Heart Failure with Atrial Fibrillation

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1. Knowing that the client has two risk Complete a focused cardiac his-
factors that cannot be modified, which tory assessment.
intervention is most important for the
nurse to include in the clients plan of
care?

2. Which assessment finding provides the Peripheral Edema

earliest indication that the client is ex-
periencing right-sided heart failure?

3. Based on the electrocardiogram rhythm Obtain a 12 lead ECG.

strip, what intervention should the
nurse implement first?

4. After the clients cardiac rhythm is con- Administer a prescribed stat dose
firmed, which action should the nurse of digoxin.
implement next?

5. When preparing the client for the Ask the client to lay on their left
echocardiogram, which intervention side during the test.
should the nurse implement?

6. The nurse prepares a dose of digox- 1 mL

in 0.125 mg IV push. The medication is
supplied as 0.25 mg in 2 mL. How many
mL should the nurse prepare to give?

7. After administration of the prescribed Decrease in baseline blood pres-

captopril, which assessment finding sure.
warrants intervention by the nurse?

8. The nurse is monitoring the clients Potassium 3.0 mEq/L

serum electrolytes. Which of the client's
serum laboratory values requires inter-
vention by the nurse?

9. The client is concerned about how eas- Monitor INR levels every 4-6
ily they are bruising since they started weeks.
taking the warfarin. Which intervention

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 Heart Failure with Atrial Fibrillation
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is most important for the nurse to in-
clude in the client's plan of care?

10. The nurse observed a family member Teach the client and his family
bringing the client food from home. what foods are low in sodium.
Which intervention is most important
for the nurse to implement?

11. The client asks the nurse why they have Report a gain of 3 pounds in one
to be weighed every day. The nurse ex- week
plains that the weight gain is one of the
first signs of retaining fluid. Which inter-
vention is most important for the nurse
to include in the client's plan of care?

12. What is the first action that the nurse Elevate the head of the client's
should implement when entering the bed
client's room?

13. Select additional instructions the nurse -Monitor blood pressure prior to
should include in the client's teaching administration of digoxin.
plan. SATA -Do not stop taking any pre-
scribed potassium supplements.
-Regular blood draws will be nec-
essary to measure PT and INR.

14. The client has been taking alpha- adren- -Avoid abrupt transitions to an
ergic blocker carvedilol 3.125 mg PO erect posture
twice daily. Which interventions are im- -Take with food, restrict salt and
portant for the nurse to include in the alcohol intake
clients discharge plan? SATA -Do not quickly discontinue med-
ication
-Do not take extra medicine to
make up a missed dose.

15. The client will be going home on Slow pulse rate

carvedilol 12.5 mg PO twice daily.
Choose the most important side effect
for the nurse to include in the discharge
teaching and document in the EMR.
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16. The client is now on furosemide 20 mg -Wear sunblock and long sleeves
PO twice daily. The client is aware that when out in the sun
this medication increases urinary out- -Swollen skin remains indented
put. Which interventions should be in- after being pressed
cluded in the client's discharge teach- -Report dry mouth and excessive
ing? SATA thirst

17. What is the most important intervention Obtain a serum potassium level
for the nurse to implement?

18. Which of the client's serum laborato- Calcium 16 mg/dL

ry values requires intervention by the
nurse

19. Which assessment finding provides the Anorexia, nausea, and vomiting.
earlies indication that the client is expe-
riencing digoxin toxicity?

20. After treatment with digoxin immune Potassium 3.2 mEq.L

FAB, which of the client's serum labora-
tory values requires intervention by the
nurse?

21. Which member of the nursing staff An experienced critical care RN

would be best assigned to the client who has been assigned to "Float"
while they are receiving treatment for on the unit.
his digoxin toxicity?

22. While applying supplemental oxygen, Patient upright unless contraindi-

which intervention is priority for the cated and give O2 by nasal can-
nurse to initiate? nula or non rebreather mask

23. How would this reading by interpreted Respiratory acidosis

by the nurse?

24. The client's daughter and the nurse The clients documented wishes
should utilize which source during this for life saving measures
decision making process?

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25. If the client had not provided an ad- -Social worker
vance directive, who should be con- -Clergy person
sulted next, with regard to helping the -Healthcare providers
daughter make the best decision re- -Extended family
garding the client's care? SATA

26. The best nursing action in response to Notify the HCP of the daughter's
this decision would be to? wishes

27. The nurse's best response in this situa- "You are going through a very dif-
tion would be what? ficult time."

28. Choose the best nursing action to im- Stay seated next to the daughter
plement in response to the daughter's and remain quietly attentive.
behavior.

29. Which menu selection by the client in- Fruit snacks to include bananas,
dicates that effective teaching has been oranges, and dried apricots.
taken place?

30. In an effort to monitor his heart failure, Weighing everyday on the same
what is the most important intervention scale.
that the client can perform at home?

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