Chapter 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases

Chapter 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. Left-sided heart failure is characterized by
a. pulmonary congestion.
b. decreased systemic vascular resistance.
c. jugular vein distention.
d. peripheral edema.
ANS: A
Left-sided heart failure is characterized by pulmonary congestion and edema. Right-sided heart failure is characterized by
congestion in the systemic venous system that increases systemic vascular resistance. Jugular vein distention is a classic sign of
right-sided heart failure. Peripheral edema is seen in right-sided failure.
REF: Pg. 414
2. The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
a. afterload reduction.
b. -antagonist agents.
c. preload reduction.
d. digitalis.
ANS: D
Digitalis may be used for symptom management of heart failure. Cardiac glycosides directly inhibit the sodium-potassium pump
present in the cell membrane of all cells. The intracellular changes allow more calcium to remain in the cell, thus strengthening
myocardial contraction. Contractility is not improved through afterload reduction. Beta-blockers inhibit the effects of sympathetic
activation and have the potential to reduce cardiac output. Preload reduction is not the therapy of choice in improving cardiac
contractility.
REF: Pg. 418
3. Hypertrophy of the right ventricle is a compensatory response to
a. aortic stenosis.
b. aortic regurgitation.
c. tricuspid stenosis.
d. pulmonary stenosis.
ANS: D
Right ventricular hypertrophy is the direct result of pulmonary disorders that increase pulmonary vascular resistance and impose a
high afterload on the right ventricle. Aortic stenosis does not lead to right ventricular hypertrophy. Aortic regurgitation is not
associated with right ventricular hypertrophy. Hypertrophy of the right ventricle is not a compensatory response to tricuspid
stenosis.
REF: Pg. 411
4. The common denominator in all forms of heart failure is
a. poor diastolic filling.
b. reduced cardiac output.
c. pulmonary edema.
d. tissue ischemia.
ANS: B
The common manifestation of all forms of heart failure is the failure of the heart to pump blood adequately. The clinical
presentation may differ depending on which ventricle fails (left or right, or both). Poor diastolic filling is not seen in all forms of
heart failure. Pulmonary edema is seen in left-sided failure. Tissue ischemia is directly related to myocardial infarction, which may
induce heart failure.
REF: Pg. 413
5. Cor pulmonale refers to
a. biventricular failure.
b. left ventricular hypertrophy secondary to lung disease.
c. right ventricular hypertrophy secondary to pulmonary hypertension.
d. right ventricular failure secondary to right ventricular infarction.
ANS: C
Pulmonary disorders that result in increased pulmonary vascular resistance impose a high afterload on the right ventricle. The
resultant right ventricular hypertrophy known as cor pulmonale may progress to right ventricular failure as the lung disease worsens.
Biventricular failure is most often the result of primary left ventricular failure that progresses to the right. Cor pulmonale is not
associated with left ventricular hypertrophy. Only 3% of MIs occur in the right ventricle.