Font size
WorksheetsHeart Failure – NCLEX
Total questions: 60
Worksheet time: 30mins
A nurse explains heart failure to a patient. Which statement best describes the pathophysiology of heart failure?
The heart pumps faster to compensate for low oxygen levels
The heart is unable to pump enough blood to meet the oxygen needs of tissues
The heart valves fail to open completely during systole
Blood pressure is persistently elevated due to arterial stiffness
Which condition is the most common underlying cause of right-sided heart failure?
Chronic obstructive pulmonary disease
Valvular heart disease
Left-sided heart failure
Primary pulmonary hypertension
A patient with heart failure has an echocardiogram showing an ejection fraction of 30%. How should the nurse interpret this finding?
Normal systolic function
Mild diastolic dysfunction
Severe systolic dysfunction
Normal finding for older adults
Which clinical manifestation is most consistent with left-sided heart failure?
Hepatomegaly
Peripheral edema
Pulmonary crackles
Jugular venous distention
A nurse is caring for a patient admitted with acute decompensated heart failure (ADHF). Which finding requires the most immediate intervention?
Fatigue and weakness
Weight gain of 2 lb in one week
Pink, frothy sputum
Decreased urine output
Which laboratory value is most useful for assessing ventricular stretch in heart failure?
Troponin
BNP
Creatinine
Potassium
A patient has heart failure with preserved ejection fraction. Which type of heart failure does this indicate?
Systolic heart failure
Right-sided heart failure
Diastolic heart failure
Acute heart failure
Which medication class is first-line for reducing fluid overload in heart failure?
Beta blockers
ACE inhibitors
Loop diuretics
Positive inotropes
Which nursing intervention is a core measure for hospitalized patients with heart failure?
Monitor blood glucose every 4 hours
Daily weights at the same time each day
Encourage high-protein diet
Limit physical activity completely
Which patient statement indicates correct understanding of heart failure discharge teaching?
“I should weigh myself weekly to monitor fluid status.”
“I can stop my medications once my symptoms improve.”
“I should report a 3-lb weight gain in one day.”
“Canned foods are acceptable if they are low fat.”
Which finding best differentiates acute decompensated heart failure (ADHF) from chronic heart failure?
Peripheral edema
Fatigue with activity
Tachypnea with use of accessory muscles
Decreased urine output
A nurse auscultates lung sounds on a patient with left-sided heart failure. Which finding is expected?
Wheezing in upper lobes
Diminished breath sounds bilaterally
Crackles at lung bases
Pleural friction rub
Which complication of heart failure results from fluid accumulation in the pleural space?
Pulmonary edema
Pleural effusion
Atelectasis
Pneumothorax
A patient with chronic heart failure develops atrial fibrillation. Why is this dysrhythmia common in HF patients?
Increased myocardial oxygen supply
Stretching of atrial chambers from volume overload
Decreased sympathetic stimulation
Reduced ventricular wall thickness
Which assessment finding suggests right-sided heart failure?
Orthopnea
Pulmonary crackles
Hepatomegaly
Pink, frothy sputum
A nurse reviews diagnostic results for a patient with suspected heart failure. Which test provides information about ejection fraction and chamber size?
Chest x-ray
BNP level
12-lead ECG
Echocardiogram
Which electrolyte imbalance is the nurse most concerned about in a patient receiving loop diuretics for heart failure?
Hypernatremia
Hypercalcemia
Hypokalemia
Hypermagnesemia
A patient with heart failure reports gaining 6 lb in one week. What does this most likely indicate?
Improved nutritional intake
Increased muscle mass
Fluid volume overload
Medication effectiveness
Which medication would the nurse question administering to a heart failure patient with severe renal impairment?
Low-dose beta blocker
Loop diuretic
Aggressive diuretic therapy
ACE inhibitor
Which patient education statement shows correct understanding of sodium restriction in heart failure?
“I can season foods freely with salt as long as I avoid fluids.”
“I will choose fresh foods and avoid canned or processed items high in sodium.”
“I should increase sodium intake when I feel weak.”
