Heart Failure Quiz Nursing
Questions: 16 · 10 minutes
1. A patient following a heart failure action plan gains 2.5 pounds overnight and has more ankle swelling. What is the most appropriate instruction?
Wait until the next scheduled appointment if breathing remains comfortable
Stop drinking all fluids until the weight returns to baseline
Follow the prescribed action plan and promptly contact the care team
Double the next diuretic dose without checking the prescribed plan
2. In an adult with heart failure, an S3 heart sound is commonly associated with which condition?
Delayed electrical conduction through the atrioventricular node
Closure of the semilunar valves at the end of systole
Pericardial layers rubbing together during respiration
Rapid ventricular filling in the setting of volume overload
3. Where do loop diuretics such as furosemide primarily inhibit sodium and chloride reabsorption?
Proximal convoluted tubule
Thick ascending limb of the loop of Henle
Distal convoluted tubule only
Collecting duct at the aldosterone receptor
4. Which cluster is most characteristic of systemic venous congestion associated with right-sided heart failure?
Photophobia, neck stiffness, and pinpoint pupils
Dry cough, unilateral wheezing, and reduced bowel sounds
Jugular venous distention, dependent edema, and abdominal fullness
Bounding pulses, flushed skin, and widened pulse pressure
5. Which new assessment pattern in a patient with heart failure most strongly suggests worsening systemic hypoperfusion and requires urgent escalation?
Warm hands, normal mentation, and increased urine output
Mild ankle swelling after prolonged standing with unchanged breathing
Occasional dry cough with stable blood pressure and oxygenation
Cool clammy skin, new confusion, and markedly reduced urine output
6. Which change most directly reduces cardiac output in systolic heart failure with reduced ejection fraction?
Impaired ventricular contractility reduces the amount of blood ejected with each beat
Accelerated ventricular relaxation causes excessive filling between beats
Reduced venous pressure prevents blood from entering the atria
Increased arterial oxygen content prevents adequate ventricular filling
7. What does an elevated B-type natriuretic peptide, or BNP, level generally reflect in a patient being evaluated for heart failure?
Destruction of cardiac muscle caused specifically by coronary occlusion
Increased myocardial wall stretch associated with volume or pressure load
Reduced production of hormones by the ventricular walls
Bacterial inflammation limited to the heart valves
8. Which description best matches New York Heart Association functional class II?
Symptoms occur at rest, and any activity increases discomfort
No limitation occurs with ordinary physical activity
Ordinary activity causes symptoms, but the patient is comfortable at rest
Symptoms occur only during unusually strenuous athletic activity
9. A patient with heart failure develops worsening orthopnea. Which additional finding most strongly supports left-sided pulmonary congestion?
Dependent ankle edema that improves with elevation
New bibasilar crackles on lung auscultation
Visible jugular venous distention while upright
Tender enlargement of the liver
10. A patient is comparing two packaged soups while following a sodium-restricted plan. Which label-reading strategy is most useful?
Compare sodium per serving and account for the number of servings eaten
Use the front-label serving image to estimate the sodium amount
Compare only the percentage of total fat listed on each package
Choose the product with fewer calories regardless of sodium content
11. A patient taking digoxin reports nausea and yellow-tinted vision, and the apical pulse is unusually slow. What should the nurse suspect?
Expected therapeutic effects of improved cardiac output
A harmless adjustment to reduced dietary sodium
Possible digoxin toxicity requiring prompt assessment
Typical symptoms of potassium excess caused by digoxin
12. A patient taking spironolactone for HFrEF begins using a potassium-containing salt substitute. Which complication is the primary concern?
Severe hypocalcemia
Hyperkalemia
Iron-deficiency anemia
Respiratory alkalosis
13. Which patient statement best demonstrates effective teach-back about daily weight monitoring for heart failure?
“I will weigh myself only on days when my ankles look swollen.”
“I will compare weights taken at different times and in different clothing.”
“I will use my weekly average, so a sudden one-day increase does not need attention.”
“I will weigh myself each morning under similar conditions and follow my plan for a rapid gain.”
14. A clinically stable, euvolemic patient with HFrEF is prescribed an evidence-based beta blocker. Which approach is generally appropriate?
Start at a low dose and titrate gradually while monitoring tolerance
Begin at the full target dose to produce an immediate effect
Use it only when the resting pulse rises above the normal range
Discontinue it whenever mild fatigue occurs after an early dose
15. Which laboratory values are especially important to monitor after starting or increasing an ACE inhibitor for heart failure?
Thyroid-stimulating hormone and free thyroxine
Serum amylase and lipase
Platelet count and clotting time
Serum potassium and renal function
16. A patient with acute heart failure is severely short of breath and has diffuse crackles. While urgent evaluation and treatment are initiated, which position usually best supports breathing?
Upright in high-Fowler position
Trendelenburg position
Prone with the head turned to one side
Flat and supine