Naplex Quiz On Heart Failure! Exam
- 1.
Which of the following are cardiotoxic drugs?
- A.
Daunorubicin
- B.
Cyclophosphamide
- C.
Allopurinol
- D.
Ethanol
- E.
Trastuzumab and imatinib
- F.
Chlordiazepoxide
- G.
Lisinopril
Correct Answer(s)
A. Daunorubicin
B. CyclopHospHamide
D. Ethanol
E. Trastuzumab and imatinib -
- 2.
A patient with cardiac disease that has fatigue, palpitations, dyspnea, and/or angina after a 15-minute brisk walk (resulting in slight limitations of physical activity) would fit best in what category of HF according to the NYHA?
- A.
Class I
- B.
Class II
- C.
Class III
- D.
Class IV
Correct Answer
B. Class IIExplanation
This pt has slight limitations of physical activity. Class I has no limitations; class III has marked limitations (minimal exertion will lead to symptoms).Rate this question:
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- 3.
A patient with hypertension, CAD, or diabetes would fit into what heart failure classification scheme according to the American College of Cardiology and the American Heart Association?
- A.
Stage A
- B.
Stage B
- C.
Stage C
- D.
Stage D
Correct Answer
A. Stage AExplanation
Stage A includes pts at high risk of developing heart failure, but without presence of sx that are strongly associated with heart failure. According to this classifcation, neither pts in Stage A or B actually have heart failure.Rate this question:
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- 4.
If a pt is considered "warm and wet", this means...
- A.
The pt recently fell into a hot tub
- B.
The pt has adequate perfusion and no s/s of volume overload.
- C.
The pt has inadequate perfusion and no s/s of volume overload.
- D.
The pt has adequate perfusion but s/s of volume overload.
- E.
The pt has inadequate perfusion and no s/s of volume overload.
Correct Answer
D. The pt has adequate perfusion but s/s of volume overload.Explanation
About 70% of pts are assigned to the warm and wet classification.Rate this question:
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- 5.
Which of the following statements is false?
- A.
NSAIDs, glucocorticoids, rosiglitazone, and pioglitazone may worsen HF by causing sodium and water retention.
- B.
HF is the only major CVD that is INCREASING is prevalence.
- C.
The primary manifestations of HF are dyspnea/fatigue that may limit physical activity and fluid retention.
- D.
Orthopnea, tachypnea, cough, ascites, jugular venous distention, hepatomegaly, and S3 gallop are other symptoms of HF.
- E.
Pts with a LVEF less than 55% are generally considered to have systolic function.
- F.
Pts with dyspnea secondary to HF will have elevated plasma BNP concentrations.
Correct Answer
E. Pts with a LVEF less than 55% are generally considered to have systolic function. -
- 6.
Which of the following is true regarding loop diuretics?
- A.
May cause hypokalemia and hypomagnesmia
- B.
NSAIDs may diminish the medication's diuretic effect
- C.
Food decreases the bioavailability of furosemide and bumetanide
- D.
Pts allergic to sulfa-containing meds may be allergic to loop diuretics
- E.
Pt's may need to wear sunscreen while taking med
Correct Answer(s)
A. May cause hypokalemia and hypomagnesmia
B. NSAIDs may diminish the medication's diuretic effect
C. Food decreases the bioavailability of furosemide and bumetanide
D. Pts allergic to sulfa-containing meds may be allergic to loop diuretics
E. Pt's may need to wear sunscreen while taking medExplanation
Loop diuretics are known to cause hypokalemia and hypomagnesemia, which means that they can lead to low levels of potassium and magnesium in the body. Additionally, the diuretic effect of loop diuretics can be diminished by NSAIDs. Food intake can also decrease the bioavailability of furosemide and bumetanide, making the medication less effective. Some patients who are allergic to sulfa-containing medications may also be allergic to loop diuretics. Lastly, loop diuretics can make the skin more sensitive to sunlight, so patients may need to wear sunscreen while taking the medication.Rate this question:
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- 7.
Match the ACE inhibitor to its brand/generic.
- A.
Enalapril - Vasotec
- B.
Ramipril - Altace
- C.
Captopril - Zestril
- D.
Quinapril - Accupril
- E.
Perindopril - Aceon
- F.
Trandolapril - Mavik
Correct Answer(s)
A. Enalapril - Vasotec
B. Ramipril - Altace
D. Quinapril - Accupril
E. Perindopril - Aceon
F. Trandolapril - MavikExplanation
Captopril's brand name is Capoten (often given TID). Lisinopril's brand name is Zestril or Prinivil.Rate this question:
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- 8.
Which of the following are true regarding ACE inhibitors?
- A.
ACEIs reduce mortality by 20-30% and slow the progression of HF
- B.
Captopril should be taken on an empty stomach, either 1 hour before or 2 hours after meals
- C.
Use of salt substitutes that contain potassium should be encouraged
- D.
