NCLEX Heart Failure Practice Test

These questions are part of the practice quiz. Start practicing

• What does HFrEF stand for?
• Which description matches first-line therapy for heart failure and mentions that some patients develop a nagging cough?
• In a patient with acute heart failure and hypoxemia, which noninvasive modality can improve oxygenation?
• What role does weight monitoring play in heart failure discharge education?
• Which statement accurately differentiates dobutamine and milrinone in heart failure therapy?
• Which statement demonstrates correct self-management for a patient on Digoxin?
• Name a common precipitating factor for acute heart failure exacerbation.
• Initial management of acute decompensated heart failure typically includes which approach?
• Which beta-blocker is commonly used in stable heart failure with reduced ejection fraction (HFrEF) and has proven mortality benefit?
• In HFpEF, which therapy is not associated with proven mortality benefit?
• Which finding would indicate acute decompensated heart failure presenting with pulmonary edema?
• A patient with heart failure on Losartan and Spironolactone shows tall peaked T-waves on EKG. Which lab finding confirms this condition?
• Which device therapy is indicated for reducing mortality in some heart failure patients and may require biventricular pacing?
• Why is daily weight monitoring essential for patients managing heart failure at home?
• Which symptom is most characteristic of left-sided heart failure?
• An infant is ordered a scheduled dose of Digoxin. The apical pulse rate is 78 bpm. What should the nurse do?
• Which of the following actions is most appropriate if a patient on Digoxin reports vision changes?
• Why is daily weight monitoring essential in heart failure management, and what weight change is concerning?
• How does obesity affect heart failure management and prognosis?
• Which item on a menu would be lowest in sodium for a 2000-mg sodium diet?
• When might noninvasive ventilation be preferred to intubation in acute decompensated heart failure?
• In acute decompensated heart failure with severe congestion, what IV therapy is first-line to reduce preload?
• What electrolyte disturbance is most commonly associated with loop diuretics in heart failure?
• What is the recommended activity approach for stable HF patients?
• Which sign or symptom indicates digoxin toxicity?
• Which medication class can cause hyperkalemia and requires potassium monitoring in heart failure?
• What is the overall goal of heart failure therapy?
• Which HF therapy is primarily used to relieve symptoms rather than reduce mortality?
• A patient with left-sided heart failure is experiencing dyspnea. Which nursing intervention is most appropriate to improve breathing?
• Which classes have demonstrated mortality reduction in heart failure with reduced ejection fraction as part of guideline-directed medical therapy?
• What is the typical daily sodium intake recommended for most heart failure patients?
• Which EF finding supports left-sided systolic dysfunction?
• Which of the following statements represents typical CRT criteria in heart failure?
• While assessing a patient with ascites, the nurse notes jugular venous distention with the head of the bed at 45 degrees. This finding indicates:
• Which of the following is a risk factor for heart failure?
• During dietary teaching for a patient recently hospitalized with an exacerbation of chronic heart failure, which statement demonstrates understanding of sodium restriction?
• Inotropes such as dobutamine and milrinone share which potential adverse effect?
• Why is careful monitoring of intake and output important in heart failure patients?
• Before administering Digoxin, which assessment is essential?
• When starting ACE inhibitors in heart failure, which labs should be monitored regularly?
• Which is a late sign of heart failure?
• What is the general treatment emphasis for HFpEF?
• A patient taking Digoxin has severe bradycardia, nausea, and vomiting, with a Digoxin level of 4 ng/mL. What medication would the physician order?
• Which diuretic is preferred for rapid relief of edema in heart failure?
• For HF patients at discharge, what daily practice is commonly recommended to detect fluid retention?
• Laboratory results show sodium 139 mEq/L, potassium 5.6 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dL in a patient on digoxin. What is the priority action?
• What is the therapeutic plasma range for Digoxin?
• What constitutes a positive response to guideline-directed therapy in HF?
• What term best describes heart failure with reduced ejection fraction?
• Which patient is at MOST risk for developing Digoxin toxicity?
• What is a key aspect of posttransplant management to prevent rejection?
• Which medication increases the patient’s risk of Digoxin toxicity by promoting potassium loss?
• What is the role of LVAD in heart failure management?
• Which group should receive pneumococcal vaccination as part of HF care?
• A patient reports seeing yellowish-green halos around lights and experiences vision changes. Which medication is likely causing this toxicity?
• Which biomarker is elevated in heart failure?
• Which biomarker level is elevated in HF and correlates with severity?
• What is the mechanism of ARBs in HF?
• How can diuretic therapy influence renal function in HF patients?
• True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal ejection fraction.
• SGLT2 inhibitors provide mortality and hospitalization benefits beyond glucose control in heart failure patients.