“I only need to restrict sodium if my weight increases.”
Which assessment finding is most concerning in a patient with heart failure receiving IV loop diuretics?
Urine output of 40 mL/hr
Blood pressure of 138/84 mm Hg
Potassium level of 3.1 mEq/L
Weight loss of 1 lb in 24 hours
A patient with heart failure has a BNP level of 920 pg/mL. How should the nurse interpret this result?
Normal finding for older adults
Indicates renal failure
Suggests acute worsening of heart failure
Confirms myocardial infarction
Which medication is most appropriate to reduce afterload in a patient with chronic heart failure?
Loop diuretic
ACE inhibitor
Positive inotrope
Antiarrhythmic agent
Which nursing intervention best helps prevent hospital readmission for patients with heart failure?
Limiting all physical activity
Teaching daily weight monitoring
Encouraging increased fluid intake
Reducing follow-up appointments
A nurse is caring for a patient with diastolic heart failure. Which explanation best describes this condition to the patient?
“Your heart cannot pump blood out of the ventricles.”
“Your heart muscle is weak and thin.”
“Your heart cannot relax enough to fill properly.”
“Your heart valves are leaking blood backward.”
Which finding is most consistent with decreased cardiac output in heart failure?
Bounding peripheral pulses
Warm, flushed skin
Confusion and restlessness
Increased urine output
Which complication of heart failure is caused by reduced renal perfusion?
Pleural effusion
Cardiorenal syndrome
Pulmonary edema
Atrial fibrillation
A nurse reviews the medication list of a patient with heart failure. Which drug would the nurse recognize as a positive inotrope?
Metoprolol
Furosemide
Digoxin
Lisinopril
Which nursing assessment is most important to perform at the beginning of each shift for a patient with heart failure?
Abdominal girth measurement
Capillary blood glucose
Lung sound auscultation
Neurological assessment
Which patient is at highest risk for developing heart failure?
A 25-year-old with a history of asthma
A 40-year-old with controlled diabetes
A 68-year-old with long-standing hypertension
A 50-year-old who exercises daily
A patient with heart failure is admitted with dyspnea and crackles. Which intervention should the nurse implement first?
Obtain daily weight
Administer prescribed beta blocker
Place the patient in high Fowler’s position and apply oxygen
Restrict sodium intake
Which finding best indicates fluid volume overload in a patient with heart failure?
Dry mucous membranes
Weight gain of 3 lb in 24 hours
Decreased blood pressure
Hypoactive bowel sounds
A patient with heart failure asks why daily weights are more important than intake and output. Which response by the nurse is best?
Daily weights reflect fluid changes more accurately.
Urine output is unreliable in heart failure.
Daily weights are required by hospital policy.
Intake and output are only used in acute illness.
Which assessment finding suggests worsening left-sided heart failure?
Peripheral edema
Jugular venous distention
Increasing crackles on lung auscultation
Abdominal distention
Which medication would the nurse expect to be used cautiously or avoided in a patient with heart failure and bradycardia?
Loop diuretics
ACE inhibitors
Beta blockers
Vasodilators
A patient with heart failure is prescribed fluid restriction. Which rationale best explains this intervention?
To prevent dehydration
To decrease preload and cardiac workload
To improve renal perfusion
To reduce afterload
Which clinical manifestation is associated with decreased perfusion to the kidneys in heart failure?
Increased urine output
Nocturia
Oliguria
Hematuria
Which patient statement indicates a need for additional discharge teaching related to heart failure?
I will weigh myself every morning before breakfast.
I should call my provider if I gain 5 pounds in a week.
I can stop my diuretic once my swelling goes down.
I will limit foods high in sodium.
Which complication of heart failure results from chronic liver congestion?
Splenomegaly
Hepatomegaly
Ascites due to infection
Acute pancreatitis
Which nursing diagnosis is most appropriate for a patient with symptomatic heart failure?
Risk for impaired skin integrity
Activity intolerance
Impaired verbal communication
Chronic pain
Which assessment finding is most indicative of decreased cardiac output in a patient with heart failure?
