1.
Which set of symptoms represents the "classic triad" in heart failure?
Correct Answer
B. Dyspnea, fatigue, and edema
Explanation
The "classic triad" in heart failure refers to the three most common symptoms experienced by individuals with this condition. Dyspnea, which is shortness of breath or difficulty breathing, is a common symptom due to the heart's inability to pump enough blood to meet the body's oxygen demands. Fatigue is another common symptom as the heart's reduced pumping ability leads to decreased blood flow and oxygen delivery to the muscles and organs, causing a feeling of tiredness. Edema, which is the accumulation of fluid in the tissues, particularly in the legs, ankles, and feet, is also a common symptom of heart failure due to the heart's inability to adequately pump blood throughout the body, causing fluid to back up and accumulate.
2.
All of the following are common reasons for medication non-adherence in patients with heart failure except …
Correct Answer
A. Trouble swallowing pills because of laryngeal edema
Explanation
Patients with heart failure may experience difficulties with medication adherence due to various reasons such as the high cost of medications, lack of transportation to the pharmacy, and difficulty understanding prescription labels. However, trouble swallowing pills because of laryngeal edema is not a common reason for medication non-adherence in patients with heart failure. This suggests that the other factors mentioned are more significant in contributing to medication non-adherence in this patient population.
3.
Which symptom is least likely to be associated with heart failure?
Correct Answer
C. Non-pitting edema
Explanation
Non-pitting edema is the least likely symptom to be associated with heart failure. Edema refers to the accumulation of fluid in the tissues, which is a common symptom of heart failure. However, non-pitting edema is a type of edema that does not leave an indentation when pressure is applied to the swollen area. In heart failure, pitting edema is more commonly observed, where pressure on the swollen area causes an indentation. Therefore, non-pitting edema is less likely to be associated with heart failure.
4.
What is the rule of thumb for teaching patients when to report changes in weight for heart failure management?
Correct Answer
D. Gain of 3 pounds in one day or 5 pounds in one week
Explanation
Patients with heart failure should be taught to report a gain of 3 pounds in one day or 5 pounds in one week. Rapid weight gain can be a sign of fluid retention, which is a common problem in heart failure patients. Monitoring weight changes is important because it can indicate worsening heart failure and the need for adjustments in medication or treatment. This rule of thumb helps patients and healthcare providers identify when weight changes may be a cause for concern and prompt further evaluation or intervention.
5.
What is true about I’s and O’s in monitoring heart failure?
Correct Answer
D. A positive I/O balance means the patient has taken in more than put out
Explanation
A positive I/O balance means that the patient has consumed more fluids than they have eliminated. This can be determined by comparing the intake (fluids consumed) to the output (fluids eliminated). If the intake is greater than the output, it indicates a positive balance. This information is important in monitoring heart failure as it can help determine if the patient is retaining fluids, which can be a sign of worsening heart function.
6.
Patients with well-controlled heart failure should do all of the following except …
Correct Answer
A. Weigh themselves weekly
Explanation
Patients with well-controlled heart failure should do all of the following except report chest pain. Weighing themselves weekly is important for monitoring fluid retention, as sudden weight gain can be a sign of worsening heart failure. Taking their medication consistently is crucial for managing the condition and preventing complications. Following a low salt diet helps reduce fluid retention and manage blood pressure. However, reporting chest pain is more relevant for patients with uncontrolled heart failure, as it may indicate a heart attack or other serious cardiac issues.
7.
If a person with heart failure is restricted to 2000 mg of sodium daily, what is the maximum number of full servings of french fries (230 mg of sodium per serving) the person can have if that is all they eat on a given day (however inadvisable)?
Correct Answer
B. 8
Explanation
If a person with heart failure is restricted to 2000 mg of sodium daily, and each serving of french fries contains 230 mg of sodium, we can calculate the maximum number of servings they can have by dividing the daily sodium limit by the sodium content per serving. In this case, 2000 mg ÷ 230 mg = 8. Therefore, the person can have a maximum of 8 full servings of french fries if that is all they eat on a given day.
8.
Which food item would not count as a liquid in calculating fluid intake in patients with heart failure?
Correct Answer
B. Strawberries
Explanation
Strawberries would not count as a liquid in calculating fluid intake in patients with heart failure because they are a solid food item. Unlike liquids such as pudding, orange juice, or Jello, strawberries do not have a high water content and are not consumed in a liquid form. Therefore, they would not contribute to the overall fluid intake of a patient with heart failure.
9.
The intake of which of the following is not safe in patients with heart failure, even in moderation?
Correct Answer
C. Chewing tobacco
Explanation
Chewing tobacco is not safe in patients with heart failure, even in moderation. Chewing tobacco contains nicotine, which can increase heart rate and blood pressure, putting additional strain on the heart. It can also constrict blood vessels, reducing blood flow to the heart and increasing the risk of heart attacks. Chewing tobacco has been linked to various cardiovascular problems, including heart failure. Therefore, it is not recommended for patients with heart failure to consume chewing tobacco.
10.
What is always true about exercise in patients with heart failure?
