HEART FAILURE WITH ATRIAL
FIBRILLATION PRACTICE TEST 2026
QUESTIONS WITH ANSWERS GRADED A+
●● Know that the client has 2 risk factors that cannot be modified,
which intervention is most important for the nurse to include in the
client's plan of care?.
Answer: Answer: Complete a focused cardiac history assessment
MI, CAD, and ischemic heart disease are among the most common
underlying causes of HF. In fact, the most common cause of HF is MI.
The nurse should also ask the client if they have HTN which is another
primary underlying condition cause HF.
A. Identify any history of lung disease
B. Complete a focused cardiac history assessment
C. Evaluate the client's lower extremities for varicosities
D. Review hx for episodes of hypotension
●● Risk Factors.
Answer: HF results in the inability of the heart to provide sufficient
blood flow to meet the oxygen needs of the body's tissues and organs.
HF occurs most commonly in clients over the age of 60, and occurs
more commonly in males than females
,●● Clinical Manifestations.
Answer: Right-sided (right ventricular) heart failure often occurs due to
left-side 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-
side HF.
●● Which assessment finding provides the earliest indication that the
client is experiencing right-side HF?.
Answer: Answer: C. Peripheral Edema
Right-sided HF 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.
A. Dyspnea at rest
B. Sinus tachycardia
C. Peripheral edema
D. Lack of energy
●● Cardiac dysrhythmias.
Answer: Left-sided HF results in pulmonary fluid overload, and right-
sided HF results in peripheral fluid overload. Left-sided HF usually
occurs first, and can trigger right-sided HF. 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 3L/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: Answer: B. 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 occurring. A-fib
commonly occurs in HF. 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.
A. Ensure the client has 2 large bore IV sites
B. Obtain a 12 lead ECG
C. Gather supplies to obtain venous blood to be sent to the lab
D. Prepare the client for elective cardioversion
FIBRILLATION PRACTICE TEST 2026
QUESTIONS WITH ANSWERS GRADED A+
●● Know that the client has 2 risk factors that cannot be modified,
which intervention is most important for the nurse to include in the
client's plan of care?.
Answer: Answer: Complete a focused cardiac history assessment
MI, CAD, and ischemic heart disease are among the most common
underlying causes of HF. In fact, the most common cause of HF is MI.
The nurse should also ask the client if they have HTN which is another
primary underlying condition cause HF.
A. Identify any history of lung disease
B. Complete a focused cardiac history assessment
C. Evaluate the client's lower extremities for varicosities
D. Review hx for episodes of hypotension
●● Risk Factors.
Answer: HF results in the inability of the heart to provide sufficient
blood flow to meet the oxygen needs of the body's tissues and organs.
HF occurs most commonly in clients over the age of 60, and occurs
more commonly in males than females
,●● Clinical Manifestations.
Answer: Right-sided (right ventricular) heart failure often occurs due to
left-side 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-
side HF.
●● Which assessment finding provides the earliest indication that the
client is experiencing right-side HF?.
Answer: Answer: C. Peripheral Edema
Right-sided HF 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.
A. Dyspnea at rest
B. Sinus tachycardia
C. Peripheral edema
D. Lack of energy
●● Cardiac dysrhythmias.
Answer: Left-sided HF results in pulmonary fluid overload, and right-
sided HF results in peripheral fluid overload. Left-sided HF usually
occurs first, and can trigger right-sided HF. 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 3L/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: Answer: B. 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 occurring. A-fib
commonly occurs in HF. 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.
A. Ensure the client has 2 large bore IV sites
B. Obtain a 12 lead ECG
C. Gather supplies to obtain venous blood to be sent to the lab
D. Prepare the client for elective cardioversion
