NUR2502: Multidimensional Care III /
MDC 3 Final Exam Study Guide
Questions and Answers ()
1. What are the signs and symptoms of left-sided heart
failure?
Correct Answer: Weakness, fatigue, pulmonary edema,
shortness of breath (SOB), and orthopnea.
Rationale: Left-sided heart failure reduces the heart’s ability
to pump blood effectively into systemic circulation, causing
blood to back up into the pulmonary circulation. This results
in pulmonary congestion and edema, producing dyspnea,
orthopnea, fatigue, weakness, cough, and potentially
hypoxemia.
2. What are the signs and symptoms of right-sided heart
failure?
Correct Answer: Peripheral edema, weight gain, enlarged
liver, jugular venous distention (JVD), and increased thirst.
,Rationale: Right-sided heart failure causes systemic venous
congestion because the right ventricle cannot effectively move
blood into the pulmonary circulation. This produces JVD,
dependent/peripheral edema, rapid weight gain from fluid
retention, hepatomegaly, ascites, and gastrointestinal
congestion.
3. What diagnostic tests and laboratory studies are used to
evaluate heart failure?
Correct Answer: Echocardiogram. Labs include BNP, stress
test, chest X-ray, BUN, CBC, and creatinine.
Rationale: An echocardiogram evaluates cardiac structure and
function, including ventricular ejection fraction and wall
motion. BNP is released in response to ventricular stretch and
is useful in evaluating heart failure. BUN and creatinine assess
renal function, while CBC can identify anemia or infection
that may worsen cardiac workload. Chest X-ray can
demonstrate cardiomegaly and pulmonary congestion. A stress
test may evaluate cardiac function and ischemia when
clinically appropriate.
,4. What should a patient with heart failure be taught?
Correct Answer: Daily weight, low-sodium diet, fluid
restriction, diet and exercise, and when to notify the provider.
Rationale: Daily weight monitoring is one of the most
sensitive methods for detecting fluid retention. Sodium
restriction decreases water retention, while fluid restriction
may be prescribed for patients with significant congestion.
Appropriate physical activity improves functional capacity.
Patients should promptly report rapid weight gain, worsening
shortness of breath, increased edema, chest pain, or other signs
of decompensation.
5. What medications may be used to treat heart failure?
Correct Answer: ACE inhibitors, ARBs, diuretics, aspirin,
nitrates, and beta blockers.
Rationale: Heart failure pharmacotherapy is directed toward
reducing cardiac workload, controlling fluid retention,
improving ventricular remodeling, and decreasing morbidity
and mortality. ACE inhibitors and ARBs reduce afterload and
neurohormonal activation. Diuretics reduce fluid overload.
Beta blockers decrease sympathetic stimulation and improve
, ventricular function over time. Nitrates may reduce preload,
while aspirin may be indicated when underlying coronary
artery disease or another appropriate indication is present.
6. What are risk factors for developing heart failure?
Correct Answer: Hypertension, diabetes, coronary artery
disease (CAD), drinking, smoking, obesity, sedentary lifestyle,
and mitral regurgitation.
Rationale: Chronic hypertension, diabetes, CAD, obesity,
tobacco use, excessive alcohol consumption, and physical
inactivity can progressively damage the myocardium or
increase cardiac workload. Valvular disorders such as mitral
regurgitation can also cause chronic volume overload and
eventually contribute to heart failure.
7. What are examples of valvular heart disease?
Correct Answer: Mitral stenosis, mitral regurgitation, mitral
prolapse, aortic stenosis, and aortic regurgitation.
Rationale: Valvular disease occurs when one or more heart
valves become stenotic or incompetent. Stenosis obstructs
forward blood flow, whereas regurgitation allows blood to
MDC 3 Final Exam Study Guide
Questions and Answers ()
1. What are the signs and symptoms of left-sided heart
failure?
Correct Answer: Weakness, fatigue, pulmonary edema,
shortness of breath (SOB), and orthopnea.
Rationale: Left-sided heart failure reduces the heart’s ability
to pump blood effectively into systemic circulation, causing
blood to back up into the pulmonary circulation. This results
in pulmonary congestion and edema, producing dyspnea,
orthopnea, fatigue, weakness, cough, and potentially
hypoxemia.
2. What are the signs and symptoms of right-sided heart
failure?
Correct Answer: Peripheral edema, weight gain, enlarged
liver, jugular venous distention (JVD), and increased thirst.
,Rationale: Right-sided heart failure causes systemic venous
congestion because the right ventricle cannot effectively move
blood into the pulmonary circulation. This produces JVD,
dependent/peripheral edema, rapid weight gain from fluid
retention, hepatomegaly, ascites, and gastrointestinal
congestion.
3. What diagnostic tests and laboratory studies are used to
evaluate heart failure?
Correct Answer: Echocardiogram. Labs include BNP, stress
test, chest X-ray, BUN, CBC, and creatinine.
Rationale: An echocardiogram evaluates cardiac structure and
function, including ventricular ejection fraction and wall
motion. BNP is released in response to ventricular stretch and
is useful in evaluating heart failure. BUN and creatinine assess
renal function, while CBC can identify anemia or infection
that may worsen cardiac workload. Chest X-ray can
demonstrate cardiomegaly and pulmonary congestion. A stress
test may evaluate cardiac function and ischemia when
clinically appropriate.
,4. What should a patient with heart failure be taught?
Correct Answer: Daily weight, low-sodium diet, fluid
restriction, diet and exercise, and when to notify the provider.
Rationale: Daily weight monitoring is one of the most
sensitive methods for detecting fluid retention. Sodium
restriction decreases water retention, while fluid restriction
may be prescribed for patients with significant congestion.
Appropriate physical activity improves functional capacity.
Patients should promptly report rapid weight gain, worsening
shortness of breath, increased edema, chest pain, or other signs
of decompensation.
5. What medications may be used to treat heart failure?
Correct Answer: ACE inhibitors, ARBs, diuretics, aspirin,
nitrates, and beta blockers.
Rationale: Heart failure pharmacotherapy is directed toward
reducing cardiac workload, controlling fluid retention,
improving ventricular remodeling, and decreasing morbidity
and mortality. ACE inhibitors and ARBs reduce afterload and
neurohormonal activation. Diuretics reduce fluid overload.
Beta blockers decrease sympathetic stimulation and improve
, ventricular function over time. Nitrates may reduce preload,
while aspirin may be indicated when underlying coronary
artery disease or another appropriate indication is present.
6. What are risk factors for developing heart failure?
Correct Answer: Hypertension, diabetes, coronary artery
disease (CAD), drinking, smoking, obesity, sedentary lifestyle,
and mitral regurgitation.
Rationale: Chronic hypertension, diabetes, CAD, obesity,
tobacco use, excessive alcohol consumption, and physical
inactivity can progressively damage the myocardium or
increase cardiac workload. Valvular disorders such as mitral
regurgitation can also cause chronic volume overload and
eventually contribute to heart failure.
7. What are examples of valvular heart disease?
Correct Answer: Mitral stenosis, mitral regurgitation, mitral
prolapse, aortic stenosis, and aortic regurgitation.
Rationale: Valvular disease occurs when one or more heart
valves become stenotic or incompetent. Stenosis obstructs
forward blood flow, whereas regurgitation allows blood to
