Progressive Care Nursing Certification (PCCN) Practice Exam

For a patient with a history of heart failure who presents with hypotension and hypovolemia, what should the nurse initiate?

1. IV fluids

2. Nesiritide (Natrecor)

3. Mannitol (Osmitrol)

4. Digoxin (Lanoxin)

The correct answer is: IV fluids

In the context of a patient with a history of heart failure presenting with hypotension and hypovolemia, initiating intravenous (IV) fluids is a crucial intervention. Administering IV fluids helps to restore circulating blood volume, which is essential in treating hypotension caused by hypovolemia. This approach aims to improve hemodynamic stability by enhancing preload, thereby increasing cardiac output without overloading the heart, which is particularly important in patients with heart failure who may struggle with fluid overload. The use of IV fluids serves to address the underlying issue of low blood volume, which is a direct contributor to hypotension. By increasing the venous return to the heart, IV fluids can help restore normal blood pressure and improve perfusion to vital organs. In contrast, other options like Nesiritide, Mannitol, and Digoxin serve different purposes. Nesiritide is a recombinant form of B-type natriuretic peptide used primarily for the treatment of acutely decompensated heart failure but may not be the first-line treatment for hypotension due to hypovolemia. Mannitol is an osmotic diuretic primarily used to manage increased intracranial pressure and does not address hypovolemia. Digoxin is a medication used to