Cardiac output is composed of heart rate × stroke volume. Normal resting cardiac output is 4–5 liters per minute.
Question 2
A client is being prescribed lisinopril at discharge from the hospital by the health care provider. The discharge instructions by the nurse should include that lisinopril acts by doing which of the following?
Inhibits beta 1 and beta 2
Inhibits angiotensin-converting enzyme
Prevents the release of angiotensin
Blocks angiotensin II from activating angiotensin receptors
✓
Correct Answer
Blocks angiotensin II from activating angiotensin receptors
Lisinopril inhibits the enzyme that converts angiotensin I to angiotensin II.
Question 3
A client has been prescribed lisinopril 7.5 mg twice daily. The tablets are 2.5 mg. How many tablets should the client take per dose?
2 tablets
1 tablet
3 tablets
✓
4 tablets
Correct Answer
3 tablets
.
Question 4
A client with heart failure who had been taking valsartan recently had the medication switched to sacubitril/ valsartan. The client understands how valsartan works but is confused about sacubitril. The nurse explains that sacubitril:
Inhibits angiotensin-converting enzyme, which lowers blood pressure
Helps BNP stay in the system longer, which lowers blood pressure
✓
Lowers heart rate to allow for more oxygen to get to the heart muscle tissue
Causes nitric oxide to be released in smooth muscles, which lowers blood pressure
Correct Answer
Helps BNP stay in the system longer, which lowers blood pressure
Sacubitril inhibits neprilysin, which is an enzyme that breaks down BNP. BNP stimulates vasodilation and sodium and water excretion, which decrease afterload and preload, respectively.
Question 5
A client is taking valsartan, carvedilol, and spironolactone daily. What monitoring should the nurse educate the client about to ensure safe medication administration?
Electrolytes, because two of the medications cause a decrease in potassium
Electrolytes, because two of the medications cause an elevation in potassium
✓
Glucose, because the combination of medications can lower blood glucose
Uric acid, because the combination of medications can increase uric acid
Correct Answer
Electrolytes, because two of the medications cause an elevation in potassium
Valsartan and spironolactone can cause potassium to be reabsorbed in the nephron. Clients are at risk for hyperkalemia.
Question 6
A client with heart failure had a new medication added to their regimen, dapagliflozin. The nurse recognizes that this medication is effective through which mechanism?
Inhibiting alpha receptors in the arteries
Inhibiting sodium and glucose reabsorption
✓
Enhancing beta-1 receptors in the heart
Enhancing the release of BNP
Correct Answer
Inhibiting sodium and glucose reabsorption
Dapagliflozin is a sodium-glucose cotransporter 2 inhibitor and has received FDA approval for use in the treatment of heart failure.
Question 7
A client with heart failure has been prescribed furosemide 60 mg every morning. The tablets come in 40 mg. How many tablets should the client take each morning?
1½ tablets
✓
1 tablet
½ tablet
2 tablets
Correct Answer
1½ tablets
.
Question 8
A Black client with heart failure has recently had their medication regimen changed to the combination medication hydralazine and isosorbide dinitrate. What education does the nurse provide the client?
Hydralazine/isosorbide dinitrate works better than other heart failure medications for Black clients.
✓
This medication combination will cause better diuresis.
This medication regimen will increase afterload.
These two medications increase systemic vascular resistance.
Correct Answer
Hydralazine/isosorbide dinitrate works better than other heart failure medications for Black clients.
Research has shown that beta blockers and medications affecting the RAAS do not work as well in the treatment of heart failure for Black clients as hydralazine and isosorbide dinitrate do.
Question 9
The nurse is caring for a client with heart failure who takes digoxin. Which assessment finding should the nurse report to the health care provider prior to administering the drug?
Temperature 98.2°F
Blood pressure 124/78 mm Hg
Respiratory rate 16 breaths/minute
Heart rate 54 beats/minute
✓
Correct Answer
Heart rate 54 beats/minute
Digoxin is a cardiac glycoside and slows the heart rate. It can cause bradycardia. The health care provider should be notified before administering this drug.
Question 10
A nurse is providing education to a client who has a new prescription for ivabradine. The nurse knows the client has understood the instructions when the client makes which statement?
"I will take this medication right before I go to bed."
"I will take my blood pressure right before I take this medication."
"I will stop drinking grapefruit juice."
✓
"I will stop eating green, leafy vegetables."
Correct Answer
"I will stop drinking grapefruit juice."
Ivabradine is an I(f) current inhibitor. Grapefruit juice increases blood levels of ivabradine by inhibiting its metabolism. The excess amount of medication can intensify the medication's hypotensive effect, placing the client at an increased risk for syncopal episodes.