Cyclosporine and tacrolimus may increase the risk of nephrotoxicity and hyperkalemia
- E.
ACEIs are pregnancy category A during the first trimester, but pregnancy category B during the second and third trimesters
Correct Answer(s)
A. ACEIs reduce mortality by 20-30% and slow the progression of HF
B. Captopril should be taken on an empty stomach, either 1 hour before or 2 hours after meals
D. Cyclosporine and tacrolimus may increase the risk of nepHrotoxicity and hyperkalemiaExplanation
Additional potassium should be used cautiously (not encouraged). ACEIs are pregnancy category C during the 1st trimester and pregnancy category D during the second and third trimesters.Rate this question:
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- 9.
Which of the following is fale regarding ARBs?
- A.
Current guidelines recommend candesartan or valsartan for pts that can't take ACEIs
- B.
Candesartan's brand name is Micardis
- C.
Valsartan's brand name is Diovan
- D.
ARBs are as likely as ACEIs to cause impaired renal function, hyperkalemia, & hypotension
Correct Answer
B. Candesartan's brand name is MicardisExplanation
The given statement is true. Candesartan's brand name is indeed Micardis.Rate this question:
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- 10.
Which of the following beta-blockers has been shown to reduce mortality and should be used in all stable pts with current/prior HF sx and reduced LVEF, unless CI?
- A.
Immediate release metoprolol
- B.
Extended release metoprolol
- C.
Labetalol
- D.
Bisoprolol
- E.
Carvedilol
- F.
Esmolol
Correct Answer(s)
B. Extended release metoprolol
D. Bisoprolol
E. CarvedilolExplanation
Extended release metoprolol, bisoprolol, and carvedilol have all been shown to reduce mortality and should be used in all stable patients with current/prior heart failure symptoms and reduced left ventricular ejection fraction, unless there are contraindications. These beta-blockers have demonstrated efficacy in improving symptoms, reducing hospitalizations, and prolonging survival in patients with heart failure.Rate this question:
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- 11.
Which of the following is a false counseling point for a patient taking beta-blockers for heart failure...
- A.
Take carvedilol with food
- B.
Beta blockers may cause worsening of HF and fluid retention upon initiation or dose titration, so weigh yourself regularly to assess for fluid overload
- C.
Fatigue or weakness may occur initially, but should resolve within a few weeks
- D.
Beta blockers can mask the signs of hypoglycemia (all except sweating)
- E.
Be sure to take your medication as directed, it is important because beta blockers can decrease the risk of death and hospitalization associated with HF
- F.
None - all of the above are true counseling points
Correct Answer
F. None - all of the above are true counseling pointsExplanation
All of the counseling points mentioned for a patient taking beta-blockers for heart failure are true. Carvedilol should be taken with food to enhance its absorption. Beta blockers may initially cause worsening of heart failure and fluid retention, so regular weighing can help assess for fluid overload. Fatigue or weakness may occur initially but should resolve within a few weeks. Beta blockers can mask the signs of hypoglycemia except sweating. It is important to take the medication as directed because beta blockers can decrease the risk of death and hospitalization associated with heart failure.Rate this question:
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- 12.
___________ is eliminated 50% by the kidneys. While ___________ and ___________ are metabolized by the liver.
- A.
Carvedilol; bisoprolol and metoprolol
- B.
Metoprolol, carvedilol and metoprolol
- C.
Bisoprolol; metoprolol and carvedilol
Correct Answer
C. Bisoprolol; metoprolol and carvedilolExplanation
Bisoprolol is eliminated 50% by the kidneys, while metoprolol and carvedilol are metabolized by the liver.Rate this question:
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- 13.
A patient should be stable (minimal fluid overload/volume retention) before initiating a beta blocker.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Before initiating a beta blocker, it is important for a patient to be stable in terms of fluid overload and volume retention. This is because beta blockers can potentially worsen these conditions. By ensuring that the patient is stable, the risk of exacerbating fluid overload or volume retention can be minimized, making it safer to initiate a beta blocker treatment. Therefore, the statement is true.Rate this question:
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- 14.
What is the brand name for Eplerenone?
Correct Answer
inspra
InspraExplanation
Inspra is the brand name. Spironolactone's brand name is Aldactone.Rate this question:
- 15.
Zebeta is the brand name for which drug?
- A.
Metoprolol
- B.
Eplerenone
- C.
Diltiazem
- D.
Bisoprolol
- E.
Digoxin
Correct Answer
D. BisoprololExplanation
Coreg - carvedilol. Toprol - metoprolol.Rate this question:
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- 16.
What is the effect if paroxetine/fluoxetine are used with metoprolol/carvedilol?
- A.
Possible increased SSRI concentrations
- B.
Possible decreased SSRI concentrations
- C.
Possible increased plasma concentrations of the beta blocker
- D.
Possible decreased plasma concentrations of the beta blocker
- E.
