse would expect the
patient's ejection fraction to be at which level?
● Severely reduced
The nurse is administering nitroglycerin, which he knows decreases preload as well as

afterload. Preload refers to which of the following?
● The amount of blood presented to the ventricles just before systole
● Dizziness
Which New York Heart Association classification of heart failure has a poor prognosis
and includes symptoms of cardiac insufficiency at rest?
● IV
A nurse in the emergency department is caring for a client with acute heart failure.
Which laboratory value is most important for the nurse to check before administering
medications to treat heart failure?
● Potassium
● Vision changes
Which medication is categorized as a loop diuretic?
● Furosemide
for this client?
● Left sided heart failure

A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What
clinical manifestations does the nurse anticipate finding when performing an
assessment? (Select all that apply.)
● Dyspnea
● Cough
● Crackles
Which of the following is the primary cause of pulmonary or peripheral congestion?
● Inadequate cardiac output
A client with heart failure reports a sudden change in the ability to perceive colors. The
client reports nausea, and assessment reveals an irregular pulse of 39 beats per
minute. What is the nurse's best action?
● Report the possibility of digitalis toxicity to the care provider promptly
In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided
heart failure?
● Leg Edema
Which is a classic sign of cardiogenic shock?
● Tissue hypoperfusion
A client is receiving captopril (Capoten) for heart failure. The nurse should notify the
physician that the medication therapy is ineffective if an assessment reveals:
● Peripheral edema

A nurse is administering lanoxin, which she knows increases contractility as well as

cardiac output. Contractility refers to which of the following?
● The force of the contraction related to the status of the myocardium
Preload
● Is the amount of blood presented to the ventricles just before systole. It increases
pressure in the ventricles, which STRETCHES the ventricle wall. Like a piece of
elastic, the muscle fibers need to be stretched to produce optimal recoil and
forceful ejection of blood.
Afterload
● Refers to the amount of resistance to the ejection of blood from the ventricle. To
eject blood, the ventricles much overcome the resistance caused by tension in
the aorta, systemic vessels, and pulmonary artery.
A client diagnosed with pulmonary edema has a PaCO2 of 72 mm Hg and an oxygen

saturation of 84%. What method of oxygen delivery would best meet the needs of this
client?
● Intubation and mechanical ventilation

The nurse identifies which symptom as a manifestation of right-sided heart failure (HF)?
● Congestion in peripheral tissues

A patient in severe pulmonary edema is being intubated by the respiratory therapist.
What priority action by the nurse will assist in the confirmation of tube placement in the
proper position in the trachea?
● Call for a chest x-ray
nurse is discussing cardiac hemodynamics with a nursing student. The nurse explains
preload to the student and then asks the student what nursing interventions might cause
decreased preload. The student correctly answers which of the following?
● Administration of a vasodilating drug (as ordered by a physician)
With which disorder is jugular vein distention prominent?
● Heart Failure
to look for which of the following assessment findings for this client?
Sixty-six-year-old David Steiner is already being treated for hypertension. His doctor,
concerned about the potential for heart failure, has him come back for check-ups
regularly. What does hypertension have to do with heart failure?
● Hypertension causes the heart's chambers to enlarge and weaken
A client with right-sided heart failure is admitted to the medical-surgical unit. What
information obtained from the client may indicate the presence of edema?
● The client says his rings have become tight and are difficult to remove.
The nurse is preparing to administer hydralazine and isosorbide dinitrate (Dilatrate).

When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the
● Hold the medication and call the physician
Which pulse should the nurse palpate during rapid assessment of an unconscious adult
● Carotid
● Electrolyte and water loss
When the nurse observes that the patient has increased difficulty breathing when lying
flat, the nurse records that the patient is demonstrating
● orthopnea
Which is a potassium-sparing diuretic used in the treatment of heart failure?
● Spironolactone (Aldactone)

slow respiratory rate
A client with chronic heart failure is receiving digoxin (Lanoxin), 0.25 mg by mouth daily,
and furosemide (Lasix), 20 mg by mouth twice daily. The nurse instructs the client to
notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because
these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause:
● visual disturbances
A client with left-sided heart failure complains of increasing shortness of breath and is
findings as signs and symptoms of:
● acute pulmonary edema
Which of the following medications is categorized as a loop diuretic
● Furosemide (Lasix)
Which of the following is a characteristic of right-sided heart failure
● JVD
Which of the following is a key diagnostic laboratory test for heart failure?
● B-type natriuretic peptide (BMP)

The nursing instructor is teaching their clinical group how to assess a client for
congestive heart failure. How would the instructor teach the students to assess a client
with congestive heart failure for nocturnal dyspnea?
● By questioning how many pillows the client normally uses for sleep
The student nurse is caring for a client with heart failure. Diuretics have been ordered.
What method would help the nurse evaluate the client's response to diuretics?
● Using a urinary catheter
Which of the following describes difficulty breathing when a patient is lying flat?
● Orthopnea
The nurse recognizes which of the following symptoms as a classic sign of cardiogenic
shock?
● Restlessness and confusion
Which of the following nursing interventions should a nurse perform when a patient with
valvular disorder of the heart has a heart rate less than 60 beats per minute before
administering beta-blockers?
● Withhold the drug and inform the primary health care provider
● IV
You are caring for a client with suspected right-sided heart failure. What would you know
that clients with suspected right-sided heart failure may experience
Ronald is a 46-year-old who has developed congestive heart failure. He has to learn to
adapt his diet and you are his initial counselor. Which of the following should you tell
him to avoid?
● Canned peas
A nurse taking care of a patient recently admitted to the ICU observes the patient
coughing up large amounts of pink, frothy sputum. Auscultation of the lungs reveals
course crackles to lower lobes bilaterally. Based on this assessment, the nurse
recognizes this patient is developing which of the following problems?
● Decompensated heart failure with pulmonary edema
A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin
therapy, which laboratory value may predispose the client to digoxin toxicity
● Potassium level of 2.8 mEq/L
heart failure?
● Leg edema
The nursing instructor is discussing heart failure with their clinical group. The instructor
talks about heart failure in terms of a decreasing ejection fraction of the heart. What
diagnostic test is used to measure the ejection fraction of the heart?
● echocardiogram
Which of the following clinical manifestations are consistent with right-sided heart failure
(HF)?
● Positive hepatojugular reflux
The patient with cardiac failure is taught to report which of the following symptoms to
the physician or clinic immediately?
● persistent cough
Which of the following body system responses correlates with systolic heart failure
(HF)?
● decreased in renal perfusion

