ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 37 Questions
Question 1 of 5
The nurse is caring for a patient with chronic heart failure. Which of the following conditions is a cause of chronic heart disease?
Correct Answer: D
Rationale: Congenital heart disease is a cause of chronic heart failure. Dysrhythmias, pulmonary embolus, and myocarditis are causes of acute heart failure.
Question 2 of 5
The nurse is caring for a patient who is receiving IV furosemide and morphine for the treatment of acute decompensated heart failure (ADHF) with severe orthopnea. When evaluating the patient response to the medications, which of the following is the best indicator that the treatment has been effective?
Correct Answer: D
Rationale: Because the patient's major clinical manifestation of ADHF is orthopnea (caused by the presence of fluid in the alveoli), the best indicator that the medications are effective is a decrease in dyspnea with the head of bed at 30 degrees. The other assessment data also may indicate that diuresis or improvement in cardiac output has occurred but are not as specific to evaluating this patient's response.
Question 3 of 5
Which topic will the nurse plan to include in discharge teaching for a patient with systolic heart failure and an ejection fraction of 38%?
Correct Answer: D
Rationale: The core measure for the treatment of heart failure in patients with a low ejection fraction is to receive an ACE inhibitor to decrease the progression of heart failure. Aerobic exercise may not be appropriate for a patient with this level of heart failure, salt substitutes are not usually recommended because of the risk of hyperkalemia, and the patient will need to see the primary care provider more frequently than annually.
Question 4 of 5
The nurse is conducting a health history on a patient with heart failure. Which of the following conditions in the patient's health history is a precipitating cause of heart failure?
Correct Answer: B
Rationale: Anemia is a precipitating cause of heart failure. Also, hypovolemia and hypothyroidism are precipitating causes. Diabetes is not a precipitating cause of heart failure.
Question 5 of 5
A patient who has chronic heart failure tells the nurse, 'I felt fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!' Which of the following information should the nurse document related to this assessment?
Correct Answer: D
Rationale: Paroxysmal nocturnal dyspnea is caused by the reabsorption of fluid from dependent body areas when the patient is sleeping and is characterized by waking up suddenly with the feeling of suffocation. Pulsus alternans is the alternation of strong and weak peripheral pulses during palpation. Orthopnea indicates that the patient is unable to lie flat because of dyspnea. Pleural effusions develop over a longer time period.