Chapter 20, Heart Failure

Chapter NCLEX-Style Review Questions

1. A 56-year-old male presented to the emergency department with chest pain and shortness of breath that occurred suddenly. He was admitted to the unit for management of a myocardial infarction and heart failure. Measurement of his heart size and ejection fraction (EF) at the catheterization showed an EF of 30% and a normal size heart. Which of the following statements best describes acute heart failure?

a. Symptoms develop gradually over months.

b. Symptoms develop quickly over hours to days.

c. Symptoms occur with exertion.

d. Symptoms are minimal even with exertion.

2. Which of the following statements describes the relationship between heart failure and cardiomyopathy?

a. Heart failure is synonymous with cardiomyopathy.

b. Heart failure is caused by a cardiomyopathy.

c. Cardiomyopathy is caused by heart failure.

d. Heart failure and cardiomyopathy are unrelated. 3. At discharge, a patient was started on an ACE inhibitor and a beta-blocker as

well as eplerenone. Which of the following statements best describes the

benefit of ACE inhibitors in the treatment of heart failure with decreased left

ventricular function?

a. ACE inhibitors block catecholamines and decrease blood pressure.

b. ACE inhibitors block the renin–angiotensin system.

c. ACE inhibitors block the effect of prostaglandins.

d. ACE inhibitors block beta-adrenergic receptors.

4. A 73-year-old woman is admitted with acute decompensation of chronic heart failure. She is unable to lie flat in bed and has been sleeping in a recliner for 3 nights. On examination, the admitting physician states that “her PA pressures must be really high.” Which of the following assessment findings is consistent with increased pulmonary artery (PA) pressures in a patient with ADHF?

a. Atrial fibrillation

b. Cold clammy skin

c. Orthostatic hypotension

d. Orthopnea 5. A patient has a history of recurrent gout for which she was recently treated.

Common treatment for gout includes colchicine, allopurinol, ibuprofen, or corticosteroids. The admitting physician suggests that her current decompensation is related to the treatment for her gout. Which of the following classes of drugs should be avoided in patients with heart failure?

a. Beta-blockers

b. Aminoglycosides

c. NSAIDs

d. Beta-agonists