Progressive Care Nursing Certification (PCCN) Practice Exam

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A patient with systolic heart failure presents with slight dyspnea at rest. What medication should the nurse anticipate administering?

  1. Metoprolol

  2. Milrinone

  3. Lisinopril

  4. Diltiazem

The correct answer is: Lisinopril

In the context of a patient with systolic heart failure who demonstrates slight dyspnea at rest, anticipating the administration of lisinopril makes sense due to its role as an angiotensin-converting enzyme (ACE) inhibitor. Lisinopril's primary function is to reduce morbidity and mortality in patients with heart failure by decreasing afterload and preload, thereby improving cardiac output and reducing the workload on the heart. It also helps alleviate symptoms of heart failure, such as dyspnea, by promoting vasodilation and reducing fluid retention. Moreover, controlling blood pressure and providing neurohormonal modulation are crucial in managing systolic heart failure, which is where lisinopril plays an important role. The use of this medication can lead to improved functional status and better overall management of heart failure symptoms. While other medications may be useful in certain contexts—like metoprolol for heart rate control and milrinone for short-term treatment of severe heart failure—lisinopril is the most appropriate choice in this situation because of its foundational benefits in managing chronic heart failure and specifically addressing the symptoms the patient is experiencing. Diltiazem, a calcium channel blocker, is usually avoided in heart failure patients as it can negatively impact cardiac contract