Correct Answer
A. Patients should check with their doctor first
Explanation
It is always important for patients with heart failure to consult with their doctor before starting any exercise regimen. This is because the doctor can assess the patient's specific condition and provide personalized recommendations regarding the type, duration, and intensity of exercise that would be safe and beneficial for the patient. Exercise can have various effects on individuals with heart failure, and the doctor's guidance is crucial in order to ensure that the exercise program is appropriate and does not pose any risks to the patient's health.
11.
Which option is consistent with the New York Heart Association diagnosis of Class 3 heart failure?
Correct Answer
D. Symptoms with minimal exertion
Explanation
The New York Heart Association (NYHA) classifies heart failure into four classes based on the severity of symptoms. Class 3 heart failure is characterized by symptoms that occur with minimal exertion. This means that even slight physical activity can result in symptoms such as shortness of breath, fatigue, or chest pain. In contrast, symptoms at rest would indicate a more severe class of heart failure, while asymptomatic heart failure would suggest a milder form of the condition. Therefore, the option "Symptoms with minimal exertion" is consistent with the NYHA diagnosis of Class 3 heart failure.
12.
Acute diastolic heart failure may be treated with all of the following except:
Correct Answer
C. Dobutamine
Explanation
Dobutamine is a medication that increases the strength of the heart's contractions, making it useful in treating conditions like acute systolic heart failure. However, in the case of acute diastolic heart failure, the problem lies with the heart's ability to relax and fill with blood during the diastolic phase. Dobutamine does not directly address this issue, so it would not be an effective treatment for acute diastolic heart failure. Nitroglycerin, Lasix, and ultrafiltration, on the other hand, can help alleviate symptoms and improve outcomes in this condition.
13.
What is the most common class of medications in the chronic treatment of diastolic heart failure?
Correct Answer
A. Diuretics
Explanation
Diuretics are the most common class of medications in the chronic treatment of diastolic heart failure. Diastolic heart failure is characterized by impaired relaxation and filling of the heart, leading to fluid retention. Diuretics help to reduce fluid buildup in the body by increasing urine production and promoting the excretion of excess fluid. This helps to relieve symptoms such as edema and shortness of breath, and improve overall heart function. While other medications like ACE inhibitors, beta blockers, and angiotensin receptor blockers may also be used in the treatment of heart failure, diuretics are typically the first line of therapy for managing fluid overload.
14.
The mainstay of chronic treatment of patients with systolic heart failure may include…
Correct Answer
D. All of the above
Explanation
The mainstay of chronic treatment for patients with systolic heart failure may include angiotensin receptor blockers, implantable cardiac defibrillators, and diuretics. Angiotensin receptor blockers help to relax blood vessels, reduce blood pressure, and improve blood flow, which can alleviate symptoms of heart failure. Implantable cardiac defibrillators are used to monitor heart rhythms and deliver electric shocks if dangerous arrhythmias occur. Diuretics help to remove excess fluid from the body, reducing strain on the heart. Therefore, all of these treatment options can be utilized in the management of systolic heart failure.
15.
Biventricular pacemakers in patients with systolic heart failure are useful when…
Correct Answer
D. Walls are beating out of sync
Explanation
In patients with systolic heart failure, biventricular pacemakers are useful when the walls of the heart are beating out of sync. This condition, known as ventricular dyssynchrony, occurs when the right and left ventricles do not contract simultaneously, leading to inefficient pumping of blood. Biventricular pacemakers help to synchronize the contractions of both ventricles, improving heart function and reducing symptoms such as fatigue and shortness of breath.
16.
Which vital sign may become abnormal last in patients with acute heart failure?
Correct Answer
A. Oxygen saturation
Explanation
In patients with acute heart failure, oxygen saturation may become abnormal last. This is because oxygen saturation measures the amount of oxygen in the blood, and in acute heart failure, the heart is unable to pump blood effectively, leading to inadequate oxygenation. As a result, oxygen saturation levels may remain relatively normal until the condition progresses to a more severe stage. In contrast, heart rate, respiratory rate, and blood pressure are more likely to be affected earlier as the heart's ability to pump blood is compromised.
17.
Health literacy refers to one’s ability to…
Correct Answer
D. All of the above
Explanation
Health literacy refers to an individual's ability to read, understand, and act on health information. It encompasses all three aspects mentioned in the options: reading health information, understanding it, and then taking appropriate actions based on that information. Having health literacy is crucial for individuals to make informed decisions about their health, engage in preventive measures, and effectively manage their healthcare. Therefore, the correct answer is "All of the above."
18.
Palliative care is best described as…
Correct Answer
C. Symptom therapy not designed to cure
Explanation
Palliative care is a form of medical care that focuses on providing relief from the symptoms and suffering associated with a serious illness, rather than aiming to cure the illness itself. It aims to improve the quality of life for patients and their families by addressing physical, emotional, and spiritual needs. Palliative care can be provided alongside curative treatment, but its primary goal is to alleviate pain, manage symptoms, and enhance comfort, rather than seeking a cure.