Journal Logo


Managing heart failure: What you need to know

GENERAL PURPOSE To provide nurses with an overview of heart failure, including its signs and symptoms, diagnostic tests, and treatment. LEARNING OBJECTIVES After reading this article and taking this test, you should be able to: 1. Define heart failure pathophysiology. 2. Identify assessment and diagnostic findings of heart failure. 3. Indicate heart failure treatment and related nursing interventions.

1. Which statement is correct about heart failure?

a. It's chronic and progressive but not fatal.

b. The heart can't keep up with the body's oxygen demand.

c. It's only caused by structural abnormalities.

d. It involves atrial dysfunction.

2. Characteristics of left ventricular systolic dysfunction include

a. increased stroke volume.

b. decreased left ventricular end-diastolic pressure.

c. cardiac muscle constriction.

d. increased left ventricular diastolic pressure.

3. Reduced cardiac output in heart failure

a. inhibits compensatory neurohormonal responses.

b. causes bradycardia and vasodilation.

c. leads to an increase in sodium and water retention.

d. impairs remodeling of the ventricle.

4. Diastolic dysfunction is characterized by

a. stiffening of the left ventricle.

b. increased left ventricular end-diastolic volume.

c. decreased left ventricular filling pressure.

d. a relaxed left ventricle.

5. Which statement is correct about diagnostic test findings for heart failure?

a. A patient with cardiomegaly on chest X-ray has diastolic dysfunction.

b. In a patient with left ventricular dysfunction, the ECG may show a left ventricular electrical abnormality reflecting hypertrophy or dilation.

c. A patient with symptoms of heart failure and an ejection fraction less than 30% has diastolic dysfunction.

d. A patient with symptoms of heart failure and a normal heart size on chest X-ray has systolic dysfunction.

6. What BNP level indicates abnormal ventricular function?

a. greater than 25 pg/ml

b. greater than 50 pg/ml

c. greater than 75 pg/ml

d. greater than 100 pg/ml

7. What lifestyle modification may reduce the need for diuretics?

a. reducing sodium and fluid consumption

b. eating a low-fat diet

c. limiting alcohol intake

d. losing weight

8. The most common adverse reaction associated with ACE inhibitors is

a. hypotension.

b. potassium retention.

c. cough.

d. deteriorating renal function.

9. A patient who can't take ACE inhibitors can instead be prescribed a

a. beta-blocker.

b. diuretic.

c. digoxin.

d. angiotensin receptor blocker.

10. Which statement is correct about diuretic therapy for heart failure?

a. Diuretic therapy provides protection against further myocardial damage.

b. Loop diuretics are effective in patients with renal impairment.

c. Low-dose spironolactone is a preferred first-line drug.

d. Aldosterone receptor antagonists are contraindicated.

11. Which statement is correct about nesiritide?

a. It prevents diuresis.

b. It acts like endogenous BNP.

c. It causes vasoconstriction.

d. It raises BP.

12. Beta-blockers are used to treat heart failure because they

a. increase heart rate.

b. increase peripheral vasoconstriction.

c. reduce myocardial ischemia.

d. get rid of excess fluid.

13. Which statement is correct about enhanced external counterpulsation?

a. Pneumatic cuff inflation is synchronized with BP.

b. Venous return decreases with cuff inflation during diastole.

c. It's safe for patients with severe peripheral vascular disease.

d. Cuff deflation during systole reduces afterload.

14. Which statement is correct about biventricular pacing?

a. It reduces left ventricular filling.

b. Leads are placed only in one ventricle.

c. It promotes synchronized ventricular contraction.

d. It is indicated as a first-line treatment for heart failure.

15. Which statement is correct about the Myosplint device?

a. Its flexible cords are tightened to reduce left ventricular size.

b. It's composed of a mesh fabric that surrounds the ventricles.

c. It supports the myocardium and reduces wall stress.

d. It prevents progression of ventricular remodeling.

16. Systolic dysfunction may be caused by all of the followingexcept

a. myocardial ischemia.

b. constrictive pericardial disease.

c. alcoholic cardiomyopathy.

d. hypothyroidism.

17. Which type of cardiomyopathy causes diastolic dysfunction heart failure?

a. viral

b. idiopathic dilated

c. toxin-induced

d. restrictive

18. A patient who reports fatigue and dyspnea during activities of daily living would be classified as New York Heart Association

a. Class I

b. Class II

c. Class III

d. Class IV

19. A patient with diabetes but no symptoms of heart failure would be considered ACC/AHA

a. Stage A.

b. Stage B.

c. Stage C.

d. Stage D.

20. According to ACC/AHA guidelines, at what stage should aldosterone antagonist and angiotensin receptor blocker therapy be considered?

a. Stage A

b. Stage B

c. Stage C

d. Stage D only

© 2004 Lippincott Williams & Wilkins, Inc.