No drug interaction
Correct Answer
C. Possible increased plasma concentrations of the beta blockerExplanation
When paroxetine/fluoxetine are used with metoprolol/carvedilol, there is a potential for increased plasma concentrations of the beta blocker. This means that the levels of the beta blocker in the blood may be higher than usual, leading to an increased effect of the medication. This interaction could potentially result in an intensified therapeutic response or increased side effects of the beta blocker. It is important to monitor patients closely for any signs of toxicity or adverse effects when these medications are used together.Rate this question:
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- 17.
Which of the following is true regarding aldosterone antagonists?
- A.
May cause bronchoconstriction in patients with COPD
- B.
Spironolactone can increase digoxin plasma concentrations
- C.
Eplerenone undergoes hepatic metabolism via P450
- D.
Eplerenone can cause gynecomastia
- E.
Serum creatinine should be < 2.5 mg/dL in men or < 2 mg/dL in women before intiating therapy
Correct Answer(s)
B. Spironolactone can increase digoxin plasma concentrations
C. Eplerenone undergoes hepatic metabolism via P450
E. Serum creatinine should be < 2.5 mg/dL in men or < 2 mg/dL in women before intiating therapyExplanation
Spironolactone can increase digoxin plasma concentrations because it inhibits the renal excretion of digoxin, leading to increased levels of digoxin in the blood. Eplerenone undergoes hepatic metabolism via P450 enzymes, which means that it is metabolized in the liver by these enzymes. Serum creatinine should be < 2.5 mg/dL in men or < 2 mg/dL in women before initiating therapy with aldosterone antagonists because elevated creatinine levels may indicate impaired renal function, which can increase the risk of adverse effects associated with these medications.Rate this question:
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- 18.
Major adverse events with digoxin occur in three body systems. Which of the following is NOT included?
- A.
Pulmonary (upper respiratory tract infections, cough)
- B.
Carviovascular (cardiac arrhythmias, bradycardia, heart block)
- C.
GI (anorexia, abdominal pain, N/V)
- D.
Neurological (visual disturbances, disorientation, confusion, fatigue)
Correct Answer
A. Pulmonary (upper respiratory tract infections, cough)Explanation
The correct answer is "Pulmonary (upper respiratory tract infections, cough)". This option is not included because it does not represent a major adverse event associated with digoxin. Digoxin primarily affects the cardiovascular system, causing cardiac arrhythmias, bradycardia, and heart block. It also affects the gastrointestinal system, leading to symptoms such as anorexia, abdominal pain, and nausea/vomiting. Additionally, digoxin can have neurological effects, including visual disturbances, disorientation, confusion, and fatigue. However, it does not typically cause upper respiratory tract infections or cough.Rate this question:
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- 19.
If quinidine, verapamil, or amiodarone is added to a drug regimen with digoxin, the dose of digoxin should be _______ by 50%.
- A.
Increased
- B.
Decreased
Correct Answer
B. DecreasedExplanation
When quinidine, verapamil, or amiodarone are added to a drug regimen with digoxin, these medications can inhibit the clearance of digoxin from the body, leading to increased levels of digoxin. This can result in digoxin toxicity. To prevent this, the dose of digoxin should be decreased by 50% when these medications are added to the regimen.Rate this question:
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- 20.
Which of the following are true regarding heart failure?
- A.
Verapamil and diltiazem can precipitate or worsen heart failure
- B.
Digoxin goal plasma concentrations is 2.5-5 ng/mL
- C.
Patients with ADHF often require IV diuretics, vasodilators, and negative inotropes
- D.
Headache, dizziness, and GI complaints are common adverse effects with hydralazine-isosorbide dinitrate
- E.
No loading dose of digoxin is needed in HF; in fact, lower doses (0.125mg QOD) may need to be used in the elderly
Correct Answer(s)
A. Verapamil and diltiazem can precipitate or worsen heart failure
D. Headache, dizziness, and GI complaints are common adverse effects with hydralazine-isosorbide dinitrate
E. No loading dose of digoxin is needed in HF; in fact, lower doses (0.125mg QOD) may need to be used in the elderlyExplanation
Digoxin - 0.5 - 1
Pts with ADHF often require POSITIVE inotropes (dopamine, dobutamine, milrinone)Rate this question:
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- 21.
Demadex is the brand name for ________.
- A.
Milrinone
- B.
Dobutamine
- C.
Hydralazine-Isosorbide
- D.
Torsemide
- E.
Nesiritide
Correct Answer
D. TorsemideExplanation
Demadex is a brand name for Torsemide. Torsemide is a loop diuretic medication that is used to treat edema (fluid retention) caused by conditions such as congestive heart failure, kidney disease, or liver disease. It works by increasing urine production and reducing the amount of excess fluid in the body. Torsemide is commonly prescribed to help reduce swelling and fluid buildup in patients with these conditions.Rate this question:
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Current Version
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Mar 22, 2023Quiz Edited by
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Apr 21, 2012Quiz Created by
Caitlinb
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