ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 37 Questions
Question 1 of 5
The nurse is caring for an older-adult patient with heart failure and learns that the patient lives alone and sometimes confuses the 'water pill' with the 'heart pill.' When planning for the patient's discharge the nurse will facilitate which of the following actions?
Correct Answer: B
Rationale: The data about the patient suggest that assistance in developing a system for taking medications correctly at home is needed. A home health nurse will assess the patient's home situation and help the patient develop a method for taking the two medications as directed. There is no evidence that the patient requires services such as dementia care, long-term care, or around-the-clock home care.
Question 2 of 5
The nurse working in the heart failure clinic will know that teaching for a patient with newly diagnosed heart failure has been effective when the patient does which of the following actions?
Correct Answer: C
Rationale: Teaching for a patient with heart failure includes information about the need to weigh daily and notify the health care provider about an increase of more than 2 kg in a 2 day period. Nitroglycerin patches are used primarily to reduce preload (not to prevent chest pain) in patients with heart failure and should be used daily, not on an 'as necessary' basis. Diuretics should be taken earlier in the day to avoid nocturia and sleep disturbance. The patient should call the clinic if increased orthopnea develops, rather than just compensating by elevating the head of the bed further.
Question 3 of 5
The nurse is caring for a patient with right-sided heart failure who asks the nurse what caused the heart failure. Which of the following causes is the primary cause of right-sided heart failure?
Correct Answer: C
Rationale: The primary cause of right-sided failure is left-sided failure. In this situation, left-sided failure results in pulmonary congestion and increased pressure in the blood vessels of the lungs (pulmonary hypertension).
Question 4 of 5
The nurse is caring for a patient with heart failure with reduced ejection fraction. Which of the following values should the nurse expect to assess in the patient related to ejection fraction?
Correct Answer: A
Rationale: Normal EF is greater than 55% of the ventricular volume. Patients with HF-REF requiring specialist intervention generally have an EF less than or equal to 40%.
Question 5 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.