NURS-6050N Heart Failure Nursing Study Guide 2026 |
Walden University Nursing | Practice Questions &
Rationales
Heart Failure Nursing Practice Examination 2026
Question 1
A 72-year-old man presents to the primary care clinic complaining of increasing
shortness of breath over the past two months. He reports becoming breathless after
climbing one flight of stairs, whereas he previously had no difficulty. His medical
history includes hypertension, hyperlipidemia, and a myocardial infarction five
years ago. Vital signs are blood pressure 150/88 mmHg, heart rate 90 beats/minute,
respiratory rate 20 breaths/minute, temperature 36.8°C (98.2°F), and oxygen
saturation 95% on room air. Lung sounds are clear, and no peripheral edema is
noted.
Which finding in this patient's history is most suggestive of early heart failure?
A. Elevated blood pressure
B. Progressive exertional dyspnea
C. Hyperlipidemia
D. Normal oxygen saturation
Correct Answer: B. Progressive exertional dyspnea
,Rationale:
Progressive exertional dyspnea is often one of the earliest manifestations of heart
failure because the failing heart cannot adequately increase cardiac output during
physical activity. This results in pulmonary congestion and reduced oxygen
delivery during exertion. Although hypertension is a major risk factor for
developing heart failure, it is not itself an early symptom. Hyperlipidemia
contributes to cardiovascular disease but does not directly indicate heart failure. A
normal oxygen saturation at rest does not exclude early heart failure, as many
patients maintain adequate oxygenation until the disease progresses. Recognizing
worsening exercise intolerance allows nurses to identify heart failure early and
facilitate timely intervention.
Question 2
A 68-year-old woman with a history of chronic hypertension presents to the clinic
complaining that she wakes suddenly during the night feeling as though she is
suffocating. She reports needing to sit upright on the side of the bed for several
minutes before she can breathe comfortably again. Her blood pressure is 146/84
mmHg, heart rate 92 beats/minute, respiratory rate 22 breaths/minute, and oxygen
saturation is 94% on room air.
Which term best describes this patient's symptom?
A. Orthopnea
B. Dyspnea on exertion
C. Paroxysmal nocturnal dyspnea
D. Hyperventilation
,Correct Answer: C. Paroxysmal nocturnal dyspnea
Rationale:
Paroxysmal nocturnal dyspnea is characterized by sudden episodes of severe
shortness of breath that awaken a patient from sleep due to fluid redistribution into
the pulmonary circulation while lying flat. Sitting upright reduces venous return
and pulmonary congestion, improving breathing. Orthopnea refers to shortness of
breath that occurs immediately upon lying down rather than awakening after sleep.
Dyspnea on exertion occurs during physical activity, while hyperventilation refers
to rapid breathing that is unrelated to the classic nighttime symptoms of heart
failure. Identifying paroxysmal nocturnal dyspnea helps nurses recognize
worsening left-sided heart failure.
Question 3
A 75-year-old man is admitted to the medical unit with worsening fatigue, ankle
swelling, and shortness of breath. He has a history of ischemic cardiomyopathy.
Assessment reveals blood pressure 138/80 mmHg, heart rate 102 beats/minute,
respiratory rate 24 breaths/minute, oxygen saturation 93% on room air, bilateral
pitting edema to the knees, jugular venous distention, and bibasilar crackles.
Which assessment finding most strongly indicates fluid volume overload?
A. Blood pressure of 138/80 mmHg
B. Bilateral pitting edema
C. Heart rate of 102 beats/minute
D. Oxygen saturation of 93%
, Correct Answer: B. Bilateral pitting edema
Rationale:
Bilateral pitting edema is a classic indicator of fluid volume overload resulting
from increased venous pressure and sodium and water retention in patients with
heart failure. Although mild tachycardia and a slightly reduced oxygen saturation
may occur in heart failure, they are less specific indicators of excess fluid. The
patient's blood pressure is not diagnostic of volume overload. Nurses should
routinely evaluate edema because changes in its severity often reflect worsening or
improving heart failure and guide treatment effectiveness.
Question 4
A 70-year-old woman with chronic heart failure attends a follow-up appointment
after being discharged from the hospital two weeks ago. She states she has been
trying to improve her diet. Which lunch does she report eating today?