• Backward failure in heart failure most directly leads to congestion in which circulatory beds?
• A patient with dyspnea, orthopnea, and leg edema presents with suspected heart failure. Which pathophysiologic change most directly explains their symptoms?
• Heart failure with reduced ejection fraction is defined as EF ≤40%.
• In managing heart failure, which of the following is a potential side effect of beta-blockers?
• Which inotrope is commonly used for heart failure with cardiogenic shock?
• How do loop diuretics help relieve symptoms in heart failure, and what electrolyte disturbance must be watched?
• What is a key adverse effect of loop diuretics requiring monitoring?
• Which statement best describes the primary effect of digoxin on myocardial contractility?
• Which agent is used to acutely reduce preload in pulmonary edema?
• What electrolyte abnormality is increased by ACE inhibitors?
• Which symptom suggests digoxin toxicity?
• Which lab result confirms heart failure?
• What is the primary dietary modification recommended for heart failure patients to reduce volume overload?
• What is the QRS duration threshold used in CRT criteria?
• What is the purpose of measuring BNP/NT-proBNP in heart failure?
• A patient with chronic heart failure is prescribed digoxin and hydrochlorothiazide. Which instruction is appropriate?
• HF with preserved EF is primarily due to which dysfunction?
• What is the daily sodium target commonly recommended for heart failure patients to help prevent fluid overload?
• Which statement best describes when ICD therapy should be considered in heart failure?
• Which symptom pattern would be considered a red flag requiring urgent evaluation in a patient with HF?
• Which symptom is an early sign of worsening HF due to increased filling pressures?
• Before administering digoxin to a patient with influenza and chronic heart failure, what should the nurse assess?
• Which inotrope is commonly used to support cardiac output in cardiogenic shock?
• For a patient with long-standing heart failure who has entered hospice, what measure should the nurse prioritize?
• An older adult with chronic heart failure and atrial fibrillation asks why warfarin has been prescribed to continue at home. What is the best response?
• In HF, which test is used to monitor valvular disease progression?
• Why is potassium monitoring important when using ACE inhibitors with aldosterone antagonists or CKD?
• Digoxin belongs to which drug family?
• Which finding would most strongly suggest fluid overload in a patient with chronic heart failure?
• A patient taking digoxin and a diuretic should be instructed about potassium. Which statement is correct?
• A patient with acute decompensated heart failure becomes dyspneic. Before dangling the patient at the bedside, which assessment should be performed first?
• Which imaging modality is most widely used to assess left ventricular systolic function?
• Which dietary modification is routinely recommended for heart failure patients to manage volume status?
• Which test is NOT used to diagnose heart failure?
• Which statement about nitrates in acute decompensated heart failure is true?
• Which symptom is NOT part of the typical left-sided heart failure symptom cluster?
• Which is a normal potassium range relevant to monitoring patients on Digoxin therapy?
• An outpatient who has chronic heart failure returns after 2 weeks of therapy with metoprolol. Which assessment finding is most important to report to the health care provider?
• How does neurohormonal activation contribute to the progression of heart failure?
• Which symptom is most characteristic of left-sided heart failure leading to pulmonary congestion?
• When teaching about nitroglycerin patch use, which precaution should the nurse include?
• What discharge planning steps are known to reduce HF readmissions?
• Which drug class is most associated with fluid retention and should be avoided in heart failure?
• What sign might indicate renal hypoperfusion in heart failure?
• When assisting a patient with edema due to heart failure who is taking Hydralazine and Isordil to the bathroom, what is the nursing priority?
• Which of the following statements regarding neurohormonal activation in heart failure is most accurate?
• In the ICU, a patient with acute decompensated heart failure reports severe dyspnea, anxiety, tachypnea, and tachycardia. Among the orders, the nurse’s priority action is to:
• Which laboratory biomarker is elevated in heart failure and correlates with disease severity?
• Which medication class reduces mortality in HFrEF by inhibiting the RAAS?
• Which sign is NOT considered an early sign of Digoxin toxicity?
• Which symptom is most characteristic of left-sided heart failure?
• Which discharge-practice element is essential for reducing HF readmissions?
• How does atrial fibrillation affect HF management?
• What is a key consequence of neurohormonal activation in heart failure?
• What is the primary goal of diuretic therapy in heart failure?
• What is the priority assessment for a patient receiving IV nesiritide (Natrecor) to treat heart failure?
• What is a common precipitating factor for heart failure decompensation requiring urgent care?
• What should the nurse recognize as an indication for the use of dopamine in the care of a patient with heart failure?
• A patient on digoxin develops nausea, confusion, and vision disturbances. What is the likely issue and immediate action?
• Which test best estimates left ventricular systolic function in routine practice?
