Progressive Care Nursing Certification (PCCN) Practice Exam

Which medication class is primarily avoided in heart failure due to its tendency to worsen the condition?

1. ACE inhibitors

2. Calcium channel blockers

3. Beta blockers

4. Nitrates

The correct answer is: Calcium channel blockers

Calcium channel blockers are generally avoided in heart failure because they can negatively impact cardiac function. In heart failure, the heart's ability to pump blood effectively is compromised, and certain calcium channel blockers can further reduce myocardial contractility. This reduction in contractility can exacerbate heart failure symptoms such as fluid retention and decreased exercise tolerance. In contrast, ACE inhibitors and beta blockers are typically used in heart failure management. ACE inhibitors help by reducing afterload and improving cardiac output, while beta blockers can improve heart function over time by allowing the heart to work more efficiently. Nitrates can also be beneficial in managing symptoms associated with heart failure, particularly in cases of acute heart failure or when there is significant fluid overload. It’s important for individuals with heart failure to avoid medications that can worsen the condition, which is why calcium channel blockers are usually not recommended.