VSIM Extra Credit Pharmacology Pre Quiz | Answered Latest 2025/26.

VSIM Extra Credit Pharmacology Pre Quiz 1. Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:* 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. 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." 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 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. 5. True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal ejection fraction.* True False 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. 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. 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 C. BUN 9 D. Troponin 0.02 9. Which of the following tests/procedures are NOT used to diagnose heart failure?* A. Echocardiogram B. Brain natriuretic peptide blood test C. Nuclear stress test D. Holter monitoring 10. What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath.* A. Left ventricular systolic dysfunction B. Left ventricular ride-sided dysfunction C. Right ventricular diastolic dysfunction D. Left ventricular diastolic dysfunction Heart failure nclex questions. Registered Nurse RN. (2017, April 24). Patient CC: Chest pain and edema Age: 86 years Gender: Male An 86 year old male patient presents to the emergency room after complaining of chest pain and swelling of his ankles. His wife states that he has been coughing for the past few days and has been feeling dizzy. Patient is positive for Clostridium Difficile. Labs collected: Troponin- high sensitivity EKG Results: Troponin- 60ng/L EKG- high precordial QRS voltage, poor precordial R wave progression and low limb lead voltage Treatment: IVMorphine- 4 mg intravenously [IV] with increments of 2–8 mg IV repeated at 5–15‐minute intervals IV Nitroglycerin - 50 mg/250mL Symptoms: Abnormal heartbeat, chest tightness, dizziness, sweating His vital signs were 98.6, 160/98, 120, RR 18 95% on Room Air. Doctors orders: Take patients vitals Q6 hours If patients oxygen drops below 90% on Room Air, call the physician 4mg IV morphine Q4 as needed. Assess pain 20 minutes after administration. Perform correct assessments for patients status. Begin VSIM Before entering the room, what PPE should you use? ● Gloves ● Gown ● Mask ● Face shield Me: “Hello, my name is Isabel I am going to be your nurse today. I will wash my hands.” ● Washes hands “Please verify your name and date of birth” “My name is Harry Smith, my birthday is 07/20/1938.” ● Identity patient, matches patients chart “ I will now take your vitals”. ● Assess respirations- 21 “Will this show how well my lungs are working?” “Yes, this will measure the saturation of oxygen carried in your red blood cells.” ● Attach pulse oximeter- 88% on Room Air ● Attach NIBP- 150/76 Patient- “Which arm would you like to use?” “I would like to use your right arm please.” ● Take patients temperature- 98.7 F “ I am going to call the doctor so they can come and review the findings and decide what treatment to continue with”. ● Call doctor SBAR What should be included in the SBAR to the provider? a. Patients oxygen level is 88% on Room Air b. Patient is hungry c. Respirations are 21 d. Patient's name and Room Number NEW ORDERS IN PT CHART ● Place the patient on nasal cannula 2L to make sure the patient's oxygen becomes 90% or greater. ● Reassess patient’s oxygen and respirations “I would now like to auscultate your heart.” “No problem.” ● Auscultating heart Patients' heart sounds are abnormal, with an S3 sound heard. ● Reassess patients oxygen and respirations Patients oxygen is now 95% on 2L nasal cannula and respirations are 17. “Are you allergic to anything?” “No, I am not allergic to anything.” “Are you in any pain?” “Yes, I am having pain in my chest on the left side” “Could you describe the pain?” “A tight pressure in my chest. It hurts more when I breathe in.” “How would you rate your pain on a scale of 1-10?” “9” “Would you like something for your pain?” “Yes please”. Medication administration Start IV Assess IV Flush IV Dose: 4 mg Morphine Intravenously over 1 hour. Verify doctor's order Verify dose with nurse Conti C. R. (2011). Intravenous morphine and chest pain. Clinical cardiology, 34(8), 464–465. End patient Simulation SBAR handoff Situation Harry presented to the ED complaining of chest pain. I recommend another EKG and labs. Background Harry takes medication fort high blood pressure. Come see the patient in the next 30 minutes. Assesment Harry’s vitals were 98.6, 160/98, 120, RR 18 95% on Room Air. Harry’s troponin levels were 60ng/L. Harry came from home and lives with his wife. Recommendation Monitor Harry’s vital signs and provide pain therapy management. Harry’s oxygen is 95% on 2L Nasal Cannula Post Quiz 1. What are test that should be run to determine the if Harry has CHF ? A. EKG B. Chest X-Ray C. Flu test 2. True or false, you should call Harry’s doctor if his oxygen drops below 90% on Room Air. True False 3. What vital signs are abnormal? A. 98.6 B. 160/98 C. 120 D. 95% on Room Air. References Conti C. R. (2011). Intravenous morphine and chest pain. Clinical cardiology, 34(8), 464–465. Heart failure nclex questions. Registered Nurse RN. (2017, April 24).