On his return to the cardiac step-down unit after his diagnostic procedure, a client
awaits the report from his cardiologist. As the client's nurse, you review the process of
measuring ejection fraction and explain to the client that it measures the percentage of
blood the left ventricle ejects upon contraction. What is the typical percentage of blood a
healthy heart ejects?
● 55%
A client is returning from the operating room after inguinal hernia repair. The nurse
notes that he has fluid volume excess from the operation and is at risk for left-sided
heart failure. Which sign or symptom indicates left-sided heart failure?
● Bibasilar crackles
A patient with congestive heart failure is admitted to the hospital with complaints of
shortness of breath. How should the nurse position the patient in order to decrease
preload?
● Head of the bed elevated at 45 degrees and lower arms supported by pillows
A nurse is caring for a client with acute pulmonary edema. To immediately promote
oxygenation and relieve dyspnea, the nurse should:
● place in high fowlers
A total artificial heart (TAH) is an electrically powered pump that circulates blood into the
pulmonary artery and the aorta, thus replacing the functions of both the right and left
ventricles. What makes it different from an LVAD?
● An LVAD only supports a failing left ventricle
nurse the early symptom of heart failure
Which of the following is the hallmark of systolic heart failure?
● low ejection fraction (EF)
Which treatment is the best therapy for a stable client with digoxin toxicity?
● Time and symptomatic treatment

A patient with acute pericarditis is exhibiting distended jugular veins, tachycardia,
tachypnea, bradycardia, and muffled heart sounds. The senior nursing student
recognizes these symptoms occur when
filling.
A client is at risk for excess fluid volume. Which nursing intervention ensures the most
accurate monitoring of the client's fluid status?
● Weighing the client daily at the same time each day
A client with a history of an anterior wall myocardial infarction is being transferred from
the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report
to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have
been in the high normal range." The CSU nurse should be especially observant for
● pulmonary crackles
A client is admitted to the ICU with a diagnosis of heart failure. The client is exhibiting
symptoms of weakness, ascites, weight gain, and jugular vein distention. The nurse
would know that the client is exhibiting signs of what kind of heart failure?
● Right-sided heart failure
The nurse assessing a patient with an exacerbation of heart failure identifies which of
the following symptoms as a cerebrovascular manifestation of heart failure (HF)?
● Dizziness
Which of the following symptoms should the nurse expect to find as an early symptom
of chronic heart failure?
● Fatigue
Which of the following is a key diagnostic indicator of heart failure?
● BNP


A client is receiving furosemide (Lasix), a loop diuretic, to prevent fluid overload. The
order is for 50 mg intraveneous now. The pharmacy supplies Lasix 80 mg per 2 mL.
How many mL will the nurse give the client? Enter the correct number ONLY
● 1.25
You are working in a long-term care facility with a group of older adults with cardiac
disorders. Why would it be important for you to closely monitor an older adult receiving
digitalis preparations for cardiac disorders?
● Older adults are at increased risk for toxicity.
● Class I (Mild)
● Potassium
The nurse is discussing cardiac hemodynamics with a nursing student. The nurse
explains afterload to the student and then asks the student what nursing interventions
might cause decreased afterload. The student correctly answers which of the following?

A client has been prescribed furosemide (Lasix) 80 mg twice daily. The cardiac monitor
technician informs the nurse that the client has started having rare premature ventricular
contractions followed by runs of bigeminy lasting 2 minutes. During the assessment, the
nurse determines that the client is asymptomatic and has stable vital signs. Which of the
following actions should the nurse perform next?
● Check the client's potassium level.
The nurse is preparing to administer furosemide (Lasix) to a client with severe heart
failure. What lab study should be of most concern for this client while taking Lasix?
● Potassium level of 3.1
The pathophysiology of pericardial effusion is associated with all of the following except:
● Increased venous return.
left-sided heart failure when he makes which statement?
● "I sleep on three pillows each night."
Which of the following is a key diagnostic indicator of heart failure (HF)?
● Brain natriuretic peptide (BNP)
● Echocardiogram
The nurse is providing discharge instructions to a client with heart failure preparing to
leave the following day. What type of diet should the nurse request the dietitian to
discuss with the client?
● Low-sodium diet
A patient taking an ACE inhibitor has developed a dry, hacking cough. Because of this
side effect, the patient no longer wants to take that medication. What medication that
has similar hemodynamic effects does the nurse anticipate the physician ordering?
● Valsartan (Diovan)
extra heart sound immediately after the second heart sound (S2). The nurse should
document this as:
● a third heart sound (S3).
● vision changes.
What mechanical device increases coronary perfusion and cardiac output and
decreases myocardial workload and oxygen consumption in a client with cardiogenic
shock?
● Intra-aortic balloon pump
A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly,

crackles, and jugular vein distention. What condition should the nurse suspect?
● Heart failure
The nurse is discussing cardiac hemodynamics with a nursing student, who

understands the following formula: CO = HR X SV (cardiac output equals heart rate
times stroke volume). The student asks what determines stroke volume. The correct
response by the nurse is which of the following?
● Stroke volume depends on three factors: preload, afterload, and contractility.
A new client has been admitted with right-sided heart failure. The nurse knows to look
for which of the following assessment findings when assessing this client?
The nurse identifies which of the following symptoms as a characteristic of right-sided

heart failure?
● Jugular vein distention (JVD)
The physician writes orders for a patient to receive an angiotensin II receptor blocker for
treatment of heart failure. What medication does the nurse administer?
● Echocardiogram
When assessing a client with left-sided heart failure, the nurse expects to note:
● air hunger.
Which of the following is a manifestation of right-sided heart failure?
● Systemic venous congestion
A nurse has come upon an unresponsive, pulseless victim. She has placed a 911 call
and begins CPR. The nurse understands that if the patient has not been defibrillated
within which time frame, the chance of survival is close to zero?
● 10 minutes
A 76-year-old client has a significant history of congestive heart failure. During his
semiannual cardiology examination, for what should you, as his nurse, specifically
assess? Select all that apply.
● Examine the client's neck for distended veins. -Monitor the client for signs of
lethargy or confusion.
The nurse observes that a patient has 2+ pitting edema in the lower extremities. What
does the nurse know that the presence of pitting edema indicates regarding fluid
retention?
● A weight gain of 10 lbs
A patient has missed 2 doses of digitalis (Digoxin). What laboratory results would
indicate to the nurse that the patient is within therapeutic range?
● 2.0 mg/mL
A client is prescribed digitalis medication. Which condition should the nurse closely
monitor when caring for the client?
● nausea and vomiting

clinic immediately?
● Echocardiogram

The Cardiac Nurse Clinician is teaching a group of clients with heart failure about
self-management of their disease. What dietary advice should the Nurse Clinician give
to clients with severe heart failure until edema resolves?
● Avoid the intake of processed and commercially prepared foods.
The nurse identifies which symptom as a characteristic of right-sided heart failure?
ordered?
The nurse hears the alarm sound on the telemetry monitor and observes a flat line. The
patient is found unresponsive, without a pulse, and no respiratory effort. What is the first
action by the nurse?
● Call for help and begin chest compressions.

● Hold the medication and call the health care provider.
therapy, which laboratory value may predispose the client to digoxin toxicity?
Which medication reverses digitalis toxicity?

Which of the following would be inconsistent as a lifestyle change directive for the
patient diagnosed with heart failure?
● Push fluids
A client who has developed congestive heart failure must learn to make dietary
adaptations. The client should avoid:
● canned peas.
● Class I (Mild)
The nurse recognizes which symptom as a classic sign of cardiogenic shock?
● Echocardiogram
● visual disturbances.
● Heart failure
(HF)?
● Decrease in renal perfusion

A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid,

which assessment by the nurse indicates that cardiac tamponade has been relieved?
● Decrease in central venous pressure (CVP)
Frequently, what is the earliest symptom of left-sided heart failure?
● dyspnea on exertion
for this client?

