Heart Failure Quiz

In assessing an 85-year-old with ankle swelling, the nurse notes distention of the jugular veins with the head of the patient’s bed elevated 45 degrees. The nurse knows this finding is an indication of
elevated right atrial pressure
atherosclerosis of the jugular veins
jugular vein valve dysfunction
low fluid volume
A patient who is receiving dobutamine (Dobutrex) for the treatment of acute heart failure (ADHF) has the following nursing actions included in the plan of care. Which action should the RN delegate to the experienced LPN/LVN?
Assess the IV site for extravasation
Adjust the IV rate to keep the BP WNL
Monitor BP and P every hour
Teach the patient why bed rest is indicated
A patient being treated for heart failure returns to the clinic after 2 weeks of therapy with carvedilol (Coreg). Which of these findings is most important for the nurse to report to the health care provider?
Pulse rate of 56
Complaints of fatigue
BP of 86/40 mm Hg
pitting edema of the ankles 2+
The nurse has received change of shift report. Which of the following patients with heart failure should the nurse assess first?
A patient who has crackles in both posterior lung bases and is receiving oxygen
A patient who is cool and clammy, with new-onset confusion and restlessness
A patient who had dizziness after receiving the first dose of captopril (Capoten)
A patient who is receiving IV nesiritide (Natrecor) and has a blood pressure (BP) of 100/56
The nurse is caring for a client with congestive heart failure. Which finding requires priority action that needs to be taken by the nurse?
Urine output of 50 mL over 2 hours
Apical pulse rate of 106 beats/minute
Oxygen saturation of 88%
Weight gain of 1 kg (2.2 lb)
A 90 year old patient explains to the nurse that she sometimes confuses her water pills with pills for her blood pressure. The patient lives alone and so the nurse plans to facilitate which of the following in the patient's discharge?
referral to home health care
referall to a long term care facility
transfer to dementia care services
coordination of around the clock care
Patients with heart failure are usually placed on a reduced sodium diet. Which of the following food would the nurse teach the patient on a 2G sodium diet to avoid?
canned fruits and vegetables
fresh frozen vegetables
fresh cheese, milk and yogurt
eggs
The nurse uses which of the folowing diagnostic evaluations to help determine if a patient with acute shortness of breath has heart failure?
arterial blood gases
12 lead eletrocardiogram
creatine kinase
B natriuretic peptide
The nurse is caring for a patient admitted with acute heart failure (ADHF) who is receiving nesiritide (Natrecor). Which action will the nurse be expected to perform?
Titrate the medication prior to discharge
Monitor blood pressure frequently.
Recommend patient ambulate in room regularly
Teach patient safe use of the medication at home
A patient with heart failure has a new order for captopril (Capoten) 12.5 mg PO. After administering the first dose and teaching the patient about captopril, which statement by the patient indicates that teaching has been effective?
I will take the medication on afull stomach
I will increase potassium in my diet by eatin gmore bananas
I will call for help when I need to get up out of bed
I will increase sodium in my diet to prevent fluid shifts
Auscultate the patient's breath sounds
Evaluate capillary refill
Assess the patient's mental status
Palpate the abdomen for distention
When evaluating the patient with heart failure response to medications, the best indicator that the treatment is effective is
urine output more than 60 ml/hour
reduced difficulty breathing with the head of bed less than 45 degrees
less complaints of chest pain
reducing by 2 pounds overnight
A nurse is performing medication teaching as part of discharge planning for a patient taking digoxin and hydrochlorothiazide. Instructions will include:
notify the health care provider about any nausea.
avoid dietary sources of potassium.
avoid eggs and other high-cholesterol foods.
decrease flud intake
The nurse knows teaching to the patient with heart failure is effective when the patient
stated the nitroglycerin patch will cause severe headaches
reports an increase in weight from 225 to 231 pounds in a week
tells the nurse they will take lasix every night
reports using more pillows to sleep at night
The client with acute heart failure is complaining of difficulty breathing. The nurse observes the client is dyspneic, tachypneic and tachycardic while exhibiting increased anxiety. The priority action for the nurse is to
administer IV morphine sulfate
administer IV valium
increase the dopamine drip
increase the nitroglycerin drip
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