Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
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Chapter 28, Caring for Clients With Heart Failure
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The nurse is preparing a client for a multiple gated acquisition (MUGA) scan. What would be an important instruction for the nurse to give a client who is to undergo a MUGA scan? |
| A) | Avoid any activity at least 2 hours before the test. |
| B) | Drink plenty of fluids during the test. |
| C) | Avoid dairy products a day before and a day after the test. |
| D) | Lie very still at intermittent times during the test. |
| Ans: | D |
| Feedback: | |
| The nurse should instruct the client, who is to undergo a MUGA scan, to lie very still at intermittent times during the 45-minute test. The client need not to drink plenty of fluids, avoid activities before or after the test, or avoid dairy products during the test. |
| 2. | You are caring for a client with suspected right-sided heart failure. What would you know that clients with suspected right-sided heart failure may experience? |
| A) | Increased urine output |
| B) | Gradual unexplained weight gain |
| C) | Increased perspiration |
| D) | Sleeping in a chair or recliner |
| Ans: | B |
| Feedback: | |
| Clients with right-sided heart failure may have a history of gradual, unexplained weight gain from fluid retention. Left-sided heart failure produces paroxysmal nocturnal dyspnea, which may prompt the client to use several pillows in bed or to sleep in a chair or recliner. Right-sided heart failure does not cause increased perspiration or increased urine output. |
| 3. | A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion? |
| A) | Assess for reduced urine output. |
| B) | Assess for reduced blood sodium levels. |
| C) | Assess for elevated blood potassium levels. |
| D) | Assess for elevated blood urea nitrogen levels. |
| Ans: | D |
| Feedback: | |
| Elevated blood urea nitrogen indicates impaired renal perfusion in a client with left-sided heart failure. Serum sodium levels may be elevated. Reduced urine output or elevated blood potassium levels do not indicate impaired renal perfusion in a client with left-sided heart failure. |
| 4. | The student nurse is caring for a client with heart failure. Diuretics have been ordered. What method might be used with a debilitated patient to help the nurse evaluate the client’s response to diuretics? |
| A) | Using mechanical ventilation |
| B) | Using a urinary catheter |
| C) | Using a pulmonary artery catheter |
| D) | Using a biventricular pacemaker |
| Ans: | B |
| Feedback: | |
| To evaluate response to diuretics, a urinary catheter is used. Mechanical ventilation helps maintain a normal breathing pattern. A pulmonary artery catheter helps estimate cardiac output. A biventricular pacemaker is used to sustain life. |
| 5. | You are working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for you to closely monitor an older adult receiving digitalis preparations for cardiac disorders? |
| A) | Older adults are at increased risk for toxicity. |
| B) | Older adults are at increased risk for cardiac arrests. |
| C) | Older adults are at increased risk for hyperthyroidism. |
| D) | Older adults are at increased risk for asthma. |
| Ans: | A |
| Feedback: | |
| Older adults receiving digitalis preparations are at increased risk for toxicity because of the decreased ability of the kidneys to excrete the drug due to age-related changes. The margin between a therapeutic and toxic effect of digitalis preparations is narrow. Using digitalis preparations does not increase the risk of cardiac arrests, hyperthyroidism, or asthma. |
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