A nurse is teaching clients newly diagnosed with coronary heart disease (CHD) about
the disease process and risk factors for heart failure. Which problem can cause
left-sided heart failure (HF)?
● Myocardial ischemia
A client arrives at the ED with an exacerbation of left-sided heart failure and reports
shortness of breath. Which is the priority nursing intervention?
● Assess oxygen saturation

A client has a significant history of congestive heart failure. What should the nurse
specifically assess during the client's semiannual cardiology examination? Select all that
apply.
● Examine the client's neck for distended veins.

● Monitor the client for signs of lethargy or confusion.
The nurse assessing a client with an exacerbation of heart failure identifies which
symptom as a cerebrovascular manifestation of heart failure (HF)?
● Dizziness
Which action will the nurse include in the plan of care for a client admitted with acute
decompensated heart failure (ADHF) who is receiving milrinone?
● Monitor blood pressure frequently
developing
● Pulmonary crackles
● Dyspnea
● Cough
The clinical manifestations of pulmonary congestion associated with left-sided heart

failure include dyspnea, cough, pulmonary crackles, and low oxygen saturation levels,
but not ascites or jugular vein distention.In a client with chronic bronchitis, which sign
would lead the nurse to suspect right-sided heart failure?
● Leg edema
oxygenation and relieve dyspnea, what action should the nurse perform?
● place the client in high Fowler's position
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at
the end of diastole?
● Preload
● Echocardiogram
A client is receiving furosemide, a loop diuretic, to prevent fluid overload. The order is
for 50 mg intraveneous now. The pharmacy supplies furosemide 80 mg per 2 mL. How
many mL will the nurse give the client? Enter the correct number ONLY.
● 1.25
● (50 mg/80 mg) x 2 mL = 1.25 mL.

tachypnea, bradycardia, and muffled heart sounds. The nurse recognizes these as
symptoms of what occurrence?
filling.
● 10 minutes
● 55%
A nurse is assessing a client with congestive heart failure for jugular vein distension
(JVD). Which observation is important to report to the physician?
● JVD is noted 4 cm above the sternal angle.
When assessing a client with left-sided heart failure, the nurse expects to note:
● air hunger.
A client is receiving captopril for heart failure. During the nurse's assessment, what sign
indicates that the medication therapy is ineffective?
● peripheral edema
Which statement best describes the therapeutic action of loop diuretics?
● They block sodium reabsorption in the ascending loop and dilate renal vessels.
Which is a manifestation of right-sided heart failure?
A client with pulmonary edema has been admitted to the ICU. What would be the
standard care for this client?
● BP and pulse measurements every 15 to 30 minutes
The nurse is preparing to administer furosemide to a client with severe heart failure.
What lab study should be of most concern for this client while taking furosemide?

A client who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day ago
suddenly reports chest pain and shortness of breath and is visibly anxious. The nurse
immediately assesses the client for other signs and symptoms of
● pulmonary embolism.
A client with heart failure must be monitored closely after starting diuretic therapy. What
is the best indicator for the nurse to monitor?
● weight.
been in the high normal range." What additional assessment information would be
important for the CSU nurse to obtain?
explains preload to the student and then asks the student what nursing interventions
might cause decreased preload. The student correctly answers which of the following?
A nurse is caring for a client with left-sided heart failure. During the nurse's assessment,
the client is wheezing, restless, tachycardic, and has severe apprehension. The nurse
knows that these are symptoms of what?
● Acute pulmonary edema
The nurse is caring for a client in the hospital with chronic heart failure that has marked
limitations in his physical activity. The client is comfortable when resting in the bed or
chair, but when ambulating in the room or hall, he becomes short of breath and fatigued
easily. What type of heart failure is this considered according to the New York Heart
Association (NYHA)?
● Class III (Moderate)

● Congestion in the peripheral tissues
oxygenation status?
● Arterial blood gases
A nurse reviews the patient's chart. The doctor noted in the progress notes that he
suspected the patient was experiencing decreased left ventricular function. The nurse
knows to look for documentation of all of the following to validate that diagnosis except:
● Increased stroke volume.
A nurse administers furosemide to treat a client with heart failure. Which adverse effect
must the nurse watch for most carefully?
● Low serum potassium level
A client in the hospital informs the nurse he "feels like his heart is racing and can't catch
his breath." What does the nurse understand occurs as a result of a tachydysrhythmia?
● It reduces ventricular ejection volume.
● Low-sodium diet
A client is awaiting the availability of a heart for transplant. What option may be
available to the client as a bridge to transplant?
● Ventricular assist device (VAD)

VADs may be used for one of three purposes:
● a bridge to recovery,
● a bridge to transport,
● destination therapy (mechanical circulatory support when there is no option for a
heart transplant).
Cardiogenic shock is pump failure that primarily occurs because of which of the
following?
● Inadequate tissue perfusion
Which treatment is the best therapy for a stable client with digoxin toxicity?
● Time and symptomatic treatment
Following a left anterior myocardial infarction, a client undergoes insertion of a

pulmonary artery catheter. Which finding most strongly suggests left-sided heart failure?
● Increased pulmonary artery diastolic pressure
A client with stage IV heart failure has a living will indicating a ventilator may not be
used. The client begins experiencing severe dyspnea. What should the nurse who is
caring for this client do?
● administer oxygen, morphine, and a bronchodilator for client comfort.
The triage nurse in the Emergency Department (ED) is admitting a client with a history
of Class III heart failure. What symptoms would the nurse expect the client to exhibit?
● The client is comfortable at rest, but less than ordinary activity causes fatigue,
heart palpitation, or dyspnea.
The nurse is developing a plan of care for a client following pericardiocentesis. Which
interventions should the nurse implement? Choose all that apply.
● Assess vital signs every 15 minutes for the first hour.

● Monitor heart and lung sounds.
● Record fluid output.
● Evaluate the cardiac rhythm.
A client has been rushed to the ED with pulmonary edema and is going to need oxygen
immediately. Which oxygen delivery system should be used first?
● mask
A client with left-sided heart failure is in danger of impaired renal perfusion. How would
the nurse assess this client for impaired renal perfusion?
● Assess for elevated blood urea nitrogen levels.
The nurse documents pitting edema in the bilateral lower extremities of the client. What
does this documentation mean?
● There is excess fluid volume in the interstitial space in areas affected by gravity.
The nurse observes a client with an onset of heart failure having rapid, shallow
breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse
anticipate finding initially?
● Respiratory alkalosis
A client with a history of myocardial infarction is admitted with shortness of breath,

anxiety, and slight confusion. Assessment findings include a regular heart rate of 120
beats/minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg,
bibasilar crackles on lung auscultation, and a urine output of 5 ml over the past hour.
The nurse anticipates preparing the client for transfer to the intensive care unit and
pulmonary artery catheter insertion because:
● the client is going into cardiogenic shock.
Before discharge, which instruction should a nurse give to a client receiving digoxin?
● "Call the physician if your heart rate is above 90 beats/minute."

