Cardiac Question #2


The nurse is assessing an elderly client admitted with a diagnosis of chronic heart failure (HF). The spouse asks the nurse the primary cause for HF, and the nurse responds that HF may be caused by:


  1. Endocarditis
    • Rationale:
  2. Pleural effusion
    • Rationale:
  3. Atherosclerosis
    • Rationale:
  4. Atrial-septal defect
    • Rationale:



The progressive buildup of plaque, inflammatory cells, and other substances that adhere to the cell wall may narrow arteries and affect arterial dilation and expansion and ability to carry blood supply resulting in coronary artery disease (CAD). Atherosclerosis is a main condition associated with age and HF. Endocarditis is caused by an infection of the endocardium (usually bacteria, fungi, and from migration of bacteria from other parts of the body). While endocarditis may have complications if left untreated, it does not fit the diagnosis for chronic HF. Pleural effusion is a collection of fluid in the pleural space, and may arise from cardiopulmonary disorders or systemic inflammatory disorders (such as cancer); however, is not primary cause for chronic HF. Although atrial septal defects may result in HF, manifestation may occur from infancy through early childhood, and adults with undetected atrial septal defects may also have pulmonary hypertension, shortened life span, and may have HF. The selection of atrial septal defect does not fit the question since the client is elderly, with chronic HF, and better fits the selection for atherosclerosis.

Learning Outcomes

Test Taking Tip

Video Rationale