NR 601 Week 2 Quiz: Heart Failure & Coronary
Artery Disease – 80 Multiple-Choice Questions
with Rationales- Chamberlain
HEART FAILURE (~15 questions)
1. Which finding best supports a new diagnosis of heart failure in a client with known
coronary artery disease and diabetes?
A. Clear lung sounds, trace protein in urine, and history of obesity
B. Normal pro-BNP and blood pressure of 140/88
C. BNP level of 780 pg/mL and shortness of breath with exertion
D. Elevated potassium and peaked T waves on ECG
Answer: C
Rationale: BNP > 100 pg/mL indicates heart failure. Shortness of breath with exertion is
a classic symptom. Clear lung sounds and normal pro-BNP argue against HF.
2. Which diagnostic finding best supports a diagnosis of chronic left-sided heart
failure?
A. Normal chest X-ray and right atrial enlargement on echocardiogram
B. Flattened diaphragm and hyperinflated lungs on chest X-ray
C. ST segment changes on ECG and clear lung fields
D. Cardiomegaly on chest X-ray and vascular redistribution in the lungs
Answer: D
Rationale: Left-sided HF causes pulmonary congestion and cardiomegaly. Vascular
redistribution (cephalization) is seen on chest X-ray.
3. Which clinical presentation is most consistent with left-sided heart failure?
A. Jugular vein distention, hepatomegaly, and cold extremities
B. Clear lung sounds, irregular heart rate, and ankle swelling
C. Peripheral edema, ascites, and weight gain
D. Shortness of breath on exertion, orthopnea, and paroxysmal nocturnal dyspnea
Answer: D
Rationale: Left-sided HF presents with pulmonary symptoms: dyspnea, orthopnea,
PND. JVD and hepatomegaly are right-sided signs.
,4. Which patient is at the highest risk for developing heart failure?
A. A 60-year-old with well-controlled hypothyroidism and no cardiac history
B. A 52-year-old with hypertension, type 2 diabetes, and hyperlipidemia
C. A 35-year-old who consumes alcohol socially and does not exercise
D. A 40-year-old with mild asthma and BMI 24
Answer: B
Rationale: Hypertension, diabetes, and hyperlipidemia are major risk factors for HF. The
combination significantly increases risk.
5. Which assessment finding is most consistent with developing coronary artery
disease in an older adult client?
A. Sudden onset of unilateral lower extremity weakness
B. Warm, well-perfused extremities and brisk capillary refill
C. Occasional shortness of breath during exertion and an S3 heart sound
D. Chronic productive cough and inspiratory wheezes
Answer: C
Rationale: Exertional dyspnea and S3 (ventricular gallop) are early signs of left
ventricular dysfunction, often due to CAD.
6. A client with heart failure reports worsening shortness of breath, weight gain of 5
lbs in 2 days, and 2+ pitting edema. Which nursing diagnosis is most appropriate?
A. Ineffective breathing pattern related to anxiety
B. Excess fluid volume related to decreased cardiac output
C. Impaired gas exchange related to pulmonary edema
D. Activity intolerance related to deconditioning
Answer: B
Rationale: Weight gain and edema indicate fluid overload. Decreased cardiac output
leads to fluid retention.
7. Which medication is first-line for reducing mortality in heart failure with reduced
ejection fraction (HFrEF)?
A. Furosemide
B. Metoprolol succinate
C. Digoxin
D. Hydralazine
, Answer: B
Rationale: Beta-blockers (metoprolol succinate, carvedilol) improve survival in HFrEF.
Furosemide is for symptom relief, not mortality reduction.
8. A client with HFrEF is started on lisinopril. Which lab value should be monitored
closely?
A. Serum potassium
B. Serum sodium
C. Hemoglobin A1c
D. INR
Answer: A
Rationale: ACE inhibitors can cause hyperkalemia, especially in clients with renal
impairment or on potassium-sparing diuretics.
9. Which finding indicates worsening heart failure that requires immediate
intervention?
A. Mild fatigue after walking one block
B. Occasional dry cough
C. New onset of confusion and hypotension
D. 1+ pitting edema that improves with elevation
Answer: C
Rationale: Confusion and hypotension suggest cardiogenic shock or low cardiac
output, requiring urgent evaluation.
10. A client with chronic heart failure reports needing three pillows to sleep. This
symptom is called:
A. Paroxysmal nocturnal dyspnea
B. Orthopnea
C. Platypnea
D. Trepopnea
Answer: B
Rationale: Orthopnea is dyspnea when lying flat; relieved by sitting up. PND is sudden
nighttime dyspnea.