A nurse is assessing a client with heart failure. What breath sound is commonly
auscultated in clients with heart failure?
● fine crackles.
What mechanical device increases coronary perfusion and cardiac output and
decreases myocardial workload and oxygen consumption in a client with cardiogenic
shock?
● Intra-aortic balloon pump
The nurse is preparing a client for a multiple gated acquisition (MUGA) scan. What
would be an important instruction for the nurse to give a client who is to undergo a
MUGA scan?
● Lie very still at intermittent times during the test.
A patient in the emergency room is in cardiac arrest and exhibiting pulseless electrical
activity (PEA) on the telemetry monitor. Which of the following is a potential cause of
PEA?
● Hyperkalemia
What is the main difference between Class I and Class II heart failure as defined by the
New York Heart Association (NYHA)?
● The level of physical activity each allows
The nurse is assigned to care for a patient with heart failure. What classification of
medication does the nurse anticipate administering that will improve symptoms as well
as increase survival?
● ACE inhibitor
Which drug is most commonly used to treat cardiogenic shock?
● Dopamine (Intropin)
A nurse is discussing cardiac hemodynamics with a nursing student and explains the
concept of afterload. The student asks what medical conditions might cause increased
afterload. The nurse correctly answers which of the following?
● Hypertension and aortic valve stenosis

Which of the following types of diuretic is the first-line treatment for those diagnosed
with heart failure (HF)?
● Loop
The nurse is assessing a patient who reports no symptoms of heart failure at rest but is
symptomatic with increased physical activity. Under what classification does the nurse
understand this patient would be categorized?
● II
A health care provider in the outpatient department examines a client with chronic heart
failure to investigate recent-onset peripheral edema and increased shortness of breath.
The nurse documents the severity of pitting edema as +1. What is the best description
of this type of edema?
● Barely detectable depression when the thumb is released from the swollen area;
normal foot and leg contours
A nurse is preparing to begin one-person cardiopulmonary resuscitation. The nurse

should first:
● establish unresponsiveness.
A client with heart failure has been receiving an intravenous infusion at 150 mL/hr. Now
the client is short of breath. The nurse auscultates crackles bilaterally and notes neck
vein distention and tachycardia. Using critical thinking skills, what should the nurse do
first?
● Slow the infusion and notify the physician.
The nurse is gathering data from a client recently admitted to the hospital. The nurse
asks the client about experiencing orthopnea. What question would the nurse ask to
obtain this information?
● "Are you only able to breathe when you are sitting upright?"

A patient seen in the clinic has been diagnosed with stage A heart failure (according to
the staging classification of the American College of Cardiology [ACC]). What education
will the nurse provide to this patient?
● Information about ACE inhibitors and risk factor reduction
● orthopnea
● vision changes.
A patient has been experiencing increasing shortness of breath and fatigue. The
physician has ordered a diagnostic test in order to determine what type of heart failure
the patient is having. What diagnostic test does the nurse anticipate being ordered?
flat, the nurse records that the patient is demonstrating which of the following?
● Orthopnea
● B-type natriuretic peptide (BNP)
● Orthopnea

● Class I (Mild)

● Echocardiogram
for this client?


● BNP
that clients with suspected right-sided heart failure may experience?
How many mL will the nurse give the client? Enter the correct number ONLY.
● 1.25
him to avoid?
● canned peas
● IV
● Echocardiogram
Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)?

The nurse does an assessment on a patient who is admitted with a diagnosis of

right-sided heart failure. The nurse knows that a significant sign is which of the
following?
● Pitting edema
filling.
heart failure?
● Leg edema
Which of the following is a characteristic of right-sided heart failure?
● JVD
A client is in the early stage of heart failure. During this time, which compensatory
mechanism occurs?
● Low blood pressure triggers the baroreceptors to decrease sympathetic nervous

system stimulation.

● Call for a chest x-ray.
Which of the following medications is a human brain natriuretic peptide (BNP)

preparation?
● Natrecor

● Heart failure
preload?
● Echocardiogram
What is the primary underlying disorder of pulmonary edema?
● Decreased left ventricular pumping
valvular disorder of the heart has a heart rate less than 60 beats/min before
administering beta blockers?
● Withhold the drug and inform the primary health care provider.
(HF)?


The nurse identifies which of the following symptoms as a manifestation of right-sided

heart failure (HF)?
● II
● place the client in high Fowler's position.


● Which of the following is a classic sign of cardiogenic shock?
A patient who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day
ago suddenly develops complaints of chest pain and shortness of breath and is visibly
anxious. The nurse immediately assesses the patient for other signs and symptoms of
which of the following problems?
● Pulmonary embolism
● Dyspnea
● Cough

● orthopnea
● vision changes.
A patient has been experiencing increasing shortness of breath and fatigue. The
physician has ordered a diagnostic test in order to determine what type of heart failure
the patient is having. What diagnostic test does the nurse anticipate being ordered?
flat, the nurse records that the patient is demonstrating which of the following?
● Orthopnea
● Orthopnea

● Class I (Mild)

● Echocardiogram
for this client?

● BNP
that clients with suspected right-sided heart failure may experience?

How many mL will the nurse give the client? Enter the correct number ONLY.
● 1.25
him to avoid?
● canned peas
● IV
● Echocardiogram

following?
● Pitting edema

filling.
heart failure?
● Leg edema
Which of the following is a characteristic of right-sided heart failure?
● JVD
A client is in the early stage of heart failure. During this time, which compensatory
mechanism occurs?
● Low blood pressure triggers the baroreceptors to decrease sympathetic nervous

system stimulation.


preparation?
● Natrecor

● Heart failure
preload?
● Echocardiogram
valvular disorder of the heart has a heart rate less than 60 beats/min before
administering beta blockers?
(HF)?


The nurse identifies which of the following symptoms as a manifestation of right-sided

heart failure (HF)?

● II
● place the client in high Fowler's position.

Which of the following is a classic sign of cardiogenic shock?
A patient who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day
ago suddenly develops complaints of chest pain and shortness of breath and is visibly
anxious. The nurse immediately assesses the patient for other signs and symptoms of
which of the following problems?

● Dyspnea
● Cough
The nurse is gathering data from a client recently admitted to the hospital. The nurse
asks the client about experiencing orthopnea. What question would the nurse ask to
obtain this information?
● Are you only able to breathe when you are sitting upright?

