1–10: Cardiovascular
1. A patient with chronic heart failure (HF) is
admitted with fluid overload. Which diuretic is
first-line according to 2024 ACC Expert
Consensus?
A. Spironolactone
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
Rationale: Loop diuretics, particularly furosemide, are
first-line for symptomatic volume overload in HF to
mobilize fluid rapidly (JACC).
2. Which ACE inhibitor is recommended to improve
survival in patients with HFrEF?
A. Lisinopril
B. Enalapril
C. Captopril
D. All of the above
Rationale: Multiple ACE inhibitors (lisinopril, enalapril,
captopril) have mortality benefit in HF with reduced EF
(JACC).
3. Per 2024 ESC guidelines, dietary sodium should
be restricted to ≤ ____ mEq/day in chronic HF.
A. 50
B. 100
, C. 150
D. 200
Rationale: ESC recommends sodium intake ≤ 150
mEq/day to reduce congestion without risking
hyponatremia (Medscape).
4. Which medication class is first-line for rate
control in atrial fibrillation with HF?
A. Beta-blockers
B. Calcium-channel blockers
C. Digoxin
D. Amiodarone
Rationale: β-blockers (e.g., metoprolol) improve rate
control and mortality in AF with HF; non-DHP CCBs are
contraindicated in HFrEF (AHA Journals).
5. A patient presents with STEMI. The nurse knows
that door-to-balloon time should be ≤ ___ minutes.
A. 30
B. 45
C. 60
D. 90
Rationale: Guidelines recommend door-to-balloon in ≤ 90
minutes for primary PCI (AHA Journals).
6. Which sign indicates left-sided HF?
A. JVD
B. Hepatomegaly
, C. Pulmonary crackles
D. Peripheral edema
Rationale: Pulmonary crackles result from fluid backup
into lungs in left HF (www.heart.org).
7. In acute decompensated HF, IV morphine is used
to:
A. Increase preload
B. Reduce anxiety and preload
C. Improve renal perfusion
D. Decrease afterload
Rationale: Morphine reduces anxiety, dyspnea, and
venous return, lowering preload (professional.heart.org).
8. Which lab value most closely correlates with
severity of HF?
A. Troponin
B. BNP
C. CK-MB
D. D-dimer
Rationale: BNP levels rise proportionally with ventricular
stretch and HF severity (www.heart.org).
9. For chronic stable angina, first-line therapy
includes:
A. Sublingual nitroglycerin PRN
B. Long-acting nitrates only
C. ACE inhibitors only
D. Calcium-channel blockers only
1. A patient with chronic heart failure (HF) is
admitted with fluid overload. Which diuretic is
first-line according to 2024 ACC Expert
Consensus?
A. Spironolactone
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
Rationale: Loop diuretics, particularly furosemide, are
first-line for symptomatic volume overload in HF to
mobilize fluid rapidly (JACC).
2. Which ACE inhibitor is recommended to improve
survival in patients with HFrEF?
A. Lisinopril
B. Enalapril
C. Captopril
D. All of the above
Rationale: Multiple ACE inhibitors (lisinopril, enalapril,
captopril) have mortality benefit in HF with reduced EF
(JACC).
3. Per 2024 ESC guidelines, dietary sodium should
be restricted to ≤ ____ mEq/day in chronic HF.
A. 50
B. 100
, C. 150
D. 200
Rationale: ESC recommends sodium intake ≤ 150
mEq/day to reduce congestion without risking
hyponatremia (Medscape).
4. Which medication class is first-line for rate
control in atrial fibrillation with HF?
A. Beta-blockers
B. Calcium-channel blockers
C. Digoxin
D. Amiodarone
Rationale: β-blockers (e.g., metoprolol) improve rate
control and mortality in AF with HF; non-DHP CCBs are
contraindicated in HFrEF (AHA Journals).
5. A patient presents with STEMI. The nurse knows
that door-to-balloon time should be ≤ ___ minutes.
A. 30
B. 45
C. 60
D. 90
Rationale: Guidelines recommend door-to-balloon in ≤ 90
minutes for primary PCI (AHA Journals).
6. Which sign indicates left-sided HF?
A. JVD
B. Hepatomegaly
, C. Pulmonary crackles
D. Peripheral edema
Rationale: Pulmonary crackles result from fluid backup
into lungs in left HF (www.heart.org).
7. In acute decompensated HF, IV morphine is used
to:
A. Increase preload
B. Reduce anxiety and preload
C. Improve renal perfusion
D. Decrease afterload
Rationale: Morphine reduces anxiety, dyspnea, and
venous return, lowering preload (professional.heart.org).
8. Which lab value most closely correlates with
severity of HF?
A. Troponin
B. BNP
C. CK-MB
D. D-dimer
Rationale: BNP levels rise proportionally with ventricular
stretch and HF severity (www.heart.org).
9. For chronic stable angina, first-line therapy
includes:
A. Sublingual nitroglycerin PRN
B. Long-acting nitrates only
C. ACE inhibitors only
D. Calcium-channel blockers only
