1.a patient with a history of chronic heart failure is admitted to the ER with severe
dyspnea and a dry, hacky cough. which action should the nurse do first
a. auscultate the abdomen
b. check the capillary refill
c. auscultate the breath sounds
d. assess the level of orientation
C
2. Which of the following patients are MOST at risk for developing heart failure?
Select-all-that-apply:*
A. A 69 year old male with a history of alcohol abuse and is recovering from a
myocardial infarction.
B. A 55 year old female with a health history of asthma and hypoparathyroidism.
C. A 30 year old male with a history of endocarditis and has severe mitral
stenosis.
D. A 45 year old female with lung cancer stage 2.
E. A 58 year old female with uncontrolled hypertension and is being treated for
influenza.
The answers to this question are options: A, C, E. These patients are at most risk
for heart failure. Remember risks factor for developing heart failure include:
remember the mnemonic FAILURE: Faulty heart valves ( Option C mitral stenosis
in this case), Arrhythmias, Infarction (Option A), Lineage, Uncontrolled
hypertension (Option E), Recreational drug usage, Evaders (Option E with
influenza)
,2. A patient is being discharged home after hospitalization of left ventricular
systolic dysfunction. As the nurse providing discharge teaching to the patient,
which statement is NOT a correct statement about this condition?*
A. "Signs and symptoms of this type of heart failure can include: dyspnea,
persistent cough, difficulty breathing while lying down, and weight gain."
B. "It is important to monitor your daily weights, fluid and salt intake."
C. "Left-sided heart failure can lead to right-sided heart failure, if left untreated."
D. "This type of heart failure can build up pressure in the hepatic veins and cause
them to become congested with fluid which leads to peripheral edema."
Option D is the answer. This is a description of right-sided heart failure NOT left
ventricular systolic dysfunction. Left-sided systolic dysfunction is where the left
side of the heart is unable to CONTRACT efficiently which causes blood to back-
up into the lungs...leading to pulmonary edema.
3. Which of the following are NOT typical signs and symptoms of right-sided heart
failure? Select-all-that-apply:*
A. Jugular venous distention
B. Persistent cough
C. Weight gain
D. Crackles
E. Nocturia
F. Orthopnea
The answers are B, D, and F. Persistent cough, crackles (also called rales), and
orthopnea are signs and symptoms of LEFT-sided heart failure...not right-sided
heart failure.
,4. A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of
the following are expected findings with this condition?*
A. Echocardiogram shows an ejection fraction of 38%.
B. Heart catheterization shows an ejection fraction of 65%.
C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
D. Options A and C are both expected findings with left-sided systolic
dysfunction heart failure.
The answer is D. Both Options A and C are correct. Option B is a finding expected
in left-sided DIASTOLIC dysfunction heart failure because the issue is with the
ability of the ventricle to FILL properly...therefore a patient usually has a normal
ejection fraction. Remember a normal EF is >60% in a healthy heart.
5. True or False: Patients with left-sided diastolic dysfunction heart failure usually
have a normal ejection fraction.*
True
False
The answer is TRUE. Patient with left-sided DIASTOLIC dysfunction heart failure
normally have a normal ejection fraction. However, patients with left-sided
SYSTOLIC dysfunction heart failure usually do not because the heart is unable to
CONTRACT efficiently rather than fill properly as with diastolic dysfunction.
6. A patient has a history of heart failure. Which of the following statements by the
patient indicates the patient may be experiencing heart failure exacerbation?*
A. “I’ve noticed that I’ve gain 6 lbs in one week.”
B. “While I sleep I have to prop myself up with a pillow so I can breathe.”
C. “I haven’t noticed any swelling in my feet or hands lately.”
, D. Options B and C are correct.
E. Options A and B are correct.
F. Options A, B, and C are all correct.
The answer is E. Options A and B are classic signs and symptoms a patient may
experience with heart failure exacerbation.
7. Patients with heart failure can experience episodes of exacerbation. All of the
patients below have a history of heart failure. Which of the following patients are
at MOST risk for heart failure exacerbation?*
A. A 55 year old female who limits sodium and fluid intake regularly.
B. A 73 year old male who reports not taking Amiodarone for one month and is
experiencing atrial fibrillation.
C. A 67 year old female who is being discharged home from heart valve
replacement surgery.
D. A 78 year old male who has a health history of eczema and cystic fibrosis.
Option B is the correct answer. Patients who are in an arrhythmia (especially a-
fib) are at risk for developing heart failure because the heart is not contracting
properly and blood is pooling in the chambers.
8. A 74 year old female presents to the ER with complaints of dyspnea, persistent
cough, and unable to sleep at night due to difficulty breathing. On assessment,
you note crackles throughout the lung fields, respiratory rate of 25, and an
oxygen saturation of 90% on room air. Which of the following lab results confirm
your suspicions of heart failure?*
A. K+ 5.6
B. BNP 820
dyspnea and a dry, hacky cough. which action should the nurse do first
a. auscultate the abdomen
b. check the capillary refill
c. auscultate the breath sounds
d. assess the level of orientation
C
2. Which of the following patients are MOST at risk for developing heart failure?
Select-all-that-apply:*
A. A 69 year old male with a history of alcohol abuse and is recovering from a
myocardial infarction.
B. A 55 year old female with a health history of asthma and hypoparathyroidism.
C. A 30 year old male with a history of endocarditis and has severe mitral
stenosis.
D. A 45 year old female with lung cancer stage 2.
E. A 58 year old female with uncontrolled hypertension and is being treated for
influenza.
The answers to this question are options: A, C, E. These patients are at most risk
for heart failure. Remember risks factor for developing heart failure include:
remember the mnemonic FAILURE: Faulty heart valves ( Option C mitral stenosis
in this case), Arrhythmias, Infarction (Option A), Lineage, Uncontrolled
hypertension (Option E), Recreational drug usage, Evaders (Option E with
influenza)
,2. A patient is being discharged home after hospitalization of left ventricular
systolic dysfunction. As the nurse providing discharge teaching to the patient,
which statement is NOT a correct statement about this condition?*
A. "Signs and symptoms of this type of heart failure can include: dyspnea,
persistent cough, difficulty breathing while lying down, and weight gain."
B. "It is important to monitor your daily weights, fluid and salt intake."
C. "Left-sided heart failure can lead to right-sided heart failure, if left untreated."
D. "This type of heart failure can build up pressure in the hepatic veins and cause
them to become congested with fluid which leads to peripheral edema."
Option D is the answer. This is a description of right-sided heart failure NOT left
ventricular systolic dysfunction. Left-sided systolic dysfunction is where the left
side of the heart is unable to CONTRACT efficiently which causes blood to back-
up into the lungs...leading to pulmonary edema.
3. Which of the following are NOT typical signs and symptoms of right-sided heart
failure? Select-all-that-apply:*
A. Jugular venous distention
B. Persistent cough
C. Weight gain
D. Crackles
E. Nocturia
F. Orthopnea
The answers are B, D, and F. Persistent cough, crackles (also called rales), and
orthopnea are signs and symptoms of LEFT-sided heart failure...not right-sided
heart failure.
,4. A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of
the following are expected findings with this condition?*
A. Echocardiogram shows an ejection fraction of 38%.
B. Heart catheterization shows an ejection fraction of 65%.
C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
D. Options A and C are both expected findings with left-sided systolic
dysfunction heart failure.
The answer is D. Both Options A and C are correct. Option B is a finding expected
in left-sided DIASTOLIC dysfunction heart failure because the issue is with the
ability of the ventricle to FILL properly...therefore a patient usually has a normal
ejection fraction. Remember a normal EF is >60% in a healthy heart.
5. True or False: Patients with left-sided diastolic dysfunction heart failure usually
have a normal ejection fraction.*
True
False
The answer is TRUE. Patient with left-sided DIASTOLIC dysfunction heart failure
normally have a normal ejection fraction. However, patients with left-sided
SYSTOLIC dysfunction heart failure usually do not because the heart is unable to
CONTRACT efficiently rather than fill properly as with diastolic dysfunction.
6. A patient has a history of heart failure. Which of the following statements by the
patient indicates the patient may be experiencing heart failure exacerbation?*
A. “I’ve noticed that I’ve gain 6 lbs in one week.”
B. “While I sleep I have to prop myself up with a pillow so I can breathe.”
C. “I haven’t noticed any swelling in my feet or hands lately.”
, D. Options B and C are correct.
E. Options A and B are correct.
F. Options A, B, and C are all correct.
The answer is E. Options A and B are classic signs and symptoms a patient may
experience with heart failure exacerbation.
7. Patients with heart failure can experience episodes of exacerbation. All of the
patients below have a history of heart failure. Which of the following patients are
at MOST risk for heart failure exacerbation?*
A. A 55 year old female who limits sodium and fluid intake regularly.
B. A 73 year old male who reports not taking Amiodarone for one month and is
experiencing atrial fibrillation.
C. A 67 year old female who is being discharged home from heart valve
replacement surgery.
D. A 78 year old male who has a health history of eczema and cystic fibrosis.
Option B is the correct answer. Patients who are in an arrhythmia (especially a-
fib) are at risk for developing heart failure because the heart is not contracting
properly and blood is pooling in the chambers.
8. A 74 year old female presents to the ER with complaints of dyspnea, persistent
cough, and unable to sleep at night due to difficulty breathing. On assessment,
you note crackles throughout the lung fields, respiratory rate of 25, and an
oxygen saturation of 90% on room air. Which of the following lab results confirm
your suspicions of heart failure?*
A. K+ 5.6
B. BNP 820