● Electrolyte and water loss
Sixty six-year-old David Steiner is already being treated for hypertension. His doctor,
concerned about the potential for heart failure, has him come back for check-ups
regularly. What does hypertension have to do with heart failure
A client with chronic heart failure is receiving digoxin (Lanoxin), 0.25 mg by mouth daily,
and furosemide (Lasix), 20 mg by mouth twice daily. The nurse instructs the client to
notify the physician if nausea, vomiting, diarrhea, or abdominal cramps occur because
these signs and symptoms may signal digoxin toxicity. Digoxin toxicity may also cause
with congestive heart failure for nocturnal dyspnea
Which pulse should the nurse palpate during rapid assessment of an unconscious
adult?
● Carotid
A patient arrives at the ED with an exacerbation of left-sided heart failure and complains
of shortness of breath. Which of the following is the priority nursing intervention?
● Assess oxygen saturation level
● Low-sodium diet
● push fluids
The nurse recognizes which of the following symptoms as a classic sign of cardiogenic
shock?
extra heart sound immediately after the second heart sound (S2). The nurse should
document this as:
● a third heart sound (S3)

The nurse recognizes which of the following lab tests is a key diagnostic indicator of
heart failure?
A nurse taking care of a patient recently admitted to the ICU observes the patient
coughing up large amounts of pink, frothy sputum. Auscultation of the lungs reveals
course crackles to lower lobes bilaterally. Based on this assessment, the nurse
recognizes this patient is developing which of the following problems?
● Decompensated heart failure with pulmonary edema
oxygenation status?
On his return to the cardiac step-down unit after his diagnostic procedure, a client
awaits the report from his cardiologist. As the client's nurse, you review the process of
measuring ejection fraction and explain to the client that it measures the percentage of
blood the left ventricle ejects upon contraction. What is the typical percentage of blood a
healthy heart ejects?
● 55%
● Ventricularassistdevice (VAD)
Which of the following is a cerebrovascular manifestation of heart failure?
● dizziness
which of the following indicates that cardiac tamponade has been relieved?

A nurse is assessing a patient with congestive heart failure for jugular vein distension
(JVD). Which of the following observations is important to report to the physician?
● JVD is noted 3 cm above the sternal angle
● 10 min
A 73-year-old client has been admitted to the cardiac step-down unit where you practice
nursing. After diagnostics, she was brought to your unit with acute pulmonary edema.
Which of the following symptoms would you expect to find during your assessment?
● Moist, gurgling respirations
A client is receiving captopril (Capoten) for heart failure. The nurse should notify the
physician that the medication therapy is ineffective if an assessment reveals:
A nursing student is caring for a client with end-stage cardiomyopathy. The client's
spouse asks the student to clarify one of the last treatment options available that the
physician mentioned. After checking with the primary nurse, the student would most
likely discuss which of the following?
● Heart transplantation
A nurse and a nursing student are performing a physical assessment of a client with
pericarditis. The client has an audible pericardial friction rub on auscultation. When
leaving the room, the student asks the nurse what causes the sound. The nurse's best
response is which of the following?
● "The pericardial surfaces lose their lubricating fluid because of inflammation and
rub against each other."
Mary Seaver is admitted to the pediatrics unit where you practice nursing. She was
admitted by her pediatrician due to suspected rheumatic fever. Aggressive antibiotic
therapy and comfort measures have been instituted to minimize the long-lasting effects
of the systemic inflammation. If Mary were to develop rheumatic carditis, which cardiac
valve most likely would be affected?
● Mitral valve
A patient complaining of heart palpitations is diagnosed with atrial fibrillation caused by

mitral valve prolapse. In order to relieve the symptoms, the nurse should teach the
patient which of the following dietary interventions?
● Eliminate caffeine and alcohol
The nurse is admitting a patient with complaints of dyspnoea on exertion and fatigue.
The patient's ECG shows arrhythmias that are sometimes associated with left
ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing
cardiomyopathy?
● Echocardiogram
A client seeks medical attention for dyspnea, chest pain, syncope, fatigue, and
palpitations. A thorough physical examination reveals an apical systolic thrill and heave,
along with a fourth heart sound (S4) and a systolic murmur. Diagnostic tests reveal that
the client has hypertrophic cardiomyopathy (HCM). Which nursing diagnosis may be
appropriate?
● Decreased cardiac output

A nurse is caring for a client receiving warfarin (Coumadin) therapy following a
mechanical valve replacement. The nurse completed the client's prothrombin time and
International Normalized Ratio (INR) at 7 a.m., before the morning meal. The client had
an INR reading of 4. The nurse's first priority should be to:
● assess the client for bleeding around the gums or in the stool and notify the
physician of the laboratory results and most recent administration of warfarin.
The nurse is assessing a patient admitted with infective endocarditis. Which of the
following manifestations would the nurse expect to find?
● Small painful lesions on the pads of the fingers and toes
A patient with mitral valve prolapse is admitted for a scheduled bronchoscopy to

investigate recent hemoptysis. The physician has ordered gentamicin to be taken before
the procedure. What is the rationale for this?
● To prevent bacterial endocarditis
The nurse is creating a plan of care for a patient with a cardiomyopathy. What priority
goal should underlie most of the assessments and interventions that are selected for
this patient?
● Improved cardiac output
For a client with cardiomyopathy, the most important nursing diagnosis is:
● Decreased cardiac output related to reduced myocardial contractility.
Mary Seaver is admitted to the pediatrics unit where you practice nursing. She was
admitted by her pediatrician due to suspected rheumatic fever. Aggressive antibiotic
therapy and comfort measures have been instituted to minimize the long-lasting effects
of the systemic inflammation. If Mary were to develop rheumatic carditis, which cardiac
valve most likely would be affected?
● Mitral valve
The nursing instructor is discussing cardiomyopathies with the junior nursing class. The
instructor asks the students to work through a plan of care for a patient with a
cardiomyopathy. What priority outcomes does the instructor tell the students should be
included in the care plan for these patients?
● Improved cardiac output.

The nurse determines that a 49-year-old client recently diagnosed with subacute
bacterial endocarditis understands discharge teaching upon which client statement?
● "I have to call my doctor so I can get antibiotics before seeing the dentist."
A cardiac surgery patient's new onset of signs and symptoms is suggestive of cardiac
tamponade. As a member of the interdisciplinary team, what is the nurse's most
appropriate action?
● Prepare to assist with pericardiocentesis.
A patient with pericarditis has been admitted to the CCU. The nurse caring for the
patient knows that the most common clinical manifestation of pericarditis is what?
● Chest pain
A nurse is teaching a patient about valve replacement surgery. Which statement by the
patient indicates an understanding of the benefit of an autograft replacement valve?
● "The valve is made from my own heart valve, and I will not need to take any
blood thinning drugs when I am discharged."
A patient comes to the clinic with complaints of fever, chills, and sore throat and is
diagnosed with streptococcal pharyngitis. A nurse knows that early diagnosis and
effective treatment is essential to avoid which of the following preventable diseases?
● Rheumatic fever
The nurse is caring for a patient who is scheduled to undergo mechanical valve
replacement. Patient education should include which of the following?
● Long-term anticoagulant therapy
A patient who had a prosthetic valve replacement was taking Coumadin to reduce the
risk of postoperative thrombosis. He visited the nurse practitioner at the Coumadin clinic
once a week. Select the INR level that would alert the nurse to notify the health care
provider.
● 3.8
A nurse is caring for a client with acute mitral regurgitation related to an acute
myocardial infarction. The nurse knows to monitor the client carefully for symptoms of
which initial complication or result?
● Severe heart failure
● IV
A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client
begins to have rare premature ventricular contractions followed by runs of bigeminy with
stable signs. What action will the nurse perform next?
be measured?
● echocardiogram
What method might be used with a debilitated client to help the nurse evaluate the
client's response to diuretics?

Which describes difficulty breathing when a client is lying flat?
● Orthopnea
ordered?

failure?
● furosemide
A client asks the nurse if systolic heart failure will affect any other body function. What
body system response correlates with systolic heart failure (HF)?
● decrease in renal perfusion
The nurse is administering digoxin to a client with heart failure. What laboratory value
may predispose the client to digoxin toxicity?
● potassium level of 2.8 mEq/L
● Preload
A client has been admitted to the cardiac step-down unit with acute pulmonary edema.
Which symptoms would the nurse expect to find during assessment?
● moist, gurgling respirations
A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic

balloon pump (IABP). What does the nurse understand is the mechanism of action of
the balloon pump?
● The balloon inflates at the beginning of diastole and deflates before systole to
augment the pumping action of the heart.
The nurse is assessing a newly admitted client with chest pain. What medical disorder
is most likely causing the client to have jugular vein distention?
● heart failure
A client has been diagnosed with right-sided heart failure based on symptomology. The
cardiologist will confirm this suspicion through diagnostics. Which diagnostics are used
to reveal right ventricular enlargement? Select all that apply.
● echocardiography
for this client?
● Echocardiogram
A client has been diagnosed with systolic heart failure. What percentage will the nurse
expect the patient's ejection fraction to be?
● 30%
● 55%
Dyspnea on exertion
● Dyspnea
● Cough
● An LVAD only supports a failing left ventricle.
● Blood pressure 80/46 mm Hg
The nurse is assessing a patient who is known to have right-sided HF. What
assessment finding is most consistent with this patient's diagnosis?
● heart failure
Which is a key diagnostic indicator of heart failure?
A patient has been admitted to the hospital with exacerbation of heart failure (HF) that
has resulted in pulmonary and peripheral edema. The nurse has been carefully
monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse
best monitor the patient's fluid balance?
● By performing daily weights at the same time each day
● Orthopnea
Pulmonary edema is often caused by
● congestive heart failure.

● Potassium
clinic immediately?

The nurse is teaching a group of clients with heart failure about how to decrease leg
edema. What dietary advice will the nurse give to clients with severe heart failure?

● 1.25
Explanation:
(50 mg/80 mg) x 2 mL = 1.25 mL.
Which of the following is a key diagnostic indicator of heart failure (HF)?
A client has been diagnosed with congestive heart failure. This client's cardiac function
has been compromised since the client suffered a myocardial infarction 3 years ago.
Heart failure is classified by:
● amount of activity restriction the failure imposes.
A client diagnosed with heart failure presents with a temperature of 99.1° F, pulse 100
beats/minute, respirations 42 breaths/minute, BP 110/50 mm Hg; crackles in both lung
bases; nausea; and pulse oximeter reading of 89%. Which finding indicates a need for
immediate attention?
● lung congestion
Association (NYHA)?
● Class III (Moderate)

for this client?


● B-type natriuretic peptide
Withhold the client's next scheduled dose of furosemide and report to the care provider

heart failure?
● Leg edema
● Preload

tachypnea, bradycardia, and muffled heart sounds. The nurse recognizes these as
symptoms of what occurrence?
filling.
● 30%

● 55%
● Echocardiogram
● Echocardiogram
● Spironolactone
ordered?
On assessment, the nurse knows that a patient who reports no symptoms of heart
failure at rest but is symptomatic with increased physical activity would have heart
failure classified as Stage:
● C
Explanation:
Once a patient has structural heart disease, he has progressed from stage A to either
stage B or stage C. The difference between B and C has to do with the presence of
signs and symptoms of heart failure. When dyspnea and fatigue occur with exertion,
heart failure is suspected.

● pitting edema

● IV
● Echocardiogram
A nurse is caring for a client with a cardiac disorder who is prescribed diuretics. What
important factor should the nurse include in this client's teaching plan?
● A discussion of the signs and symptoms of electrolyte and water loss.
When the client has increased difficulty breathing when lying flat, the nurse records that
● orthopnea.
● Dizziness

A patient has missed 2 doses of digitalis. What laboratory results would indicate to the
nurse that the patient is within therapeutic range?
● 2.0 mg/mL
The nurse is asssessing a client with crackling breath sounds or pulmonary congestion.
The nurse is caring for a client with advanced heart failure. What treatment will be
considered after all other therapies have failed?
● heart transplant
The nurse is teaching a client with heart failure about the ability for the heart to pump
out blood. What diagnostic test will measure the ejection fraction of the heart?
● echocardiogram
● 30%
oxygenation and relieve dyspnea, what action should the nurse perform?
● place the client in high Fowler's position
● Dizziness

apply.

The nurse assists the client to the bathroom, which is approximately 10 feet from the
bed. The client ambulates 3 feet and states, "I cannot catch my breath." How would the
nurse document this finding?
● “Experiences exertional dyspnea when walking 3 feet; states, ?“I cannot catch
my breath.”

Head of the bed elevated 45 degrees and lower arms supported by pillows
● Dyspnea
● Cough
The nurse is providing care to a client with cardiogenic shock requring a intra-aortic
balloon pump (IABP). What is the therapeutic effect of the IABP therapy?
● decreased left ventricular workload
Assessment of a client on a medical surgical unit finds a regular heart rate of 120 beats
per minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg,
bibasilar crackles on lung auscultation, and a urine output of 5 mL over the past hour.
What is the reason the nurse anticipates transferring the client to the intensive care
unit?
● The client is going into cardiogenic shock.
be measured?
● Echocardiogram
● Lung congestion

● Pitting edema
The nurse is providing care to a client with cardiogenic shock requiring a intra-aortic
failure?
● furosemide

Which nursing intervention should the nurse perform when a client with valvular disorder
of the heart has a heart rate less than 60 beats/min before administering beta-blockers?
ordered?

● Heart failure
The nurse is teaching a group of clients with heart failure about how to decrease leg
edema. What dietary advice will the nurse give to clients with severe heart failure?
● 55%
● Dizziness
The nurse is teaching a client with heart failure about the ability for the heart to pump
out blood. What diagnostic test will measure the ejection fraction of the heart?
● Echocardiogram
clinic immediately?
● Encocardiogram
● Canned peas

● Chest x ray
The nurse is administering sublingual nitroglycerin to a client with chest pain. What
action will the nurse take after administering two sublingual tablets if the client continues
with chest pain and has a blood pressure of 120/82 mm Hg?
● Administer the third sublingual nitroglycerin tablet.
A client in the emergency room is in cardiac arrest and exhibiting pulseless electrical
activity (PEA) on the cardiac monitor. What will be the nurse's next action?
● Administer epinephrine
● Nausea and vomiting
● IV

what occurrence?
filling.
for this client?
● Development of left sided heart failure

● Measure input and output
The nurse is caring for a client with heart failure. What are the management goals for
the client with heart failure? Select all that apply
● Promoting a healthy lifestyle.

