NSG 533 Exam 3: Questions With Accurate Solutions

NSG 533 Exam 3: Questions With Accurate Solutions

Universal stages of Heart Failure (HF) Correct Ans - - At-risk for HF

• Pre HF
• HF
• Advanced HF

according to the universal definition, what is "at-risk for HF"? Correct Ans

• - do not have HF, but at risk
• no current or prior s/s
• no structural, functional, or biomarker evidence supporting HF

according to the universal definition, what is "HF" Correct Ans - - clinical syndrome

• current or prior s/s of HF
• caused by structural of functional cardiac abnormality
• elevated natriuretic peptide levels
• evidence of pulmonary or systemic congestion

who is most at risk for HF Correct Ans - black males and females; older women two biggest causes of HF Correct Ans - 1. ischemic heart disease (CAD)

2. HTN

calculate EF Correct Ans - SV/LVEDV synonym for inotropy Correct Ans - contraction (HFrEF) synonym for lusitropy Correct Ans - relaxation (HFpEF) two organizations for classification of HF Correct Ans - 1. American Heart Assocation (A,B,C,D) - based on structure

• New York Heart Association (None, I, I, II, III, IV, V) - based on physical

activity limitations how to distinguish cardiac dysfunction versus cardiac HF Correct Ans - cardiac dysfunction has structural abnormalities w/o symptoms 1 / 3

once a patient develops symptoms along with structural abnormalities, they have HF compensatory mechanisms for HF Correct Ans - 1. Hemodynamics (Frank Starling Law) - can give inotropes as short term use to increase contractility (long-term can cause mortality)

• SNS activation (increase contractility, tachycardia, vasoconstriction)
• RAAS activation (angiotensin II binds to AT 1 Receptor - vasoconstriction)

two types of angiotensin II Correct Ans - 1. circulating

• tissue-derived

effects of circulating angiotensin II on HF Correct Ans - - causes vasoconstriction

• increases secretion of ADH
• increase aldosterone secretion
• increases sodium reabsorption

are aldosterone levels high or low in HF? Correct Ans - 20x higher than normal effects of aldosterone on HF Correct Ans - - increases sodium and water reabsorption

• decreased potassium and magnesium
• decreased baroreceptor reflex
• sympathetic activation

list the comprehensive risk factors of Coronary Artery Disease Correct Ans - - dyslipidemia

• genetic studies
• modifiable risk factors
• non-modifiable risk factors
• novel risk factors

what are two classes of medications an individual with HFrEF will be started on? Correct Ans - 1. beta blocker (to counter SNS)

• ACEi (to counter RAAS) 2 / 3

what hormones worsen HF Correct Ans - - Angiontensin II (RAAS)

• catecholamines (SNS)
• endothelin
• aldosterone

hormones that are good for HF Correct Ans - - natriuretic peptides (ANP,

BNP, CNP)

• adrenmedullin
• bradykinin
• nitric oxide

types of ventricular remodeling Correct Ans - - concentric (thickened heart wall, diastolic HF, too stiff, HFpEF)

• eccentric (thin heart wall, systolic HF, contraction dysfunction, HFrEF)

blood flow of the heart from right side to left side Correct Ans - 1.deoxygenated blood from the systemic system enters the superior/inferior vena cava

• right atrium
• tricuspid valve
• right ventricle
• pulmonary valve
• pulmonary artery
• lungs where blood is oxygenated
• pulmonary veins
• left atrium
• mitral/bicuspid valve
• left ventricle
• aortic valve
• aorta
• oxygenated blood to the systemic system

s/s right sided HF Correct Ans - - jugular vein distension

• edema
• ascites
• hepatomegaly

s/s left sided HF Correct Ans - - pulmonary congestion

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