HEART FAILURE WITH ATRIAL
FIBRILLATION ACTUAL SCRIPT 2026
QUESTIONS WITH ANSWERS GRADED A+
●● Right-sided, or right ventricular, heart failure often occurs due to
left-sided heart failure when the weakened or stiff left ventricle cannot
efficiently pump blood to the rest of the body. As a result, fluid is forced
back through the lungs, weakening the heart's right side, causing right-
sided heart failure.
Which assessment finding provides the earliest indication that the client
is experiencing right-sided heart failure?
Answer: Peripheral edema
--Right-sided heart failure results in peripheral congestion due to the
inability of the right ventricle to effectively pump blood out of the heart
to the lungs, causing edema, JVD, an enlarged liver, abdominal ascites,
and weight gain. Edema and weight gain are among the earlier signs.
●● Upon admission to the Cardiac Nursing Unit, the client's dyspnea
continues. The client reports fatigue, but denies chest pain. The nurse
places the client on oxygen via a nasal cannula at 3 L/min and a cardiac
telemetry monitor. The ECG recording shows no discernible P waves,
, and a rapid, irregular ventricular response (QRS complexes). This
corresponds with the client's pulse rate, which is 136 and irregular.
Based on the electrocardiogram rhythm strip, what intervention should
the nurse implement first?
Answer: Obtain a 12 lead ECG.
-A 12 lead should be performed immediately to confirm the rhythm and
determine if there is any acute myocardial injury occuring. Atrial
fibrillation commonly occurs in heart failure. Multiple areas in the atria
initiate rapid, irregular electrical stimuli, which results in the inability to
see clear P waves on the ECG recording. Some, but not all, of these
electrical impulses travel through the AV node, causing an irregular
ventricular response. This appears as irregular QRS complexes on the
ECG recording and manifests as an irregular pulse rhythm when
assessing the client.
●● After the client's cardiac rhythm is confirmed, which action should
the nurse implement next?
Answer: Administer an ordered stat dose of digoxin
-If a dose of digoxin has already been prescribed, it should be
administered before taking further action. Digoxin slows the heart rate
FIBRILLATION ACTUAL SCRIPT 2026
QUESTIONS WITH ANSWERS GRADED A+
●● Right-sided, or right ventricular, heart failure often occurs due to
left-sided heart failure when the weakened or stiff left ventricle cannot
efficiently pump blood to the rest of the body. As a result, fluid is forced
back through the lungs, weakening the heart's right side, causing right-
sided heart failure.
Which assessment finding provides the earliest indication that the client
is experiencing right-sided heart failure?
Answer: Peripheral edema
--Right-sided heart failure results in peripheral congestion due to the
inability of the right ventricle to effectively pump blood out of the heart
to the lungs, causing edema, JVD, an enlarged liver, abdominal ascites,
and weight gain. Edema and weight gain are among the earlier signs.
●● Upon admission to the Cardiac Nursing Unit, the client's dyspnea
continues. The client reports fatigue, but denies chest pain. The nurse
places the client on oxygen via a nasal cannula at 3 L/min and a cardiac
telemetry monitor. The ECG recording shows no discernible P waves,
, and a rapid, irregular ventricular response (QRS complexes). This
corresponds with the client's pulse rate, which is 136 and irregular.
Based on the electrocardiogram rhythm strip, what intervention should
the nurse implement first?
Answer: Obtain a 12 lead ECG.
-A 12 lead should be performed immediately to confirm the rhythm and
determine if there is any acute myocardial injury occuring. Atrial
fibrillation commonly occurs in heart failure. Multiple areas in the atria
initiate rapid, irregular electrical stimuli, which results in the inability to
see clear P waves on the ECG recording. Some, but not all, of these
electrical impulses travel through the AV node, causing an irregular
ventricular response. This appears as irregular QRS complexes on the
ECG recording and manifests as an irregular pulse rhythm when
assessing the client.
●● After the client's cardiac rhythm is confirmed, which action should
the nurse implement next?
Answer: Administer an ordered stat dose of digoxin
-If a dose of digoxin has already been prescribed, it should be
administered before taking further action. Digoxin slows the heart rate