● Increasing cardiac output by strengthening muscle contractions.
● Lowering the risk for hospitalization.
● Before discharge, which instruction should a nurse give to a client receiving
digoxin?
● preload
● Peripheral edema

The nurse is caring for a client with a history of heart failure and a sudden onset of
tachypnea. What is the nurse's priority action?
● Elevate the head of the bed
developing
● decompensated heart failure with pulmonary edema
The nurse is assigned to care for a client with heart failure. What medication does the
nurse anticipate administering that will improve client symptoms as well as increase
survival?
● Lisinopril
The nurse is caring for a client with severe compensated heart failure. What human
brain natriuretic peptide (BNP) medication may be used in a critical care unit with
hemodynamic monitoring?
● Natrecor
The client asks the nurse why a stress test is needed. What statement best explains the
rationale for the health care provider to order a cardiac stress test?
● The health care provider wants to identify if the heart failure is from coronary
artery disease
What method might be used with a debilitated client to help the nurse evaluate the
client's response to diuretics?
A patient has missed 2 doses of digitalis. What laboratory results would indicate to the
nurse that the patient is within therapeutic range?
● 2.0 mg/mL
A nurse is teaching a client about heart failure. What will the nurse explain is causing
the heart to fail?
● The heart cannot pump sufficient blood to meet the body's metabolic needs
might cause increased preload. Which response by the student indicates
understanding?
● Application of antiembolic stockings

● Left ventricular failure
apply.

● 30%
● II
● Dyspnea
● Cough
Assessment of a client on a medical surgical unit finds a regular heart rate of 120 beats
per minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg,
bibasilar crackles on lung auscultation, and a urine output of 5 mL over the past hour.
What is the reason the nurse anticipates transferring the client to the intensive care
unit?
● The client is going into cardiogenic shock.
A nurse reviews the client's medical record and reads in the progress notes that the
client has decreased left ventricular function. What assessment will validate the
diagnosis?
● Orthopnea
oxygenation status?
A client with heart failure must be monitored closely after starting diuretic therapy. What
is the best indicator for the nurse to monitor?
● Weight
The nurse is assessing a client admitted with cardiogenic shock. What medication will
the nurse titrate to improve blood flow to vital organs?
● Dopamine
Which is the hallmark of heart failure?
● Low ejaculation fraction (EF)
A client with a history of heart failure is returning from the operating room after inguinal
hernia repair and the nurse assesses a low pulse oximetry reading. What is the most
important nursing intervention?
● Titrate oxygen therapy.
A client with left-sided heart failure is in danger of impaired renal perfusion. How would
the nurse assess this client for impaired renal perfusion?
● Assess for elevated blood urea nitrogen levels

● Ventricular assist device (VAD)
The nurse is teaching a client with heart failure about digoxin. What statements by the
client indicate the teaching is effective? Select all that apply.
● "I will watch my urine output to be sure that the medication is not affecting my
kidneys."
● "If I take my digoxin I should have limited episodes of shortness of breath."
The nurse observes a client with an onset of heart failure having rapid, shallow
breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse
anticipate finding initially?
● Respiratory alkalosis
The nurse is discussing basic cardiac hemodynamics and explains preload to the client.
What nursing intervention will decrease preload?
● administration of a vasodilating drug (as ordered by a health care provider)
The nurse is caring for a client with heart failure. What sign will lead the nurse to
suspect right-sided and left-sided heart failure?
● Ascites
Association (NYHA)?
● Class III
● Potassium
● vision changes
The Cardiac Nurse Clinician is teaching a group of clients with heart failure about
self-management of their disease. What dietary advice should the Nurse Clinician give
to clients with severe heart failure until edema resolves?
● moist, gurgling respirations drowsiness, numbness
The nurse is preparing to administer furosemide to a client with severe heart failure.
What lab study should be of most concern for this client while taking furosemide?

● Echocardiogram
Which is a key diagnostic indicator of heart failure?
● 1.25 mL
(HF)?
● canned peas.
● The client says his rings have become tight and are difficult to remove
● Low-sodium diet
● Orthopnea

following?
● Pitting edema
● Echocardiogram


● Push fluids

developing

heart failure?
● Leg edema
● IV
preparation?
● Natrecor
● 55%
The nurse is working in a long-term care facility with a group of older adults with cardiac
disorders. Why would it be important for the nurse to closely monitor an older adult
receiving digitalis preparations for cardiac disorders?
for this client?


● IV
● a. Withhold the drug and inform the primary health care provider.
The nurse is assigned to care for a client with heart failure. What medication does the
nurse anticipate administering that will improve client symptoms as well as increase
survival?
● lisinopril
When a client has increased difficulty breathing when lying flat, the nurse records that
● orthopnea.
● b. heart rate of 55 beats per minute
Which medication is categorized as a loop diuretic?
● a. Furosemide
● c. decreased left ventricular pumping

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart
failure?
● Blood urea nitrogen (BUN)
The nurse has completed a head-to-toe assessment of a patient who was admitted for
the treatment of heart failure (HF). Which of the following assessment findings should
signal to the nurse a possible exacerbation of the patient's condition?
● Crackles are audible on chest auscultation.
● Echocardiogram

● Hold the medication and call the health care provider.
A client with stage IV heart failure has a living will indicating a ventilator may not be
used. The client begins experiencing severe dyspnea. What should the nurse who is
caring for this client do?
● administer oxygen, morphine, and a bronchodilator for client comfort.

shortness of breath. Which is the priority nursing action?
● dopamine
It is used to treat cardiogenic shock.
● It increases perfusion pressure to improve myocardial contractility and blood flow

through vital organs.
High levels of _____________ are a sign of high cardiac filling pressure and can aid in
the diagnosis of heart failure.
● BNP
__________ ________________ cause venous dilation, which reduces the amount of

blood return to the heart and lowers preload.
● Isosorbide dinitrate
_______________lowers systemic vascular resistance and left ventricular afterload
● Hydralazine
● lung congestion

● canned peas
_______________ disease of the heart muscle that makes it harder for your heart to
pump blood to the rest of your body. It can lead to heart failure.
● Cardiomyopathy
The nurse is interviewing a client during an initial visit at a cardiologist's office. What
symptom will the nurse expect to find as an early symptom of chronic heart failure?
● fatigue
● Dizziness
Fatigue is commonly the earliest symptom of chronic heart failure; it is caused by

________ cardiac output and tissue oxygenation
● decreased
S/S of cerebrovascular manifestations of heart failure
● dizzy
● confused
● lightheaded
● restless
● anxiety
failure?
● furosemide
● Echocardiogram
● heart transplant
● a. Head of the bed elevated 45 degrees and lower arms supported by pillows
● b. moist, gurgling respirations
large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the
developing
● d. decompensated heart failure with pulmonary edema
for this client?

The client with cardiac failure is taught to report which symptom to the health care
provider or clinic immediately?
● Persistant Cough
● 30%

● Heart Failure
● Dyspnea
● Cough
Which is the hallmark of heart failure?
A 70-year-old man has been living with a diagnosis of heart failure (HF) for several
years and has been vigilant about monitoring the trajectory of disease and adhering to
his prescribed treatment regimen. The man has scheduled an appointment with his
primary care provider because he has noted a weight gain of 6 pounds over the past
week. The nurse should anticipate that this patient may benefit from which of the
following treatment measures?
● An increase in the dose of his prescribed diuretic

● pulmonary embolism
apply.