Bounding pulses
Warm, flushed skin
Fatigue and weakness
Elevated blood pressure
A nurse is reviewing laboratory results for a patient with heart failure. Which value requires the most immediate follow-up?
BNP of 480 pg/mL
Potassium of 5.9 mEq/L
Sodium of 135 mEq/L
Hemoglobin of 12.8 g/dL
Which medication is primarily used to reduce mortality and slow disease progression in chronic heart failure?
Loop diuretics
ACE inhibitors
Short-acting nitrates
Positive inotropes
Which teaching point should the nurse emphasize to a patient newly diagnosed with heart failure?
Avoid all physical activity.
Weigh yourself at the same time each day.
Increase fluid intake during exercise.
Stop medications if blood pressure improves.
Which clinical manifestation is associated with systemic venous congestion in right-sided heart failure?
Pulmonary crackles
Orthopnea
Peripheral edema
Pink, frothy sputum
A patient with heart failure is prescribed digoxin. Which finding would indicate digoxin toxicity and should be reported immediately?
Blood pressure of 140/86 mm Hg
Heart rate of 52 beats/min
Mild ankle edema
Weight loss of 1 lb
Which intervention best helps reduce cardiac workload in a patient with heart failure?
Encourage fluid intake
Maintain strict bed rest
Administer diuretics as prescribed
Increase dietary sodium
Which patient with heart failure requires priority assessment?
Weight gain of 1 lb in 3 days
Mild bilateral ankle edema
Respiratory rate of 34 breaths/min
Blood pressure of 130/82 mm Hg
Which statement best explains why patients with heart failure are at risk for frequent hospital readmissions?
Heart failure is easily cured with medication.
Symptoms worsen rapidly without lifestyle changes.
Diuretics lose effectiveness over time.
Heart failure only affects older adults.
Which outcome best indicates effective management of heart failure?
Absence of all symptoms
Stable weight and improved activity tolerance
Normal ejection fraction
Elimination of all medications
Which findings are common clinical manifestations of left-sided heart failure? (Select all that apply)
Pulmonary crackles
Peripheral edema
Dyspnea
Orthopnea
Hepatomegaly
Which conditions are common causes of heart failure? (Select all that apply)
Chronic hypertension
Coronary artery disease
Myocardial infarction
Asthma
Acute kidney injury
Which assessment findings suggest acute decompensated heart failure (ADHF)? (Select all that apply)
Tachypnea (RR > 30)
Pink, frothy sputum
Cool, clammy skin
Weight loss
Bradycardia
Which diagnostic tests are commonly used to evaluate heart failure? (Select all that apply)
BNP level
Echocardiogram
Chest x-ray
Colonoscopy
12-lead ECG
Which findings are associated with right-sided heart failure? (Select all that apply)
Jugular venous distention
Peripheral edema
Hepatomegaly
Pulmonary crackles
Ascites
Which medications are commonly included in heart failure drug therapy? (Select all that apply)
Loop diuretics
ACE inhibitors
Beta blockers
Antibiotics
Aldosterone antagonists
Which nursing interventions are core measures for hospitalized heart failure patients? (Select all that apply)
Daily weights
Strict intake and output monitoring
Low-sodium diet
High-protein diet
Fluid restriction
Which patient statements indicate correct understanding of heart failure self-management? (Select all that apply)
“I will weigh myself every morning before breakfast.”
“I should call my provider if I gain 3 pounds in one day.”
“Canned foods are usually safe if I drink more water.”
“I will take my medications even if I feel better.”
“I don’t need follow-up appointments once my symptoms improve.”
Which complications may occur in patients with chronic heart failure? (Select all that apply)
Atrial fibrillation
Pleural effusion
Cardiorenal syndrome
Acute pancreatitis
Anemia
Which findings require immediate nursing intervention in a patient with heart failure? (Select all that apply)
Respiratory rate of 34 breaths/min
Oxygen saturation of 88%
Weight gain of 1 lb in a week
Potassium level of 3.0 mEq/L
Mild ankle edema
