Heart Failure Clinical Judgment Case Study Test
Bank 2025/2026 | 220+ Verified NCLEX Next Gen
Questions & Rationales | Nursing School Back-to-
School Study Guide for RN & BSN Exam Prep
QUESTION 1: A patient with heart failure presents with shortness of breath and
edema. What is the priority nursing assessment?
A) Heart rate and rhythm
%^&*^&
B) Oxygen saturation levels %^&^*&
*%^^$%
C) Lung sounds (Correct Option)
^&%^&
D) Weight
RATIONALE: Assessing lung sounds is crucial in heart failure as it helps identify fluid
overload and pulmonary congestion, which can lead to respiratory distress.
QUESTION 2: The nurse notes crackles in the lung bases during the assessment of a
heart failure patient. What does this finding indicate?
A) Increased lung compliance
B) Pulmonary edema (Correct Option)
C) Decreased blood flow to the lungs
D) Normal lung function
RATIONALE: Crackles, or rales, are indicative of fluid in the alveoli, characteristic of
pulmonary edema due to heart failure.
QUESTION 3: What is the most appropriate nursing intervention for a patient
experiencing acute heart failure exacerbation?
A) Administering oral diuretics
B) Encouraging increased fluid intake
C) Positioning the patient in high Fowler’s position (Correct Option)
D) Providing supplemental oxygen via nasal cannula
RATIONALE: Positioning the patient in high Fowler’s position helps alleviate shortness
of breath and promotes better lung expansion.
QUESTION 4: A patient with heart failure is prescribed a low-sodium diet. What is the
rationale for this dietary restriction?
A) To increase fluid retention
,B) To enhance taste in meals
C) To prevent fluid retention (Correct Option)
D) To promote weight gain
RATIONALE: A low-sodium diet helps prevent fluid retention, which is critical in
managing heart failure and reducing workload on the heart.
QUESTION 5: The nurse is educating a patient with heart failure about daily weights.
What should the patient be instructed to do?
A) Weigh themselves only once a week
B) Weigh themselves at different times of the day
C) Weigh themselves at the same time each day (Correct Option)
D) Weigh themselves after exercise
RATIONALE: Weighing at the same time each day helps accurately monitor fluid
retention and weight gain, which are important indicators of heart failure status.
QUESTION 6: A patient with heart failure asks about the purpose of their prescribed
ACE inhibitor. What is the nurse's best response?
A) "It will help you sleep better."
B) "It helps relax your blood vessels and lowers blood pressure." (Correct Option)
C) "It will increase your heart rate."
D) "It will help prevent blood clots."
RATIONALE: ACE inhibitors help relax blood vessels, reduce blood pressure, and
decrease the workload on the heart, which is essential in heart failure management.
QUESTION 7: The patient reports feeling weak and dizzy after taking their diuretic.
What should the nurse assess first?
A) Electrolyte levels
B) Blood pressure (Correct Option)
C) Heart rate
D) Urine output
RATIONALE: Assessing blood pressure is critical as dizziness could indicate
hypotension, especially after diuretic therapy, which can lead to dehydration and
,electrolyte imbalances.
QUESTION 8: A patient with heart failure is being discharged with a prescription for
furosemide (Lasix). What should the nurse include in the discharge teaching?
A) Monitor for signs of electrolyte imbalance, such as muscle cramps. (Correct
Option)
B) Take the medication only when symptoms worsen.
C) Drink more fluids to avoid dehydration.
D) Avoid all physical activity.
RATIONALE: Patients on diuretics should be aware of signs of electrolyte imbalance, as
these can lead to serious complications.
QUESTION 9: The patient’s heart failure is classified as NYHA Class II. What does this
classification indicate?
A) No symptoms with normal activity
B) Symptoms with moderate exertion (Correct Option)
C) Symptoms at rest
D) Severe limitations in activity
RATIONALE: NYHA Class II indicates that patients experience symptoms with moderate
exertion but are comfortable at rest.
QUESTION 10: A nurse is caring for a heart failure patient who is experiencing
anxiety. What is the most appropriate nursing intervention?
A) Administering sedatives as ordered
B) Ignoring the patient’s concerns
C) Providing reassurance and information (Correct Option)
D) Encouraging the patient to stay alone
RATIONALE: Providing reassurance and clear information helps alleviate anxiety by
addressing the patient’s concerns and improving their understanding of their condition.
QUESTION 11: A patient with heart failure is being monitored for fluid overload. What
is the most reliable indicator of fluid retention?
A) Daily weight
B) Blood pressure
, C) Peripheral edema (Correct Option)
D) Heart rate
RATIONALE: Daily weight is the most reliable indicator of fluid retention, as even small
increases can signify fluid overload in heart failure patients.
QUESTION 12: The nurse notes that the patient’s heart failure is exacerbated by
noncompliance with medications. What is the best approach to address this issue?
A) Increase medication dosage
B) Schedule more frequent follow-up appointments
C) Educate the patient on the importance of adherence (Correct Option)
D) Refer the patient to a specialist
RATIONALE: Educating the patient on the importance of medication adherence can
improve compliance and help manage heart failure more effectively.
QUESTION 13: A patient with heart failure is experiencing nocturnal dyspnea. What is
the best nursing intervention?
A) Encourage daytime napping
B) Administer bronchodilators
C) Elevate the head of the bed at night (Correct Option)
D) Limit fluid intake before bedtime
RATIONALE: Elevating the head of the bed can help alleviate nocturnal dyspnea by
reducing venous return and pulmonary congestion during sleep.
QUESTION 14: A nurse is teaching a patient about the signs of worsening heart
failure. Which symptom should the nurse emphasize?
A) Increased appetite
B) Mild fatigue
C) Sudden weight gain (Correct Option)
D) Occasional cough
RATIONALE: Sudden weight gain can indicate fluid retention and worsening heart
failure, making it a critical symptom for patients to monitor.
QUESTION 15: A patient with heart failure asks about the role of beta-blockers in
Bank 2025/2026 | 220+ Verified NCLEX Next Gen
Questions & Rationales | Nursing School Back-to-
School Study Guide for RN & BSN Exam Prep
QUESTION 1: A patient with heart failure presents with shortness of breath and
edema. What is the priority nursing assessment?
A) Heart rate and rhythm
%^&*^&
B) Oxygen saturation levels %^&^*&
*%^^$%
C) Lung sounds (Correct Option)
^&%^&
D) Weight
RATIONALE: Assessing lung sounds is crucial in heart failure as it helps identify fluid
overload and pulmonary congestion, which can lead to respiratory distress.
QUESTION 2: The nurse notes crackles in the lung bases during the assessment of a
heart failure patient. What does this finding indicate?
A) Increased lung compliance
B) Pulmonary edema (Correct Option)
C) Decreased blood flow to the lungs
D) Normal lung function
RATIONALE: Crackles, or rales, are indicative of fluid in the alveoli, characteristic of
pulmonary edema due to heart failure.
QUESTION 3: What is the most appropriate nursing intervention for a patient
experiencing acute heart failure exacerbation?
A) Administering oral diuretics
B) Encouraging increased fluid intake
C) Positioning the patient in high Fowler’s position (Correct Option)
D) Providing supplemental oxygen via nasal cannula
RATIONALE: Positioning the patient in high Fowler’s position helps alleviate shortness
of breath and promotes better lung expansion.
QUESTION 4: A patient with heart failure is prescribed a low-sodium diet. What is the
rationale for this dietary restriction?
A) To increase fluid retention
,B) To enhance taste in meals
C) To prevent fluid retention (Correct Option)
D) To promote weight gain
RATIONALE: A low-sodium diet helps prevent fluid retention, which is critical in
managing heart failure and reducing workload on the heart.
QUESTION 5: The nurse is educating a patient with heart failure about daily weights.
What should the patient be instructed to do?
A) Weigh themselves only once a week
B) Weigh themselves at different times of the day
C) Weigh themselves at the same time each day (Correct Option)
D) Weigh themselves after exercise
RATIONALE: Weighing at the same time each day helps accurately monitor fluid
retention and weight gain, which are important indicators of heart failure status.
QUESTION 6: A patient with heart failure asks about the purpose of their prescribed
ACE inhibitor. What is the nurse's best response?
A) "It will help you sleep better."
B) "It helps relax your blood vessels and lowers blood pressure." (Correct Option)
C) "It will increase your heart rate."
D) "It will help prevent blood clots."
RATIONALE: ACE inhibitors help relax blood vessels, reduce blood pressure, and
decrease the workload on the heart, which is essential in heart failure management.
QUESTION 7: The patient reports feeling weak and dizzy after taking their diuretic.
What should the nurse assess first?
A) Electrolyte levels
B) Blood pressure (Correct Option)
C) Heart rate
D) Urine output
RATIONALE: Assessing blood pressure is critical as dizziness could indicate
hypotension, especially after diuretic therapy, which can lead to dehydration and
,electrolyte imbalances.
QUESTION 8: A patient with heart failure is being discharged with a prescription for
furosemide (Lasix). What should the nurse include in the discharge teaching?
A) Monitor for signs of electrolyte imbalance, such as muscle cramps. (Correct
Option)
B) Take the medication only when symptoms worsen.
C) Drink more fluids to avoid dehydration.
D) Avoid all physical activity.
RATIONALE: Patients on diuretics should be aware of signs of electrolyte imbalance, as
these can lead to serious complications.
QUESTION 9: The patient’s heart failure is classified as NYHA Class II. What does this
classification indicate?
A) No symptoms with normal activity
B) Symptoms with moderate exertion (Correct Option)
C) Symptoms at rest
D) Severe limitations in activity
RATIONALE: NYHA Class II indicates that patients experience symptoms with moderate
exertion but are comfortable at rest.
QUESTION 10: A nurse is caring for a heart failure patient who is experiencing
anxiety. What is the most appropriate nursing intervention?
A) Administering sedatives as ordered
B) Ignoring the patient’s concerns
C) Providing reassurance and information (Correct Option)
D) Encouraging the patient to stay alone
RATIONALE: Providing reassurance and clear information helps alleviate anxiety by
addressing the patient’s concerns and improving their understanding of their condition.
QUESTION 11: A patient with heart failure is being monitored for fluid overload. What
is the most reliable indicator of fluid retention?
A) Daily weight
B) Blood pressure
, C) Peripheral edema (Correct Option)
D) Heart rate
RATIONALE: Daily weight is the most reliable indicator of fluid retention, as even small
increases can signify fluid overload in heart failure patients.
QUESTION 12: The nurse notes that the patient’s heart failure is exacerbated by
noncompliance with medications. What is the best approach to address this issue?
A) Increase medication dosage
B) Schedule more frequent follow-up appointments
C) Educate the patient on the importance of adherence (Correct Option)
D) Refer the patient to a specialist
RATIONALE: Educating the patient on the importance of medication adherence can
improve compliance and help manage heart failure more effectively.
QUESTION 13: A patient with heart failure is experiencing nocturnal dyspnea. What is
the best nursing intervention?
A) Encourage daytime napping
B) Administer bronchodilators
C) Elevate the head of the bed at night (Correct Option)
D) Limit fluid intake before bedtime
RATIONALE: Elevating the head of the bed can help alleviate nocturnal dyspnea by
reducing venous return and pulmonary congestion during sleep.
QUESTION 14: A nurse is teaching a patient about the signs of worsening heart
failure. Which symptom should the nurse emphasize?
A) Increased appetite
B) Mild fatigue
C) Sudden weight gain (Correct Option)
D) Occasional cough
RATIONALE: Sudden weight gain can indicate fluid retention and worsening heart
failure, making it a critical symptom for patients to monitor.
QUESTION 15: A patient with heart failure asks about the role of beta-blockers in
