Integrated Chronic care Management For Congestive Heart Failure: Post-test

1.

The following is true of systolic heart failure.
- A.
  
  The primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction
- B.
  
  Is a ventricle filling problem
- C.
  
  Equates to an ejection fraction of 55%
- D.
  
  A and B
- E.
  
  All of the above
Correct Answer
A. The primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction

Explanation
Systolic heart failure is a condition where the heart's ability to contract and pump blood is impaired. The primary cause of this condition is coronary artery disease, which leads to a reduced blood supply to the heart muscle, causing it to weaken and contract less effectively. This can result in a decreased ejection fraction, which is the percentage of blood pumped out of the heart with each contraction. Therefore, the correct answer is "A and B" - the primary cause of systolic heart failure is coronary artery disease causing impaired heart muscle contraction, and it is also a ventricle filling problem.

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2.

The following is true of diastolic heart failure.
- A.
  
  It is more common in women with hypertension
- B.
  
  Is a ventricle emptying problem
- C.
  
  Equates to an ejection fraction of 65%
- D.
  
  A and C
- E.
  
  B only
Correct Answer
A. It is more common in women with hypertension

Explanation
Diastolic heart failure refers to a condition where the ventricles of the heart have difficulty relaxing and filling with blood during the diastole phase of the cardiac cycle. This condition is more commonly observed in women who have hypertension, or high blood pressure. The presence of hypertension can lead to increased stiffness of the heart muscle, making it harder for the ventricles to relax and fill properly. Therefore, the correct answer is that diastolic heart failure is more common in women with hypertension.

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3.

Patients with anemia and renal failure are more likely to experience rapid exacerbations.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Patients with anemia and renal failure are more likely to experience rapid exacerbations because both conditions can contribute to a decrease in the oxygen-carrying capacity of the blood. Anemia reduces the number of red blood cells available to transport oxygen, while renal failure can impair the production of erythropoietin, a hormone necessary for red blood cell production. The combination of these factors can lead to a decreased oxygen supply to the body's tissues, making patients more vulnerable to sudden worsening of symptoms and complications.

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4.

Heart failure is known to worsen in the following conditions
- A.
  
  Infections like a UTI or pneumonia
- B.
  
  Medication non-adherence
- C.
  
  Anemia
- D.
  
  Atrial fibrillation
- E.
  
  All of the above
Correct Answer
E. All of the above

Explanation
Heart failure is a condition in which the heart is unable to pump enough blood to meet the body's needs. Infections like a UTI or pneumonia can worsen heart failure because they put additional strain on the heart and can cause fluid buildup in the lungs. Medication non-adherence can also worsen heart failure because it can lead to uncontrolled blood pressure and fluid retention. Anemia, a condition characterized by a decrease in red blood cells, can worsen heart failure because it reduces the amount of oxygen that can be delivered to the body's tissues. Atrial fibrillation, an irregular heart rhythm, can also worsen heart failure because it disrupts the heart's ability to effectively pump blood. Therefore, all of the above conditions can worsen heart failure.

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5.

Which of the following patient statements would alert you to an exacerbation of heart failure.
- A.
  
  Cough
- B.
  
  Change in usual SOB
- C.
  
  Palpitations
- D.
  
  Increased fatigue
- E.
  
  B and D
- F.
  
  All of the above
Correct Answer
F. All of the above

Explanation
All of the above patient statements would alert you to an exacerbation of heart failure. Cough, change in usual shortness of breath (SOB), palpitations, and increased fatigue are all common symptoms of heart failure exacerbation. These symptoms indicate that the heart is not pumping effectively, leading to fluid buildup in the lungs and other parts of the body. Monitoring and addressing these symptoms promptly can help prevent further complications and improve the patient's condition.

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6.

The American Heart Association guidelines for treating stage C and D systolic heart failure include:
- A.
  
  ACE inhibitors
- B.
  
  Calcium Channel blockers
- C.
  
  Fluid restriction of < 3 liters/day
- D.
  
  All of the above
Correct Answer
A. ACE inhibitors

Explanation
The American Heart Association guidelines for treating stage C and D systolic heart failure include the use of ACE inhibitors. ACE inhibitors are commonly prescribed medications that help to relax blood vessels and lower blood pressure, reducing the workload on the heart. They are known to improve symptoms, slow the progression of heart failure, and increase survival rates in patients with this condition. Therefore, ACE inhibitors are an important part of the treatment plan for stage C and D systolic heart failure.

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7.

B-Type Natriuretic Peptide (BNP) decreases when heart failure worsens
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
B-Type Natriuretic Peptide (BNP) is a hormone released by the heart in response to increased pressure and stretching of heart muscle cells, which occurs in heart failure. Therefore, BNP levels typically increase when heart failure worsens. Hence, the given statement is false.

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8.

What is true of both systolic and diastolic heart failure:
- A.
  
  Components of both are seen in most heart failure patients
- B.
  
  Symptoms of SOB, fluid retention and fatigue are common
- C.
  
  Neuro-hormonal and circulatory abnormalities
- D.
  
  Treatment differs between types
- E.
  
  All of the above
- F.
  
  A, B, and C.
Correct Answer
F. A, B, and C.

Explanation
Both systolic and diastolic heart failure have components that are seen in most heart failure patients. This means that both types of heart failure share common features and characteristics. Additionally, symptoms such as shortness of breath, fluid retention, and fatigue are common in both systolic and diastolic heart failure. Moreover, both types of heart failure are associated with neuro-hormonal and circulatory abnormalities. Therefore, all of the given options (A, B, and C) are true for both systolic and diastolic heart failure.

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9.

Bradycardia, hypotension and bronchospasms are side effects seen in which of the following:
- A.
  
  ACE inhibitors
- B.
  
  ARB’s
- C.
  
  Aldosterone antagonists
- D.
  
  Beta blockers
Correct Answer
D. Beta blockers

Explanation
Beta blockers are a class of medications that are commonly used to treat conditions such as high blood pressure and heart disease. Bradycardia, hypotension, and bronchospasms are potential side effects of beta blockers. Bradycardia refers to a slower than normal heart rate, hypotension refers to low blood pressure, and bronchospasms refer to the tightening of the airways in the lungs. These side effects can occur due to the way beta blockers work in the body, specifically by blocking the effects of adrenaline on the heart and blood vessels.

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10.

Desirable self-management behaviors include:
- A.
  
  Patient ability to state the purpose of medications
- B.
  
  Patient avoids foods with excess sodium
- C.
  
  Patient avoids NSAIDS
- D.
  
  Patient adequately manages co-morbid conditions
- E.
  
  All of the above
Correct Answer
E. All of the above

Explanation
The given answer "All of the above" is correct because it encompasses all the desirable self-management behaviors mentioned in the list. These behaviors include the patient's ability to state the purpose of medications, avoiding foods with excess sodium, avoiding NSAIDS, and adequately managing co-morbid conditions. Therefore, choosing "All of the above" indicates that all of these behaviors are considered desirable for self-management.

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Integrated Chronic care Management For Congestive Heart Failure: Post-test

The following is true of systolic heart failure.

The following is true of diastolic heart failure.

Patients with anemia and renal failure are more likely to experience rapid exacerbations.

Heart failure is known to worsen in the following conditions

Which of the following patient statements would alert you to an exacerbation of heart failure.

The American Heart Association guidelines for treating stage C and D systolic heart failure include:

B-Type Natriuretic Peptide (BNP) decreases when heart failure worsens

What is true of both systolic and diastolic heart failure:

Bradycardia, hypotension and bronchospasms are side effects seen in which of the following:

Desirable self-management behaviors include: