Heart Failure Module Post Test
(195).jpg "Heart Failure Module Post Test - Quiz")
Quiz accompanying Heart Failure module November, 2012.
- 1.A patient tells you that he needs 4 pillows to sleep at night but prefers to sleep in his recliner with the head elevated. This is an example of:
- A.
A. Dyspnea on Exertion
- B.
B. Orthopnea
- C.
C. Paroxysymal Nocturnal Dyspnea
- D.
D. Bronchitis
- 2.Mr. M arrives on your floor from the ER. He is on bedrest and denies chest pain; however, you notice that his O2 sats are 87% on 2L and he is unable to complete his sentences as he rests between each few words. He tells you that he knew something was wrong this morning because he was more short of breath than usual. He explains that he had to rest in between putting his clothes on. According to the NYHA classification he would be :
- A.
A. NYHA I
- B.
B. NYHA II
- C.
C. NYHA III
- D.
B. NYHA IV
- 3.A compensatory mechanism involved in HF that leads to inappropriate fluid retention and additional workload of the heart is:
- A.
A. Ventricular dilation
- B.
B. Ventricular hypertrophy
- C.
C. Neurohormonal response
- D.
D. Sympathetic nervous system activation
- 4.Signs and symptoms of heart failure may include all of the following except:
- A.
A. Confusion
- B.
B. Frequent belching
- C.
C. Anxiety and fatigue
- D.
D. Early satiety
- 5.Findings from the Randomized Aldactone Survival Study (RALES) indicate that the addition of spironolactone , an aldosterone antagonist, lowers mortality by inhibiting the release of Aldosterone. The following are true regarding Aldosterone except
- A.
A. It promotes sodium and water retention
- B.
B. Potassium levels should be monitored carefully because of the diuretic effects of aldosterone can lead to hypokalemia
- C.
C. It is considered a mild diuretic that may reverse remodeling
- D.
D. Recommended for patients with New York Heart Association (NYHA) class III or IV with a reduced LVEF
- 6.
- Which of the following is true regarding ACE-I and ARB and their mechanism of action?
- A.
A. ARB cause increased kinin and prostaglandin production
- B.
B. ACE-I inhibit the conversion of angiotensin I to angiotensin II
- C.
C. ACE-I work directly at the site of the angiotensin receptor
- D.
D. All of the above
- 7.Mr. Bigheart is admitted with HF NYHA class III. His echocardiogram shows an ejection fraction of 39%. According to the ACC/AHA guidelines, he should be placed on an evidence-based beta blocker. Which of the following is NOT an evidence–based beta blocker?
- A.
A. Sotolol
- B.
B. Bisoprolol
- C.
C. Carvedilol
- D.
D. Metoprolol Tartrate
- E.
E. A & D
- 8.Mr. Bigheart is readmitted 3 times over the next year. At his most recent admission, his echocardiogram shows his ejection fraction to be 20%. Which one of his findings would not make Mr. Bigheart a candidate for CRT?
- A.
A. Ejection fraction = 34%
- B.
B. EKG with QRS duration = 118ms
- C.
C. He has non-ischemic cardiomyopathy
- D.
D. He is > 85 years old
- 9.Quality Measures for Heart Failure have been instituted for Mr. Bigheart. The nurse notices that the patient is not on an ACE-I/ARB. The physician informs the nurse that the patient is allergic to an ACE-Inhibitor. Identify the correct statement below.
- A.
A. It is not a problem because the patient does not need to be on an ACE/ARB for this QM.
- B.
B. There should be documentation of an allergic reaction to both an ACE & ARB for this patient.
- C.
C. He does not need an ACE-I/ARB because he is going home on Bisoprolol
- D.
D. Both B & C
- 10.Which of the following symptoms is associated mainly with right – sided HF?
- A.
A. Neck vein distention
- B.
B. Tachypnea and dyspnea
- C.
C. Adventitious breath sounds
- D.
D. Orthopnea
- 11.An ACE Inhibitor causes which of the following to occur?
- A.
A. Increased vascular resistance
- B.
B. Vasoconstriction
- C.
C. Increase in sodium excretion
- D.
D. Decrease in heart rate
- 12.Ejection fraction can be assessed by :
- A.
A. Left ventriculogram during cardiac catheterization
- B.
B. Nuclear Imaging Study
- C.
C. Echocardiogram
- D.
D. All of the above
- 13.Only an MD can make an education referral to the Heart Failure Program.
- A.
A. True
- B.
B. False
- 14.A patient has been admitted 5 times over the last year with acute decompensated heart failure. An echocardiogram shows an EF of 38%. His QRS is 130ms. He would be a good candidate for CRT therapy.
- A.
A. True
- B.
B. False
- 15.While auscultating your patient’s heart sounds, you hear a harsh , systolic murmur in the aortic area. The patient was admitted with HF which may likely be related to his history of aortic stenosis.
- A.
A. True
- B.
B. False
- 16.Side effects of Beta-blockers include all of the following except:
- A.
A. Erectile dysfunction
- B.
B. Gynecomastia
- C.
C. Hypotenstion
- D.
D. Bradycardia
- 17.A patient tells you that he needs 4 pillows to sleep at night but prefers to sleep in his recliner with the head elevated. This is an example of:
- A.
A. Dyspnea on Exertion
- B.
B. Orthopnea
- C.
C. Paroxysymal Nocturnal Dyspnea
- D.
D. Bronchitis
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