NURS 2003
NURS 2003 EXAM (2025) QUESTIONS
AND WITH COMPLETE SOLUTIONS
80% of heart failure cases are caused by what three things?
-ischemic heart disease
-chronic hypertension
-myocardial infarction
Select all that apply:
Heart failure is most common in:
a) men
b) women
c) young adults
d) old adults
a&d
What is ejection fraction?
The percentage of total amount of end-diastolic blood volume ejected during each
systole.
What is a normal ejection fraction?
more than 55% of ventricular volume
Heart failure with reduced ejection fraction can also be referred to as what?
Systolic heart failure
Heart failure with preserved ejection fraction can also be referred to as what?
Diastolic heart failure
Starling's Law
The more the heart is filled during diastole the more forcefully it contracts
Problems with the left ventricle indicate what?
NURS 2003
,NURS 2003
Issues relating to the lungs (pulmonary)
Problems with the right ventricle indicate what?
Peripheral and systemic issues (ie., enlarged liver)
Cor pulmonare
Right sided heart failure specifically from COPD
Symptoms of left-sided heart failure
-paroxsymal nocturnal dyspnea
-elevated pulmonary capillary wedge pressure
-pulmonary congestion (cough, crackles, wheezes, blood-tinted sputum or hemoptysis,
tachypnea)
-restlessness
-confusion
-orthopnea
-tachycardia
-fatigue
-pallor or cyanosis
-exertional dyspnea
-elevated HR, BP
-excessory muscles in use for breathing
-clammy cool skin (vasoconstriction)
-decreased PaO2
-decreased cardiac output
-decreased tissue perfusion
-impaired gas exchange
-oliguria
Symptoms of right-sided heart failure
-distended jugular veins
-anorexia
-GI distress/congestion
-weight gain
-edema
-fatigue
-elevated venous pressure
NURS 2003
,NURS 2003
-ascites
-enlarged liver and spleen (splenomegaly and hepatomegaly)
-exercise intolerance
-chest pain
What is the primary cause of right-sided heart failure?
Left-sided heart failure
What are the 4 compensatory mechanisms for heart failure?
1.Dilation of ventricles
2.Hypertrophy of the ventricles
3.Activation of SNS
4.Neurohormonal responses
Explain dilation of ventricles as a compensatory mechanism
Starling's Law explains that ventricular muscle fibers will stretch to increase force of
contraction and cardiac output, although elasticity may decrease over time.
Explain hypertrophy as a compensatory mechanism
Overworked and overstrained myocardial muscles will respond by increasing muscle
mass and thickness to restore cardiac output.
Explain SNS activation as a compensatory mechanism
Low cardiac output and stroke volume triggers release of epi and norepi to increase HR,
contractility, and vasocontriction.
Explain neurohormonal response as a compensatory mechanism
-RAAS: stimulates release of ADH from posterior pituitary, ANG-II and aldosterone from
adrenal glands
-Endothelin: potent vasoconstrictor
-HPA axis: cortisol
-ANP and BNP: natriuric peptides increase vasodilation and diuresis whilst preventing
hypertrophy
List the roles of ANP and BNP natriuric peptides
-natriuresis
-diuresis
-high GFR
NURS 2003
, NURS 2003
-inhibits renin release (lowers ANG enzyme production and vasoconstriction)
-vasodilation
-arterial hypotension
-reduce venous pressure
-reduce capillary pulmonary wedge pressure
Management for chronic heart failure
1.Identify type of heart failure
2.Sodium and fluid restrictions
3.Mild exercise for tolerance
4.Small meals
5.Medication adherence
6.Oxygen use
What are the 4 main treatments for heart failure?
1.ARB/ACE or ARNI (angiotensin receptor neprilysin inhibitor) to inhibit
vasoconstriction
2.Beta-blocker (-olol) to block effects of epinephrine and slow HR
3.MRA (mineralcorticoid receptor antagonist) to spake K+ and block effects of
aldosterone
4.SGLT2 inhibitor to inhibit transport of sodium and glucose, reducing inflammation and
SNS activity
Asthma
hyper-responsive inflammatory disorder of the airway
Triggers for asthma
-environmental (cold air, smoke, emotional distress)
-allergies (dust mites, pollen, mold)
-respiratory (increased inflammation with hyper-responsive activity)
-drugs and food (beta blockers, NSAIDS, salicylates)
Phases of asthma
Early phase:
-bronchospasm (peaks 30-90 min after exposure)
-vascular congestion
-increased mucus secretion
NURS 2003
NURS 2003 EXAM (2025) QUESTIONS
AND WITH COMPLETE SOLUTIONS
80% of heart failure cases are caused by what three things?
