Progressive Care Nursing Certification (PCCN) Practice Exam

In chronic heart failure, what is the main neurohormonal response observed?

1. Increased production of hemoglobin

2. Increased liver release of glycogen stores

3. Increased activation of the sympathetic nervous system

4. Increased production of cholesterol for hormones

The correct answer is: Increased activation of the sympathetic nervous system

In chronic heart failure, the body responds to reduced cardiac output and impaired arterial perfusion through several neurohormonal mechanisms, one of which is the increased activation of the sympathetic nervous system. This response is critical for compensating for the decreased ability of the heart to pump blood effectively. The sympathetic nervous system attempts to restore homeostasis by increasing heart rate, improving myocardial contractility, and causing peripheral vasoconstriction to maintain blood pressure and perfusion to vital organs. The activation of the sympathetic nervous system leads to the release of catecholamines, such as norepinephrine, which help to stimulate heart function and increase vascular resistance. However, over time, excessive stimulation can lead to further heart muscle deterioration and increased workload on the heart, ultimately leading to a negative feedback loop that exacerbates heart failure. In contrast, the other options do not reflect the primary neurohormonal mechanisms in chronic heart failure. The production of hemoglobin is related to oxygen transport and may increase in response to chronic low oxygen levels but is not a primary feature of heart failure itself. The liver's release of glycogen stores typically pertains to glucose metabolism and energy production but does not represent a primary neurohormonal adaptation in the context of heart failure. The production of