A. Ham sandwich with potato chips
B. Pepperoni pizza with canned tomato soup
C. Fried chicken with salted French fries
D. Grilled chicken breast, steamed broccoli, and brown rice
Correct Answer: D. Grilled chicken breast, steamed broccoli, and brown rice
Rationale:
Grilled chicken breast with steamed vegetables and brown rice is naturally lower in
sodium than processed or fast foods, making it the most appropriate meal for
patients with heart failure. Sodium restriction helps minimize fluid retention,
Walden University Nursing | Practice Questions &
Rationales
Heart Failure Nursing Practice Examination 2026
Question 1
A 72-year-old man presents to the primary care clinic complaining of increasing
shortness of breath over the past two months. He reports becoming breathless after
climbing one flight of stairs, whereas he previously had no difficulty. His medical
history includes hypertension, hyperlipidemia, and a myocardial infarction five
years ago. Vital signs are blood pressure 150/88 mmHg, heart rate 90 beats/minute,
respiratory rate 20 breaths/minute, temperature 36.8°C (98.2°F), and oxygen
saturation 95% on room air. Lung sounds are clear, and no peripheral edema is
noted.
Which finding in this patient's history is most suggestive of early heart failure?
A. Elevated blood pressure
B. Progressive exertional dyspnea
C. Hyperlipidemia
D. Normal oxygen saturation
Correct Answer: B. Progressive exertional dyspnea
,Rationale:
Progressive exertional dyspnea is often one of the earliest manifestations of heart
failure because the failing heart cannot adequately increase cardiac output during
physical activity. This results in pulmonary congestion and reduced oxygen
delivery during exertion. Although hypertension is a major risk factor for
developing heart failure, it is not itself an early symptom. Hyperlipidemia
contributes to cardiovascular disease but does not directly indicate heart failure. A
normal oxygen saturation at rest does not exclude early heart failure, as many
patients maintain adequate oxygenation until the disease progresses. Recognizing
worsening exercise intolerance allows nurses to identify heart failure early and
facilitate timely intervention.
Question 2
A 68-year-old woman with a history of chronic hypertension presents to the clinic
complaining that she wakes suddenly during the night feeling as though she is
suffocating. She reports needing to sit upright on the side of the bed for several
minutes before she can breathe comfortably again. Her blood pressure is 146/84
mmHg, heart rate 92 beats/minute, respiratory rate 22 breaths/minute, and oxygen
saturation is 94% on room air.
Which term best describes this patient's symptom?
A. Orthopnea
B. Dyspnea on exertion
C. Paroxysmal nocturnal dyspnea
D. Hyperventilation
,Correct Answer: C. Paroxysmal nocturnal dyspnea
Rationale:
Paroxysmal nocturnal dyspnea is characterized by sudden episodes of severe
shortness of breath that awaken a patient from sleep due to fluid redistribution into
the pulmonary circulation while lying flat. Sitting upright reduces venous return
and pulmonary congestion, improving breathing. Orthopnea refers to shortness of
breath that occurs immediately upon lying down rather than awakening after sleep.
Dyspnea on exertion occurs during physical activity, while hyperventilation refers
to rapid breathing that is unrelated to the classic nighttime symptoms of heart
failure. Identifying paroxysmal nocturnal dyspnea helps nurses recognize
worsening left-sided heart failure.
Question 3
A 75-year-old man is admitted to the medical unit with worsening fatigue, ankle
swelling, and shortness of breath. He has a history of ischemic cardiomyopathy.
Assessment reveals blood pressure 138/80 mmHg, heart rate 102 beats/minute,
respiratory rate 24 breaths/minute, oxygen saturation 93% on room air, bilateral
pitting edema to the knees, jugular venous distention, and bibasilar crackles.
Which assessment finding most strongly indicates fluid volume overload?
A. Blood pressure of 138/80 mmHg
B. Bilateral pitting edema
C. Heart rate of 102 beats/minute
D. Oxygen saturation of 93%
, Correct Answer: B. Bilateral pitting edema
Rationale:
Bilateral pitting edema is a classic indicator of fluid volume overload resulting
from increased venous pressure and sodium and water retention in patients with
heart failure. Although mild tachycardia and a slightly reduced oxygen saturation
may occur in heart failure, they are less specific indicators of excess fluid. The
patient's blood pressure is not diagnostic of volume overload. Nurses should
routinely evaluate edema because changes in its severity often reflect worsening or
improving heart failure and guide treatment effectiveness.
Question 4
A 70-year-old woman with chronic heart failure attends a follow-up appointment
after being discharged from the hospital two weeks ago. She states she has been
trying to improve her diet. Which lunch does she report eating today?
A. Ham sandwich with potato chips
B. Pepperoni pizza with canned tomato soup
C. Fried chicken with salted French fries
D. Grilled chicken breast, steamed broccoli, and brown rice
Correct Answer: D. Grilled chicken breast, steamed broccoli, and brown rice
Rationale:
Grilled chicken breast with steamed vegetables and brown rice is naturally lower in
sodium than processed or fast foods, making it the most appropriate meal for
patients with heart failure. Sodium restriction helps minimize fluid retention,