-ischemic heart disease
-chronic hypertension
-myocardial infarction
Select all that apply:
Heart failure is most common in:
a) men
b) women
c) young adults
d) old adults
a&d
What is ejection fraction?
The percentage of total amount of end-diastolic blood volume ejected during each
systole.
What is a normal ejection fraction?
more than 55% of ventricular volume
Heart failure with reduced ejection fraction can also be referred to as what?
Systolic heart failure
Heart failure with preserved ejection fraction can also be referred to as what?
Diastolic heart failure
Starling's Law
The more the heart is filled during diastole the more forcefully it contracts
Problems with the left ventricle indicate what?
NURS 2003
,NURS 2003
Issues relating to the lungs (pulmonary)
Problems with the right ventricle indicate what?
Peripheral and systemic issues (ie., enlarged liver)
Cor pulmonare
Right sided heart failure specifically from COPD
Symptoms of left-sided heart failure
-paroxsymal nocturnal dyspnea
-elevated pulmonary capillary wedge pressure
-pulmonary congestion (cough, crackles, wheezes, blood-tinted sputum or hemoptysis,
tachypnea)
-restlessness
-confusion
-orthopnea
-tachycardia
-fatigue
-pallor or cyanosis
-exertional dyspnea
-elevated HR, BP
-excessory muscles in use for breathing
-clammy cool skin (vasoconstriction)
-decreased PaO2
-decreased cardiac output
-decreased tissue perfusion
-impaired gas exchange
-oliguria
Symptoms of right-sided heart failure
-distended jugular veins
-anorexia
-GI distress/congestion
-weight gain
-edema
-fatigue
-elevated venous pressure
NURS 2003
,NURS 2003
-ascites
-enlarged liver and spleen (splenomegaly and hepatomegaly)
-exercise intolerance
-chest pain
What is the primary cause of right-sided heart failure?
Left-sided heart failure
What are the 4 compensatory mechanisms for heart failure?
1.Dilation of ventricles
2.Hypertrophy of the ventricles
3.Activation of SNS
4.Neurohormonal responses
Explain dilation of ventricles as a compensatory mechanism
Starling's Law explains that ventricular muscle fibers will stretch to increase force of
contraction and cardiac output, although elasticity may decrease over time.
Explain hypertrophy as a compensatory mechanism
Overworked and overstrained myocardial muscles will respond by increasing muscle
mass and thickness to restore cardiac output.
Explain SNS activation as a compensatory mechanism
Low cardiac output and stroke volume triggers release of epi and norepi to increase HR,
contractility, and vasocontriction.
Explain neurohormonal response as a compensatory mechanism
-RAAS: stimulates release of ADH from posterior pituitary, ANG-II and aldosterone from
adrenal glands
-Endothelin: potent vasoconstrictor
-HPA axis: cortisol
-ANP and BNP: natriuric peptides increase vasodilation and diuresis whilst preventing
hypertrophy
List the roles of ANP and BNP natriuric peptides
-natriuresis
-diuresis
-high GFR
NURS 2003
, NURS 2003
-inhibits renin release (lowers ANG enzyme production and vasoconstriction)
-vasodilation
-arterial hypotension
-reduce venous pressure
-reduce capillary pulmonary wedge pressure
Management for chronic heart failure
1.Identify type of heart failure
2.Sodium and fluid restrictions
3.Mild exercise for tolerance
4.Small meals
5.Medication adherence
6.Oxygen use
What are the 4 main treatments for heart failure?
1.ARB/ACE or ARNI (angiotensin receptor neprilysin inhibitor) to inhibit
vasoconstriction
2.Beta-blocker (-olol) to block effects of epinephrine and slow HR
3.MRA (mineralcorticoid receptor antagonist) to spake K+ and block effects of
aldosterone
4.SGLT2 inhibitor to inhibit transport of sodium and glucose, reducing inflammation and
SNS activity
Asthma
hyper-responsive inflammatory disorder of the airway
Triggers for asthma
-environmental (cold air, smoke, emotional distress)
-allergies (dust mites, pollen, mold)
-respiratory (increased inflammation with hyper-responsive activity)
-drugs and food (beta blockers, NSAIDS, salicylates)
Phases of asthma
Early phase:
-bronchospasm (peaks 30-90 min after exposure)
-vascular congestion
-increased mucus secretion
NURS 2003