• Discharge teaching about left-sided systolic dysfunction: which statement is NOT correct?
• Which diuretic is commonly used to relieve edema in heart failure?
• What is the final answer choice indicating the hemodynamic effect of IV vasodilators in acute decompensated heart failure?
• Left ventricular diastolic dysfunction typically presents with a preserved ejection fraction.
• What should a patient understand about salt substitutes while on HF medications?
• Which electrolyte abnormality commonly indicates advanced heart failure?
• How should a patient with orthopnea be positioned to ease breathing?
• Which statement about ejection fraction in heart failure is true?
• What outcome indicates effectiveness of furosemide when treating heart failure?
• Which factor increases the risk of digoxin toxicity in older adults?
• Which electrolyte abnormality should be monitored in a patient taking an ACE inhibitor in combination with a potassium-sparing diuretic?
• Which daily sodium intake is recommended for heart failure patients?
• Which diagnostic test is best for confirming heart failure and assessing prognosis by measuring ejection fraction?
• In a patient with heart failure experiencing anxiety and dyspnea, which nursing action would be most effective in alleviating anxiety?
• In acute decompensated heart failure with pulmonary edema, what is the most appropriate initial pharmacologic intervention?
• Loop diuretics are associated with which electrolyte imbalance?
• In monitoring for acute fluid overload, which sign is a key indicator that requires urgent evaluation?
• Which inotrope is commonly used for heart failure with cardiogenic shock?
• A Digoxin level of 2.5 ng/mL is detected. What action should the nurse take?
• Which laboratory parameter is most important to monitor due to loop diuretic use?
• Which vaccines are recommended for heart failure patients?
• Which drug class reduces mortality in HF with reduced ejection fraction?
• What is a primary reason for monitoring intake and output in heart failure patients?
• After MI, a patient shows jugular venous distention, weight gain, edema, and a heart rate of 108 beats/min. Which heart failure is suspected?
• Name two lab abnormalities often seen with HF.
• Which natriuretic peptide measurement is used to aid diagnosis of heart failure?
• What distinguishes guideline-directed medical therapy (GDMT) for mortality reduction in HF from symptom-relief therapies?
• During initiation of a beta-blocker in HFrEF, which parameter should be closely watched?
• Which drug combination is particularly recommended for symptomatic Black patients with heart failure to improve outcomes?
• In the hospital management of heart failure, inotropes are used to:
• How do NSAIDs affect heart failure management?
• A BNP level is significantly elevated in a patient with dyspnea. What does this indicate about heart failure status?
• Which sign most strongly suggests right-sided heart failure?
• Which regimen has proven mortality benefit especially in African American patients with HFrEF?
• Loop diuretics can cause which electrolyte abnormality?
• Noninvasive ventilation is preferred in acute decompensated heart failure when the patient has which condition?
• In heart failure management, what is a common criterion for considering an ICD?
• Which electrolyte abnormality increases the risk of digoxin toxicity?
• What is required before starting sacubitril/valsartan in a patient recently treated with an ACE inhibitor?
• Which statement is not a core measure for heart failure patients?
• A patient who had bladder surgery 2 days ago develops acute decompensated heart failure with severe dyspnea. Which action by the nurse would be indicated first?
• Which chest imaging finding is commonly seen in chronic HF, often with interstitial edema?
• In-hospital heart failure management, what is the role of inotropes?
• What is the therapeutic rationale for using IV nitrates in the acute decompensated heart failure setting?
• What clinical criteria generally indicate consideration for implantable cardioverter-defibrillator (ICD) therapy in HF?
• Which of the following is a core measure for heart failure patients with reduced ejection fraction?
• Which drug class should be avoided or used cautiously in heart failure due to fluid retention risk?
• When initiating a beta-blocker in heart failure with reduced ejection fraction, what is the best practice?
• What is the hemodynamic effect of IV vasodilators in acute decompensated heart failure?
• Which signs suggest possible cardiogenic shock requiring urgent evaluation?
• Which imaging modality is most accurate for measuring left ventricular ejection fraction?
• What vaccines are recommended for patients with heart failure to reduce infection-related decompensation?
• The patient with chronic heart failure is being discharged and the nurse should emphasize which teaching to prevent progression to acute decompensated heart failure?
• The jugular vein empties into the superior vena cava, and from there it drains into which heart chamber?
• Which statement demonstrates understanding of sodium-restricted diet for heart failure?
• Which adverse effects are associated with spironolactone in heart failure patients?
• The nurse is administering a dose of Digitalis (digoxin) to a patient with heart failure. The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which symptom?
• Which condition is a common precipitating factor for HF exacerbation?
• Why is monitoring for digoxin toxicity important in heart failure therapy?
