When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?
- A. Decreased blood pressure
- B. Increased heart rate
- C. Increased cardiac output
- D. Decreased heart rate
Correct Answer: C
Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors work by dilating blood vessels and reducing the workload on the heart. This leads to improved cardiac output, as the heart can pump more efficiently. Decreased blood pressure (choice A) is a common side effect due to vasodilation. Increased heart rate (choice B) and decreased heart rate (choice D) are not expected outcomes of ACE inhibitor use. Therefore, the most appropriate and expected outcome of administering an ACE inhibitor in heart failure is an increase in cardiac output, making choice C the correct answer.
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Which order should the nurse question?
- A. The addition of a loop diuretic with digoxin.
- B. The addition of a beta blocker with digoxin.
- C. A digoxin dose of 0.125 mg per day.
- D. The addition of an ACE inhibitor with digoxin.
Correct Answer: B
Rationale: The correct answer is B: The addition of a beta blocker with digoxin. When combined, beta blockers can enhance the effects of digoxin, leading to an increased risk of bradycardia and heart block. This combination can also exacerbate digoxin toxicity. Therefore, the nurse should question the addition of a beta blocker with digoxin to prevent potential adverse effects.
Incorrect choices:
A: The addition of a loop diuretic with digoxin - Loop diuretics may lead to hypokalemia, which can increase the risk of digoxin toxicity.
C: A digoxin dose of 0.125 mg per day - This is within the recommended dose range for digoxin and does not pose a significant concern.
D: The addition of an ACE inhibitor with digoxin - ACE inhibitors are commonly used in combination with digoxin and do not typically interact negatively.
Which neurotransmitter is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction of the heart?
- A. Norepinephrine
- B. Epinephrine
- C. Dopamine
- D. Acetylcholine
Correct Answer: A
Rationale: The correct answer is A: Norepinephrine. Norepinephrine is released by the sympathetic nervous system (SNS) to increase heart rate and the force of contraction. This neurotransmitter acts on beta-1 adrenergic receptors in the heart, leading to these effects. Epinephrine (choice B) is also released by the SNS and acts similarly to norepinephrine but is not as specific for the heart's beta-1 receptors. Dopamine (choice C) primarily acts as a precursor to norepinephrine and epinephrine and does not directly increase heart rate or force of contraction. Acetylcholine (choice D) is released by the parasympathetic nervous system and decreases heart rate and the force of contraction.
Nurse's role in management of client with permanent pacemaker implant.
- A. Monitoring
- B. Education
- C. Both A and B
- D. None of the above
Correct Answer: C
Rationale: Nurses monitor device function and educate patients about care.
What procedure involves using a catheter to create a small scar in the heart tissue to block abnormal electrical signals and restore normal heart rhythm?
- A. Catheter ablation
- B. Angioplasty
- C. Stent placement
- D. Valve replacement
Correct Answer: A
Rationale: The correct answer is A: Catheter ablation. This procedure involves using a catheter to create a small scar in the heart tissue to block abnormal electrical signals and restore normal heart rhythm. First, the catheter is guided to the heart through blood vessels. Then, using various techniques such as radiofrequency energy or freezing, the abnormal tissue causing the irregular heartbeat is destroyed to restore the heart's normal rhythm.
Choice B, Angioplasty, involves opening blocked or narrowed blood vessels to improve blood flow, not addressing abnormal heart rhythms. Choice C, Stent placement, involves inserting a mesh tube to keep arteries open, not related to treating abnormal electrical signals in the heart. Choice D, Valve replacement, is a procedure to replace damaged heart valves, not specifically targeting abnormal electrical signals in the heart.
Two weeks later, Mr. Cook returns with normal blood pressure readings. Your evaluation of this situation would be
- A. since his blood pressure is normal, he no longer needs medication
- B. since his blood pressure recordings are normal, he no longer needs to maintain his prescribed diet
- C. his medication needs to be adjusted
- D. the combination of weight loss and medication is effective
Correct Answer: D
Rationale: Weight loss and medication contribute to effective blood pressure control.