Progressive Care Nursing Certification (PCCN) Practice Exam

In a patient with acute decompensated heart failure and pulmonary edema, what therapy is usually started?

1. Oxygen therapy only

2. Diuretic therapy

3. Oxygen therapy and inotropic therapy

4. Fluid resuscitation

The correct answer is: Diuretic therapy

In the management of acute decompensated heart failure with pulmonary edema, diuretic therapy is typically the initial treatment of choice. The primary goal of diuretics, particularly loop diuretics like furosemide, is to promote the excretion of excess fluid from the body. This helps to reduce both the preload and the overall fluid overload, alleviating symptoms such as dyspnea and pulmonary congestion associated with pulmonary edema. Effective use of diuretics can quickly improve a patient's respiratory status by decreasing intravascular volume and reducing pulmonary capillary pressures, thus improving oxygenation and comfort. The rapid onset of diuretics makes them especially valuable in acute settings. While oxygen therapy may also be administered to improve oxygenation, it is generally not the primary therapeutic intervention when treating the underlying cause of pulmonary edema in heart failure. Other interventions such as inotropic support or fluid resuscitation may be employed but are not the first choice in the initial management of this acute condition.