The nurse is conducting a morning assessment of an 80-year-old female patient who

has a longstanding diagnosis of heart failure (HF). The nurse notes an elevation in
jugular venous pressure (JVP) greater than 4 cm above the woman's sternal angle, a
finding that did not exist the day before. What conclusion should the nurse draw from
this assessment finding?
● b. The woman may be experiencing an exacerbation of right-sided HF.
● Preload
_________ is the degree of stretch of the ventricular cardiac muscle fibers at the end of
diastole.
● Preload
_____________ is the amount of resistance to ejection of blood from a ventricle.
● Afterload
The ________________ ________________ is the percentage of blood volume in the

ventricles at the end of diastole that is ejected during systole.
● ejection fraction
___________ _____________ is the amount of blood pumped out of the ventricle with
each contraction.
● Stroke volume
The nurse is providing care to a client with cardiogenic shock requiring a intra-aortic
The nurse is administering furosemide to a client with heart failure. What best describes
the therapeutic action of the medication?
● d. The medication blocks sodium reabsorption in the ascending loop and dilate
renal vessels.
● Dopamine


A nurse finds a client with absent breathing and prepares to begin one-person
cardiopulmonary resuscitation. What will the nurse do first?
● Establish unresponsiveness.
Cardiac tamponade happens when ?
● Extra fluid builds up in the space around the heart. The fluid or blood puts
pressure on the heart and prevents in from pumping well.
A client has been diagnosed with right-sided heart failure based on symptomology. The
cardiologist will confirm this suspicion through diagnostics. Which diagnostics are used
to reveal right ventricular enlargement? Select all that apply.
● electrocardiogram
● chest radiograph
● echocardiography
● Echocardiogram
A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic

balloon pump (IABP). What does the nurse understand is the mechanism of action of
the balloon pump?
● The balloon inflates at the beginning of diastole and deflates before systole to
augment the pumping action of the heart.
● Echocardiogram
● Preload


following?
● Pitting edema
Before discharge, which instruction should a nurse give to a client receiving digoxin
(Lanoxin)?
(HF)?

preparation?
● Natrecor
Which of the following types of diuretic is the first-line treatment for those diagnosed
with heart failure (HF)?
● Loop
● Dizziness
The nurse is preparing a client for a multiple gated acquisition (MUGA) scan. What
would be an important instruction for the nurse to give a client who is to undergo a
MUGA scan?
● Lie very still at intermittent times during the test.

which of the following indicates that cardiac tamponade has been relieved?
A client is brought to the emergency department via rescue squad with suspicion of
cardiogenic pulmonary edema. What complication should the nurse monitor for? Select
all that apply.
● Cardiac dysrhythmias
● Respiratory arrest
● Cardiac arrest
● Dizziness
A client is experiencing an acute myocardial infarction (MI) and I.V. morphine is ordered.
The nurse knows that morphine is given because it:
● lowers resistance, reduces cardiac workload, and decreases myocardial oxygen

demand.
A nurse is assessing a client with suspected cardiac tamponade. How should the nurse
assess the client for pulsus paradoxus?
● Measure the blood pressure in either arm as the client slowly exhales and then
as the client breathes normally.
A client has been rushed to the ED with pulmonary edema and is going to need oxygen
immediately. Which oxygen delivery system should be used first?
● mask
A nurse is preparing to begin one-person cardiopulmonary resuscitation. The nurse

should first:
● establish unresponsiveness.
You are caring for a client with left-sided heart failure. When you go in to do your shift
assessment, you find your client is wheezing, restless, tachycardic, and has severe
apprehension. You know that these are symptoms of what?

Which of the following symptoms should the nurse expect to find as an early symptom
of chronic heart failure?
● Fatigue
Which of the following clinical manifestations are consistent with right-sided heart failure
(HF)?
● Positive hepatojugular reflux

apply.

● II
A client with a history of myocardial infarction is admitted with shortness of breath,
anxiety, and slight confusion. Assessment findings include a regular heart rate of 120
beats/minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg,
bibasilar crackles on lung auscultation, and a urine output of 5 ml over the past hour.
The nurse anticipates preparing the client for transfer to the intensive care unit and
pulmonary artery catheter insertion because:
● the client is going into cardiogenic shock.
● 10 minutes
oxygenation status?
Which statement best describes the therapeutic action of loop diuretics?
● They block sodium reabsorption in the ascending loop and dilate renal vessels.
The nurse is developing a plan of care for a client following pericardiocentesis. Which
interventions should the nurse implement? Choose all that apply.
● Monitor heart and lung sounds.

● Evaluate the cardiac rhythm.
● Record fluid output.
● 55%
● lung congestion
total artificial heart (TAH) is an electrically powered pump that circulates blood into the
● B-type natriuretic peptide
developing

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CHAPTER 29 - QUIZLET

● a third heart sound (S3)

● acute pulmonary edema

Which is a characteristic of right-sided heart failure?

● Jugular vein distention

● Gradual unexplained weight gain

Medical management of cardiac failure uses similar methodology whether it is

● Hypertension causes the heart's chambers to enlarge and weaken.

A patient is prescribed digitalis preparations. Which of the following conditions should

● decompensated heart failure with pulmonary edema.

● Reduce the workload on the heart.

● decreased left ventricular pumping

● acute pulmonary edema.

● Digoxin immune FAB

The diagnosis of heart failure is usually confirmed by which of the following?

● heart rate of 55 beats per minute

● measuring intake and output

● inadequate cardiac output

Which feature is the hallmark of systolic heart failure?

● Low ejection fraction (EF)

● The development of left-sided heart failure

Which is a cerebrovascular manifestation of heart failure?

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia,

● Left ventricular function

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What

● heart rate of 55 beats per minute

● I sleep on 3 pillows each night

The nurse is preparing to administer hydralazine and isosorbide dinitrate. When

● Hold the medication and call the healty care provider

An echocardiogram is usually performed to determine the

● ejection fraction, identify anatomic features such as structural abnormalities and

● Decomponsated heart failure with pulmonary edema

Classification of HF Class III

● is when there is marked limitation of physical activity. The client is comfortable at

● Digoxin immune FAB

The nurse is administering nitroglycerin, which he knows decreases preload as well as

● The amount of blood presented to the ventricles just before systole

Which is a cerebrovascular manifestation of heart failure?

Which medication is categorized as a loop diuretic?

● Left sided heart failure

Which of the following is the primary cause of pulmonary or peripheral congestion?

● Inadequate cardiac output

● Report the possibility of digitalis toxicity to the care provider promptly

● Jugular venous distention

Which is a classic sign of cardiogenic shock?

● The amount of blood presented to the ventricles just before systole

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart

● Left ventricular function

A nurse is administering lanoxin, which she knows increases contractility as well as

● The force of the contraction related to the status of the myocardium

A client diagnosed with pulmonary edema has a PaCO2 of 72 mm Hg and an oxygen

● Intubation and mechanical ventilation

A patient is prescribed digitalis preparations. Which of the following conditions should

● Congestion in peripheral tissues

● Call for a chest x-ray

● Administration of a vasodilating drug (as ordered by a physician)

With which disorder is jugular vein distention prominent?

● Hypertension causes the heart's chambers to enlarge and weaken

The nurse is preparing to administer hydralazine and isosorbide dinitrate (Dilatrate).

● Hold the medication and call the physician

● Electrolyte and water loss

Which is a potassium-sparing diuretic used in the treatment of heart failure?

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What