• Which ECG finding is part of the typical CRT criteria?
• In acute decompensated HF with pulmonary edema, which IV medication class rapidly decreases preload and afterload when BP allows?
• A patient taking Digoxin has a potassium level of 2.8 mEq/L. What action should the nurse take?
• Which statements indicate possible heart failure exacerbation?
• When starting ACE inhibitors in heart failure, what labs should be monitored regularly?
• In HFpEF, what is the role of diuretics?
• A patient with a history of chronic heart failure presents to the emergency department with severe dyspnea and a dry, hacking cough. Which action should the nurse perform first?
• Which test helps distinguish HF from primary pulmonary disease in dyspnea assessment?
• Which electrolyte requires close monitoring due to the use of diuretics and RAAS inhibitors?
• Which statement about education for patients with heart failure is NOT correct?
• In acute decompensated heart failure with severe dyspnea, what is the primary reason for placing the patient in a high Fowler's position?
• In acute decompensated heart failure with edema and hypertension, which rapid-acting therapy reduces preload and afterload?
• Which medication is used for rate control and symptom relief in heart failure with atrial fibrillation, but must be monitored for toxicity?
• How does digoxin therapy influence hospitalizations and mortality in heart failure?
• Which patient is at MOST risk for heart failure exacerbation?
• For HFpEF, which statement best describes symptomatic management and mortality benefit?
• Which statement describes milrinone’s mechanism as used in HF?
• A patient on Digoxin has an apical pulse of 61 bpm and a Digoxin level of 5 ng/mL with a potassium level of 3.3 mEq/L. What is the correct nursing action?
• A patient with heart failure should monitor their weight and report weight changes. Which threshold represents how much weight gain in a day or a week should prompt contact with a clinician?
• Which electrolyte requires monitoring due to diuretic and RAAS therapy?
• In stable heart failure, which statement best describes preload management?
• What findings are classic for pulmonary edema secondary to heart failure?
• What is the recommended follow-up interval after hospital discharge for heart failure?
• Which mechanism explains why NSAIDs worsen heart failure?
• Which natriuretic peptide is commonly used to help diagnose heart failure?
• Which sign is not typical of right-sided heart failure?
• A patient is scheduled for a heart transplant. What is a major cause of death beyond the first year after transplantation?
• A physician orders Lasix 40 mg IV twice daily. Morning labs show Na 148, BNP 900, K 2.0, BUN 10. Which nursing action is the priority?
• For heart failure with reduced ejection fraction, which medication class is commonly prescribed at discharge to improve outcomes?
• Heart failure with preserved EF is primarily due to what dysfunction?
• In heart failure with reduced ejection fraction, ICDs are considered for patients with EF ≤35% despite optimal medical therapy.
• Which statement best describes the chest imaging finding in chronic HF?
• In pulmonary edema due to acute decompensated heart failure, which lung finding is commonly observed?
• Which elements should be included in patient education for heart failure management?
• What is a key aspect of post-discharge heart failure care?
• What type of heart failure does this describe: The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing shortness of breath.
• In congestive hepatopathy due to heart failure, which laboratory abnormalities may be seen?
• Which of the following is NOT a typical sign or symptom of right-sided heart failure?
• Which hemodynamic change is commonly observed in decompensated heart failure?
• A patient with left-sided systolic dysfunction has which findings?
• When starting multiple HF medications, what is an important hemodynamic consideration?
• What are two common adverse effects of ACE inhibitors used in heart failure, and what labs should be monitored?
• For a patient following a 2000-mg sodium diet, which foods are restricted?
• Which vaccination should patients with heart failure be up-to-date with annually?
• In acute pulmonary edema, which intravenous therapy is used to acutely reduce preload?
• Which statement best describes the primary role of diuretic therapy in heart failure?
• Which of the following is an indicator of fluid overload in a patient with heart failure?
• Which statement describes CRT eligibility in terms of ejection fraction?
• What emerging HF therapy class provides mortality and hospitalization benefits beyond glucose control, even in non-diabetics?
• Which statement best indicates understanding of dietary sodium restrictions for heart failure discharge?
• Which pathophysiology best describes a left ventricular systolic dysfunction with an ejection fraction of 33%?
• Which drug combination should be avoided due to severe hypotension risk when used together?
• Which statement about hydralazine plus isosorbide dinitrate in heart failure is true?
• Which features are most characteristic of left-sided heart failure?
• Discharge planning for a patient with systolic heart failure and an ejection fraction of 33% should include information about the benefits and side effects of which medication class?
• Which condition represents faulty heart valve disease that can contribute to heart failure?
• Which electrolyte abnormality increases the risk of Digoxin toxicity when using diuretics?