Which agent is preferred for the initial treatment of heart failure?
Vasodilators
Diuretics
Calcium channel blockers
Direct renin inhibitors
The Correct Answer is B
Choice A reason: This is not the preferred agent for the initial treatment of heart failure. Vasodilators are a class of medications that lower the blood pressure by relaxing the blood vessels and reducing the resistance to blood flow. They can be used to treat hypertension, angina, and heart failure, but they are usually added to other medications, such as diuretics or beta blockers, to improve the symptoms and outcomes.
Choice B reason: This is the preferred agent for the initial treatment of heart failure. Diuretics are a class of medications that increase the urine output and reduce the fluid retention in the body. They can be used to treat hypertension, edema, and heart failure, as they reduce the preload and afterload on the heart, and decrease the pulmonary congestion and peripheral edema.
Choice C reason: This is not the preferred agent for the initial treatment of heart failure. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias, but they are not recommended for most patients with heart failure, as they may worsen the cardiac function and increase the mortality.
Choice D reason: This is not the preferred agent for the initial treatment of heart failure. Direct renin inhibitors are a class of medications that lower the blood pressure by inhibiting the enzyme renin, which initiates the renin-angiotensin-aldosterone system, a hormonal pathway that regulates the blood pressure and fluid balance. They can be used to treat hypertension, but they have not been proven to be effective or safe for patients with heart failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not a symptom of right heart failure. Hypertension is a risk factor for developing heart failure, but it does not indicate the severity or location of the heart failure.
Choice B reason: This is not a symptom of right heart failure. Dyspnea upon exertion is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the lungs.
Choice C reason: This is a symptom of right heart failure. Significant edema to both lower legs and feet is a result of increased pressure in the systemic circulation, which occurs when the right ventricle fails to pump blood effectively to the rest of the body. This causes fluid to accumulate in the dependent areas, such as the lower extremities.
Choice D reason: This is not a symptom of right heart failure. Decreased urine output is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes reduced renal perfusion and oliguria.
Correct Answer is D
Explanation
Choice A reason: Cardiac output has not fallen below normal levels. Cardiac output is the amount of blood pumped by the heart per minute. It is affected by the heart rate and the stroke volume. Angina pectoris does not directly affect the cardiac output, but it can reduce the stroke volume due to impaired ventricular filling.
Choice B reason: The vagus nerve is not stimulated. The vagus nerve is a cranial nerve that innervates the heart and other organs. It is part of the parasympathetic nervous system, which slows down the heart rate and lowers the blood pressure. Angina pectoris does not activate the vagus nerve, but it can trigger the sympathetic nervous system, which increases the heart rate and blood pressure.
Choice C reason: Myocardial stretch has not exceeded the upper limits. Myocardial stretch is the degree of tension or load on the cardiac muscle fibers. It is determined by the end-diastolic volume, which is the amount of blood in the ventricle at the end of relaxation. Angina pectoris does not cause excessive myocardial stretch, but it can impair the myocardial contractility due to ischemia.
Choice D reason: The myocardial oxygen supply has fallen below demand. This is the main cause of angina pectoris. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, are narrowed or blocked by atherosclerosis or spasm. This creates an imbalance between the oxygen demand of the heart, which increases during exertion, and the oxygen supply, which is reduced by the obstruction.
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