Integrated Chronic care Management For Congestive Heart Failure 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
The correct answer is "All of the above." Systolic heart failure can be caused by coronary artery disease, which impairs the heart muscle's ability to contract effectively. It can also be characterized by a ventricle filling problem, meaning that the heart is unable to fill with enough blood to pump out effectively. Additionally, systolic heart failure is often associated with a reduced ejection fraction, which is the percentage of blood pumped out of the heart with each contraction. Therefore, all of the statements mentioned in the answer are true for systolic heart failure.

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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 relaxing and filling with blood during the diastolic phase of the cardiac cycle. This condition is more common in women with hypertension, as high blood pressure can lead to increased stiffness of the heart muscle and impaired relaxation. The statement "It is more common in women with hypertension" accurately explains a characteristic of diastolic heart failure.

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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 anemia reduces the oxygen-carrying capacity of the blood, leading to tissue hypoxia. Renal failure further exacerbates this condition by impairing the production of erythropoietin, a hormone responsible for red blood cell production. As a result, these patients are more susceptible to worsening symptoms and complications, which can lead to rapid exacerbations of their condition.

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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 known to worsen in the presence of certain conditions. Infections such as a urinary tract infection (UTI) or pneumonia can put additional strain on the heart, leading to a worsening of heart failure symptoms. Medication non-adherence can also contribute to the deterioration of heart failure, as it can lead to inadequate management of the condition. Anemia, a condition characterized by a decrease in red blood cells, can further compromise the heart's ability to pump blood effectively. Lastly, atrial fibrillation, a type of irregular heart rhythm, can also exacerbate heart failure. Therefore, all of the mentioned conditions 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. Coughing can be a symptom of fluid accumulation in the lungs, which is a common sign of heart failure worsening. A change in usual shortness of breath (SOB) can indicate that the heart is not pumping effectively and fluid is building up. Palpitations can be a sign of irregular heartbeats, which can occur during heart failure exacerbation. Increased fatigue can be a result of decreased cardiac output and inadequate oxygen supply to the body's tissues, which is common in heart failure exacerbation. Therefore, all of these symptoms should raise concern for worsening 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 correct answer is ACE inhibitors. ACE inhibitors are recommended by the American Heart Association for treating stage C and D systolic heart failure. These medications help to relax blood vessels and lower blood pressure, reducing the workload on the heart. They also help to prevent further damage to the heart and improve overall heart function. Calcium channel blockers may be used in certain cases, but they are not a standard treatment for stage C and D heart failure. Fluid restriction is also recommended, but the specific limit of < 3 liters/day is not mentioned in the guidelines.

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7.

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

A.

True
B.

False

Correct Answer
B. False

Explanation
B-Type Natriuretic Peptide (BNP) is a hormone that is released by the heart in response to increased pressure and stretching of the heart muscle. It is used as a diagnostic marker for heart failure because its levels increase when the heart is not pumping effectively. Therefore, the correct answer is False because BNP levels actually increase when heart failure worsens, not decrease.

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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 share common components that are seen in most heart failure patients. These components include symptoms such as shortness of breath (SOB), fluid retention, and fatigue. Additionally, both types of heart failure involve neuro-hormonal and circulatory abnormalities. Therefore, all of the options A, B, and C are true for both systolic and diastolic heart failure.

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9.

Three classes of medication that can exacerbate heart failure are:

A.

Antiarrhythmics, ACE, Calcium channel blockers
B.

NSAIDS, antiarrthythmics, calcium channel blockers
C.

Beta blockers, calcium channel blockers, NSAIDS

Correct Answer
B. NSAIDS, antiarrthythmics, calcium channel blockers

Explanation
NSAIDs (nonsteroidal anti-inflammatory drugs), antiarrhythmics, and calcium channel blockers can exacerbate heart failure. NSAIDs can cause fluid retention and increase blood pressure, putting additional strain on the heart. Antiarrhythmics can have negative effects on heart function and worsen heart failure symptoms. Calcium channel blockers can also lead to fluid retention and may decrease the heart's ability to pump effectively. Therefore, these three classes of medications can potentially worsen heart failure and should be used with caution in patients with this condition.

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10.

A 2010 recommendation by the HFSA is for patients to assess and record their shortness of breath at rest or at a consistent level of activity using the modified Borg scale.

A.

True
B.

False

Correct Answer
A. True

Explanation
The given statement is true. In 2010, the HFSA (Heart Failure Society of America) recommended that patients should assess and record their shortness of breath at rest or at a consistent level of activity using the modified Borg scale. This scale is a subjective measure that allows individuals to rate their perceived level of breathlessness. By regularly monitoring and recording their shortness of breath, patients can provide valuable information to healthcare professionals for better management and treatment of their condition.

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