Questions 39

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Exam for RN Cardiovascular NCLEX Exam Questions

Extract:

The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.


Question 1 of 5

For each medication, choose the most likely option for drug classification and mechanism of action for heart failure: Spironolactone, Sacubitril/Valsartan, Dapagliflozin

Medications Drug classification
Spironolactone: MRA, Blocks aldosterone effects
Sacubitril/Valsartan: ARNI, Blocks RAAS and neprilysin
Dapagliflozin: SGLT2 inhibitor, Causes osmotic diuresis

Correct Answer: A,B,C

Rationale: Spironolactone: MRA (Mineralocorticoid Receptor Antagonist) blocks aldosterone, reducing fluid retention. Sacubitril/Valsartan: ARNI blocks RAAS and neprilysin, improving vasodilation and diuresis. Dapagliflozin: SGLT2 inhibitor causes osmotic diuresis, reducing fluid overload.

Extract:


Question 2 of 5

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Question 3 of 5

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Question 4 of 5

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Question 5 of 5

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