Artery Disease – 80 Multiple-Choice Questions
with Rationales- Chamberlain
HEART FAILURE (~15 questions)
1. Which finding best supports a new diagnosis of heart failure in a client with known
coronary artery disease and diabetes?
A. Clear lung sounds, trace protein in urine, and history of obesity
B. Normal pro-BNP and blood pressure of 140/88
C. BNP level of 780 pg/mL and shortness of breath with exertion
D. Elevated potassium and peaked T waves on ECG
Answer: C
Rationale: BNP > 100 pg/mL indicates heart failure. Shortness of breath with exertion is
a classic symptom. Clear lung sounds and normal pro-BNP argue against HF.
2. Which diagnostic finding best supports a diagnosis of chronic left-sided heart
failure?
A. Normal chest X-ray and right atrial enlargement on echocardiogram
B. Flattened diaphragm and hyperinflated lungs on chest X-ray
C. ST segment changes on ECG and clear lung fields
D. Cardiomegaly on chest X-ray and vascular redistribution in the lungs
Answer: D
Rationale: Left-sided HF causes pulmonary congestion and cardiomegaly. Vascular
redistribution (cephalization) is seen on chest X-ray.
3. Which clinical presentation is most consistent with left-sided heart failure?
A. Jugular vein distention, hepatomegaly, and cold extremities
B. Clear lung sounds, irregular heart rate, and ankle swelling
C. Peripheral edema, ascites, and weight gain
D. Shortness of breath on exertion, orthopnea, and paroxysmal nocturnal dyspnea
Answer: D
Rationale: Left-sided HF presents with pulmonary symptoms: dyspnea, orthopnea,
PND. JVD and hepatomegaly are right-sided signs.
,4. Which patient is at the highest risk for developing heart failure?
A. A 60-year-old with well-controlled hypothyroidism and no cardiac history
B. A 52-year-old with hypertension, type 2 diabetes, and hyperlipidemia
C. A 35-year-old who consumes alcohol socially and does not exercise
D. A 40-year-old with mild asthma and BMI 24
Answer: B
Rationale: Hypertension, diabetes, and hyperlipidemia are major risk factors for HF. The
combination significantly increases risk.
5. Which assessment finding is most consistent with developing coronary artery
disease in an older adult client?
A. Sudden onset of unilateral lower extremity weakness
B. Warm, well-perfused extremities and brisk capillary refill
C. Occasional shortness of breath during exertion and an S3 heart sound
D. Chronic productive cough and inspiratory wheezes
Answer: C
Rationale: Exertional dyspnea and S3 (ventricular gallop) are early signs of left
ventricular dysfunction, often due to CAD.
6. A client with heart failure reports worsening shortness of breath, weight gain of 5
lbs in 2 days, and 2+ pitting edema. Which nursing diagnosis is most appropriate?
A. Ineffective breathing pattern related to anxiety
B. Excess fluid volume related to decreased cardiac output
C. Impaired gas exchange related to pulmonary edema
D. Activity intolerance related to deconditioning
Answer: B
Rationale: Weight gain and edema indicate fluid overload. Decreased cardiac output
leads to fluid retention.
7. Which medication is first-line for reducing mortality in heart failure with reduced
ejection fraction (HFrEF)?
A. Furosemide
B. Metoprolol succinate
C. Digoxin
D. Hydralazine
, Answer: B
Rationale: Beta-blockers (metoprolol succinate, carvedilol) improve survival in HFrEF.
Furosemide is for symptom relief, not mortality reduction.
8. A client with HFrEF is started on lisinopril. Which lab value should be monitored
closely?
A. Serum potassium
B. Serum sodium
C. Hemoglobin A1c
D. INR
Answer: A
Rationale: ACE inhibitors can cause hyperkalemia, especially in clients with renal
impairment or on potassium-sparing diuretics.
9. Which finding indicates worsening heart failure that requires immediate
intervention?
A. Mild fatigue after walking one block
B. Occasional dry cough
C. New onset of confusion and hypotension
D. 1+ pitting edema that improves with elevation
Answer: C
Rationale: Confusion and hypotension suggest cardiogenic shock or low cardiac
output, requiring urgent evaluation.
10. A client with chronic heart failure reports needing three pillows to sleep. This
symptom is called:
A. Paroxysmal nocturnal dyspnea
B. Orthopnea
C. Platypnea
D. Trepopnea
Answer: B
Rationale: Orthopnea is dyspnea when lying flat; relieved by sitting up. PND is sudden
nighttime dyspnea.
