Integrated Chronic Care Management for Congestive Heart Failure: Pre-Test

1.

The following is true of systolic heart failure.

A.

The primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction
B.

Is a ventricle filling problem
C.

Equates to an ejection fraction of 55%
D.

A and B
E.

All of the above

Correct Answer
A. The primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction

Explanation
Systolic heart failure occurs when the heart muscle is weakened and unable to contract effectively. This can be caused by various factors, but the primary cause is often coronary artery disease. When the coronary arteries become narrowed or blocked, it restricts blood flow to the heart muscle, leading to impaired contraction. This can result in a decreased ejection fraction, which is the percentage of blood pumped out of the heart with each contraction. Therefore, the correct answer is "A and B" - the primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction, and it is also a ventricle filling problem.

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2.

The following is true of diastolic heart failure.

A.

It is more common in women with hypertension
B.

Is a ventricle emptying problem
C.

Equates to an ejection fraction of 65%
D.

A and C
E.

B only

Correct Answer
A. It is more common in women with hypertension

Explanation
Diastolic heart failure refers to a condition where the ventricles of the heart have difficulty filling with blood during the relaxation phase (diastole). The given answer states that it is more common in women with hypertension. This explanation suggests that women who have high blood pressure are at a higher risk of developing diastolic heart failure compared to men or women without hypertension.

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3.

Patients with anemia and renal failure are more likely to experience rapid exacerbations.

A.

True
B.

False

Correct Answer
A. True

Explanation
Patients with anemia and renal failure are more likely to experience rapid exacerbations because both conditions can contribute to decreased oxygen-carrying capacity in the blood. Anemia, which is characterized by a low red blood cell count or low hemoglobin levels, reduces the blood's ability to transport oxygen to the body's tissues. Renal failure, on the other hand, can lead to the accumulation of waste products in the blood, causing further damage to red blood cells and impairing their function. These combined effects make patients with anemia and renal failure more susceptible to rapid exacerbations of their symptoms.

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4.

Heart failure is known to worsen in the following conditions

A.

Infections like a UTI or pneumonia
B.

Medication non-adherence
C.

Anemia
D.

Atrial fibrillation
E.

All of the above

Correct Answer
E. All of the above

Explanation
Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs. Infections like urinary tract infections (UTIs) and pneumonia can put additional stress on the heart, leading to worsening of heart failure symptoms. Medication non-adherence refers to not taking prescribed medications as directed, which can result in inadequate management of heart failure and a decline in heart function. Anemia, a condition characterized by a low red blood cell count, can cause the heart to work harder to supply oxygen to the body, exacerbating heart failure. Atrial fibrillation, an irregular heart rhythm, can also worsen heart failure by disrupting the heart's ability to effectively pump blood. Therefore, all of the mentioned conditions - infections, medication non-adherence, anemia, and atrial fibrillation - can contribute to the worsening of heart failure.

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5.

Which of the following patient statements would alert you to an exacerbation of heart failure.

A.

Cough
B.

Change in usual SOB
C.

Palpitations
D.

Increased fatigue
E.

B and D
F.

All of the above

Correct Answer
F. All of the above

Explanation
All of the above patient statements would alert you to an exacerbation of heart failure. Cough can indicate fluid buildup in the lungs, which is a common symptom of heart failure. A change in usual shortness of breath (SOB) can indicate worsening heart function. Palpitations can be a sign of arrhythmias, which can occur during heart failure exacerbations. Increased fatigue can be a result of decreased cardiac output. Therefore, all of these symptoms should be taken seriously and may indicate a worsening of heart failure.

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6.

The American Heart Association guidelines for treating stage C and D systolic heart failure include:

A.

ACE inhibitors
B.

Calcium Channel blockers
C.

Fluid restriction of < 3 liters/day
D.

All of the above

Correct Answer
A. ACE inhibitors

Explanation
The American Heart Association guidelines for treating stage C and D systolic heart failure recommend the use of ACE inhibitors. ACE inhibitors are a class of medications that help relax blood vessels and lower blood pressure, reducing the workload on the heart. They are effective in improving symptoms and reducing mortality in patients with heart failure. Therefore, ACE inhibitors are a crucial component of the treatment plan for stage C and D systolic heart failure.

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7.

B-Type Natriuretic Peptide (BNP) decreases when heart failure worsens

A.

True
B.

False

Correct Answer
B. False

Explanation
BNP is a hormone released by the heart in response to increased pressure and stress. It is used as a biomarker to diagnose and monitor heart failure. When heart failure worsens, the heart is under more stress and therefore releases more BNP. Therefore, the statement that BNP decreases when heart failure worsens is incorrect.

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8.

What is true of both systolic and diastolic heart failure:

A.

Components of both are seen in most heart failure patients
B.

Symptoms of SOB, fluid retention and fatigue are common
C.

Neuro-hormonal and circulatory abnormalities
D.

Treatment differs between types
E.

All of the above
F.

A, B, and C.

Correct Answer
F. A, B, and C.

Explanation
Both systolic and diastolic heart failure have components that are seen in most heart failure patients. Symptoms such as shortness of breath, fluid retention, and fatigue are common in both types. Additionally, both types involve neuro-hormonal and circulatory abnormalities. The treatment for both types may differ, but the fact that all of the above options are true for both systolic and diastolic heart failure makes A, B, and C the correct answer.

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9.

Bradycardia, hypotension and bronchospasms are side effects seen in which of the following:

A.

ACE inhibitors
B.

ARB’s
C.

Aldosterone antagonists
D.

Beta blockers

Correct Answer
D. Beta blockers

Explanation
Beta blockers can cause bradycardia, hypotension, and bronchospasms as side effects. Bradycardia refers to a slow heart rate, hypotension is low blood pressure, and bronchospasms are the narrowing of the airways in the lungs. These side effects occur because beta blockers work by blocking the effects of adrenaline, which can slow down the heart rate, lower blood pressure, and cause constriction of the airways. Therefore, beta blockers can lead to these symptoms in patients who are taking them.

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10.

Desirable self-management behaviors include:

A.

Patient ability to state the purpose of medications
B.

Patient avoids foods with excess sodium
C.

Patient avoids NSAIDS
D.

Patient adequately manages co-morbid conditions
E.

All of the above

Correct Answer
E. All of the above

Explanation
The correct answer is "All of the above" because all the mentioned behaviors are desirable for self-management. The patient should be able to state the purpose of medications to ensure they understand why they are taking them. Avoiding foods with excess sodium is important for managing conditions like hypertension. Avoiding NSAIDs is necessary to prevent potential drug interactions or adverse effects. Adequately managing co-morbid conditions is crucial for overall health and well-being. Therefore, all these behaviors contribute to effective self-management.

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Integrated Chronic care Management For Congestive Heart Failure: Pre-test

The following is true of systolic heart failure.

The following is true of diastolic heart failure.

Patients with anemia and renal failure are more likely to experience rapid exacerbations.

Heart failure is known to worsen in the following conditions

Which of the following patient statements would alert you to an exacerbation of heart failure.

The American Heart Association guidelines for treating stage C and D systolic heart failure include:

B-Type Natriuretic Peptide (BNP) decreases when heart failure worsens

What is true of both systolic and diastolic heart failure:

Bradycardia, hypotension and bronchospasms are side effects seen in which of the following:

Desirable self-management behaviors include: