Examl 2:l NSGl 320/l NSG320l (NEWl 2025/l
2026l Update)l Adultl Healthl Nursingl Il
Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
QUESTION
acutel decompensatedl heartl failure
Answer:
suddenl onsetl ofl s/sl ofl heartl failurel wl decreasel inl functionall status,l usuallyl leadsl tol
hospitall admission
-pulmonaryl congestionl andl fluidl overload,l increasel RRl andl decreasel PaO2
STAGES
A.l highl riskl ofl heartl failure,l nol heartl disease
B.l heartl conditionl presentl wl nol symptomsl
-stagel I:l nol physicall limitations
C.l heartl conditionl presentl wl priorl orl currentl s/s
-stagel I:l nol physicall limitations
-stagel II:l slightl physicall limitations,l ordinaryl activitiesl causel s/s
-stagel III:l markedl limitation,l lessl thanl ordinaryl s/sl causel s/s
-stagel IV:l nol activityl canl bel donel withoutl s/s.l s/sl atl rest
D.l advancedl heartl diseasel wl cont.l HF
-stagel IV
LEADSl TOl
-edema,l alveolarl edema,l tachypneal
-manifestsl asl pulmonaryl edema
PULMONARYl EDEMA
-orthopnea,l paroxysmall nocturnall dyspneal
**wl orthopnea:l calll doctor
-cyanotic,l pinkl frothyl sputum,l RRl overl 30,l coughing
-cracklesl andl wheezes
-abnormall S3l andl S4
-cooll extremities,l mottled,l ashenl
-hoarseness
,QUESTION
manifestations:l RHFl vsl LHF
Answer:
RIGHTl SIDED
-increasel HR
-ascites
-hepatomegaly
-anasarca:l generall edema
-edema
-JVD
-weightl gain
-murmurl
LEFTl SIDED
-increasel HR
-S3l andl S4
-crackles
-shallowl respiration
-pulmonaryl edema
-cough
-frothyl pinkl sputum
-increasel CO2l andl decreasel O2
QUESTION
manifestations
Answer:
FATIGUE
-decreasel CO
DYSPNEA
-bcl ofl pulmonaryl congestion
-orthopnea:l troublel breathingl whenl lyingl downl bcl fluidsl goesl froml legsl tol lungs
COUGH
-bcl ofl pulmonaryl edema,l nonl productivel cough
TACHYCARDIA
-heartl triesl tol compensatel forl decreasedl CO
PALPITATION
-al fibl isl mostl common
EDEMA
WEIGHTl CHANGES
-weightl gain,l musclel mightl startl tol atrophyl butl itl isl maskedl byl edema
,SKINl CHANGES
-cool,l dry,l mottledl (blue/grey)l bcl ofl decreasedl perfusion
NEURO
-syncope
DECREASEDl URINARYl OUTPUT
-nocturia
SLEEPl PROBLEMS
-oftenl associatedl wl sleepl apnea:l daytimel sleepinessl andl snoringl
CHESTl PAIN
-bcl ofl lackl ofl O2l orl stretchl ofl myocardium
QUESTION
heartl failurel complications
Answer:
PLEURALl EFFUSION
-fluidl bwl thel 2l layersl thatl coverl thel lungsl andl chestl wall
DYSRHYTHMIAl ANDl DYSSYNCHRONOUSl CONTRACTION
-bothl atriall andl ventricularl dysrhythmiasl arel common
-al fibl isl commonl andl canl leadl tol clotsl tol theyl needl anticoagulants
-vl tachyl andl vl fibl arel alsol commonl
-vl remodelingl canl causel desynchronizedl contractionsl inl thel ventriclesl (onel vl mayl
contractl beforel thel other)l causingl worsenedl HFl symptomsl
HEPATOMEGALY
-liverl enlargesl bcl ofl congestionl ofl blood->liverl failure->l cirrhosis
CARDIORENALl SYNDROME
-decreasel COl causesl decreasesl renall perfusion,l gfr,l andl increasel CR->retainl waterl andl
Na
ANEMIA
-kidneysl producel lessl erythropoietinl causingl anemia
QUESTION
diagnosingl HF
Answer:
thel goall isl tol findl thel underlyingl cause
1.l ECHOCARDIOGRAM
l (imaging)
-chamberl sizel andl function,l distinguishl bwl HFrEFl andl HFpEF,l LVEF,l valvel function,l
pleurall effusion
, 2.l 12l LEADl ECG
3.l CHESTl XRAY
4.l 6l MINl WALKl TEST
5.l CARDIACl CATHERTERIZATIONl ANDl ANGIOGRAM
-insertl al catheterl intol al veinl (rightl side)l orl arteryl (leftl side),l thel angiograml partl isl
theyl injectl al dyel tol seel wherel itl flowsl andl ifl therel isl blockage
QUESTION
medicationsl forl HF
Answer:
ACEl INHIBITOR
-captoprill
-decreasesl afterloadl andl SVR
-decreasesl mortality
-dilatesl veinsl andl arteries
-relievel HFl symptoms
-promotesl reversel remodeling
-increasel renall bloodl flow
ANGIOTENSINl 2l RECEPTORl BLOCKER
-valsartan
-venulel andl arteriolel dilation
-decreasel mortality
-decreasel BP
-increasel renall bloodl flow
-promotesl diuresisl andl natriuresis
ALDOSTERONEl ANTAGONISTS
-spironolactone
-diuretic,l sparesl k
-cautionl wl digoxinl bcl tool muchl Kl couldl bel toxic
-mayl causel gynecomastial
BETAl BLOCKER
-metoprololl succinate
-cardiacl remodeling
-reversel remodeling
-decreasel afterloadl
DIGITALIS
-digoxin
-decreasel thel RAASl andl SNS
-decreasel HFl symptoms
>reportl nauseal andl mayl needl tol eatl Kl ifl onl furosemide
2026l Update)l Adultl Healthl Nursingl Il
Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
QUESTION
acutel decompensatedl heartl failure
Answer:
suddenl onsetl ofl s/sl ofl heartl failurel wl decreasel inl functionall status,l usuallyl leadsl tol
hospitall admission
-pulmonaryl congestionl andl fluidl overload,l increasel RRl andl decreasel PaO2
STAGES
A.l highl riskl ofl heartl failure,l nol heartl disease
B.l heartl conditionl presentl wl nol symptomsl
-stagel I:l nol physicall limitations
C.l heartl conditionl presentl wl priorl orl currentl s/s
-stagel I:l nol physicall limitations
-stagel II:l slightl physicall limitations,l ordinaryl activitiesl causel s/s
-stagel III:l markedl limitation,l lessl thanl ordinaryl s/sl causel s/s
-stagel IV:l nol activityl canl bel donel withoutl s/s.l s/sl atl rest
D.l advancedl heartl diseasel wl cont.l HF
-stagel IV
LEADSl TOl
-edema,l alveolarl edema,l tachypneal
-manifestsl asl pulmonaryl edema
PULMONARYl EDEMA
-orthopnea,l paroxysmall nocturnall dyspneal
**wl orthopnea:l calll doctor
-cyanotic,l pinkl frothyl sputum,l RRl overl 30,l coughing
-cracklesl andl wheezes
-abnormall S3l andl S4
-cooll extremities,l mottled,l ashenl
-hoarseness
,QUESTION
manifestations:l RHFl vsl LHF
Answer:
RIGHTl SIDED
-increasel HR
-ascites
-hepatomegaly
-anasarca:l generall edema
-edema
-JVD
-weightl gain
-murmurl
LEFTl SIDED
-increasel HR
-S3l andl S4
-crackles
-shallowl respiration
-pulmonaryl edema
-cough
-frothyl pinkl sputum
-increasel CO2l andl decreasel O2
QUESTION
manifestations
Answer:
FATIGUE
-decreasel CO
DYSPNEA
-bcl ofl pulmonaryl congestion
-orthopnea:l troublel breathingl whenl lyingl downl bcl fluidsl goesl froml legsl tol lungs
COUGH
-bcl ofl pulmonaryl edema,l nonl productivel cough
TACHYCARDIA
-heartl triesl tol compensatel forl decreasedl CO
PALPITATION
-al fibl isl mostl common
EDEMA
WEIGHTl CHANGES
-weightl gain,l musclel mightl startl tol atrophyl butl itl isl maskedl byl edema
,SKINl CHANGES
-cool,l dry,l mottledl (blue/grey)l bcl ofl decreasedl perfusion
NEURO
-syncope
DECREASEDl URINARYl OUTPUT
-nocturia
SLEEPl PROBLEMS
-oftenl associatedl wl sleepl apnea:l daytimel sleepinessl andl snoringl
CHESTl PAIN
-bcl ofl lackl ofl O2l orl stretchl ofl myocardium
QUESTION
heartl failurel complications
Answer:
PLEURALl EFFUSION
-fluidl bwl thel 2l layersl thatl coverl thel lungsl andl chestl wall
DYSRHYTHMIAl ANDl DYSSYNCHRONOUSl CONTRACTION
-bothl atriall andl ventricularl dysrhythmiasl arel common
-al fibl isl commonl andl canl leadl tol clotsl tol theyl needl anticoagulants
-vl tachyl andl vl fibl arel alsol commonl
-vl remodelingl canl causel desynchronizedl contractionsl inl thel ventriclesl (onel vl mayl
contractl beforel thel other)l causingl worsenedl HFl symptomsl
HEPATOMEGALY
-liverl enlargesl bcl ofl congestionl ofl blood->liverl failure->l cirrhosis
CARDIORENALl SYNDROME
-decreasel COl causesl decreasesl renall perfusion,l gfr,l andl increasel CR->retainl waterl andl
Na
ANEMIA
-kidneysl producel lessl erythropoietinl causingl anemia
QUESTION
diagnosingl HF
Answer:
thel goall isl tol findl thel underlyingl cause
1.l ECHOCARDIOGRAM
l (imaging)
-chamberl sizel andl function,l distinguishl bwl HFrEFl andl HFpEF,l LVEF,l valvel function,l
pleurall effusion
, 2.l 12l LEADl ECG
3.l CHESTl XRAY
4.l 6l MINl WALKl TEST
5.l CARDIACl CATHERTERIZATIONl ANDl ANGIOGRAM
-insertl al catheterl intol al veinl (rightl side)l orl arteryl (leftl side),l thel angiograml partl isl
theyl injectl al dyel tol seel wherel itl flowsl andl ifl therel isl blockage
QUESTION
medicationsl forl HF
Answer:
ACEl INHIBITOR
-captoprill
-decreasesl afterloadl andl SVR
-decreasesl mortality
-dilatesl veinsl andl arteries
-relievel HFl symptoms
-promotesl reversel remodeling
-increasel renall bloodl flow
ANGIOTENSINl 2l RECEPTORl BLOCKER
-valsartan
-venulel andl arteriolel dilation
-decreasel mortality
-decreasel BP
-increasel renall bloodl flow
-promotesl diuresisl andl natriuresis
ALDOSTERONEl ANTAGONISTS
-spironolactone
-diuretic,l sparesl k
-cautionl wl digoxinl bcl tool muchl Kl couldl bel toxic
-mayl causel gynecomastial
BETAl BLOCKER
-metoprololl succinate
-cardiacl remodeling
-reversel remodeling
-decreasel afterloadl
DIGITALIS
-digoxin
-decreasel thel RAASl andl SNS
-decreasel HFl symptoms
>reportl nauseal andl mayl needl tol eatl Kl ifl onl furosemide
