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WorksheetsNCLEX-Style Practice Questions (Hemodynamics, HTN, HF, Meds)
Total questions: 86
Worksheet time: 43mins
A patient with chronic heart failure presents with acute shortness of breath. Assessment findings include crackles bilaterally, RR 32, SpO2 86% on room air, and pink frothy sputum. What is the nurse’s priority action?
Administer IV furosemide
Place the patient in high Fowler’s position
Obtain a STAT ABG level
Restrict oral fluids
A patient with left sided heart failure is prescribed IV furosemide. Current vital signs are BP 84/48, HR 112, MAP 57. What should the nurse do first?
Administer the medication as prescribed
Hold the medication and notify the provider
Encourage oral fluids
Recheck the blood pressure in 30 minutes
Which patient finding is most concerning?
BP 132/84, MAP 100
BP 118/70, MAP 76
BP 98/60, MAP 70
BP 84/48, MAP 59
A patient presents with BP 212/128, confusion, severe headache, and blurred vision. What action should the nurse anticipate?
Oral antihypertensive and discharge
Gradual BP reduction with IV medication
Immediate normalization of BP
Observation only
Which patient is most likely to have increased afterload?
Patient with dehydration
Patient with hypotension
Patient with chronic hypertension
Patient with bradycardia
A patient with heart failure is prescribed metoprolol. Which assessment finding requires the nurse to hold the medication?
BP 138/86
HR 52
SpO2 98%
Weight gain of 1 lb in 24 hours
Which finding is most consistent with right sided heart failure?
Crackles in lungs
Frothy sputum
Jugular vein distention
Decreased oxygen saturation
A patient has diastolic heart failure. Which explanation best describes this condition?
The heart cannot eject blood effectively
The ventricles are stiff and cannot fill properly
Stroke volume is increased
Ejection fraction is severely reduced
Which assessment finding best reflects poor cardiac output?
Warm, flushed skin
Bounding peripheral pulses
Delayed capillary refill
Increased urine output
Which statement by a heart failure patient indicates correct understanding?
I should weigh myself weekly.
I can stop my meds when I feel better.
I should report a 3 lb weight gain in one day.
Low sodium only matters when I’m hospitalized.
A patient with heart failure suddenly becomes anxious and restless. Vital signs: RR 34, SpO2 86% on 2 L nasal cannula, HR 118, BP 146/90. What is the nurse’s priority action?
Increase oxygen flow rate
Administer prescribed furosemide
Obtain a STAT chest x-ray
Notify the provider
A patient with hypertension is prescribed lisinopril. Before administering, which assessment is most important?
Apical pulse
Blood pressure
Respiratory rate
Temperature
A patient's BP is 88/40. What does this indicate?
Adequate perfusion
Mild hypotension
MAP below safe range
Hypertensive crisis
Which patient should the nurse see first?
Chronic HF patient with 2+ ankle edema
Hypertensive patient scheduled for discharge
HF patient with new crackles and SpO2 88%
Patient asking about low sodium diet
Which intervention reduces preload?
IV normal saline
Blood transfusion
Diuretics
Trendelenburg position
Which condition increases afterload?
Hypovolemia
Hypertension
Bradycardia
Dehydration
A patient receiving nitroglycerin reports dizziness. BP is now 88/54. What should the nurse do first?
Administer another dose
Place the patient supine
Notify the provider
Check potassium level
Which medication is a positive inotrope?
Metoprolol
Digoxin
Lisinopril
Furosemide
Which patient statement requires immediate follow up?
"I feel a little tired."
"My heart rate is 54 today."
"My blood pressure is lower than usual."
"I gained one pound this week."
Which assessment finding suggests worsening left sided heart failure?
Peripheral edema
Jugular vein distention
Crackles in lungs
Ascites
A stable patient with hypertension reports dizziness when standing. What should the nurse do first?
Administer IV fluids
Assess orthostatic vital signs
Hold antihypertensive meds
Notify the provider
Which finding best indicates fluid overload?
Decreased urine output
Weight gain of 4 lb in 2 days
Dry mucous membranes
Weak pulses
Which patient should be seen first?
BP 168/92 without symptoms
BP 162/78 with headache
BP 210/124 with confusion
BP 150/88 requesting discharge
Which factor directly affects stroke volume?
Heart rate
Preload
Respiratory rate
Temperature
Which statement indicates effective heart failure teaching?
"I will drink fluids to prevent dehydration."
"I will check my weight every morning."
"I only take meds when symptoms worsen."
"Salt doesn't affect my condition."
Which finding suggests decreased cardiac output?
Bounding pulses
Warm extremities
Delayed capillary refill
Pink nail beds
A heart failure patient has SpO2 84% on room air. What is the nurse's first action?
Administer IV diuretics
Apply oxygen
Obtain ABGs
Call respiratory therapy
Which situation is highest priority?
Chronic HF patient with mild edema
Stable HTN patient asking discharge
Sudden weight gain and dyspnea overnight
Patient asking about medication schedule
Which finding is caused by right sided heart failure?
Pulmonary crackles
Frothy sputum
Hepatomegaly
Decreased oxygenation
A medication is ordered to reduce preload. The patient is dizzy with BP 84/50. What should the nurse do?
Give the medication
Reduce the dose
Hold and notify provider
Reassess in one hour
Which findings are consistent with left-sided heart failure? Select all that apply.
Crackles in the lungs
Jugular vein distention
Decreased oxygen saturation
Frothy sputum
Peripheral edema
Which assessment findings indicate decreased cardiac output? Select all that apply.
Cool extremities
Delayed capillary refill
Bounding pulses
Decreased urine output
Warm flushed skin
Which medications or interventions reduce preload? Select all that apply.
Furosemide
Nitroglycerin
IV normal saline
Morphine
Blood transfusion
Which statements should the nurse include when teaching a patient taking a beta blocker? Select all that apply.
Check heart rate before taking the medication
Hold medication if heart rate is below 60
Expect an increase in heart rate
Rise slowly from a sitting position
Stop medication abruptly if feeling better
Which findings indicate a hypertensive emergency? Select all that apply.
BP 240/120
Headache and confusion
Nosebleed only
Chest pain
Blurred vision
A patient with heart failure has SpO2 85%, RR 30, and crackles throughout lung fields. What is the nurse's priority action?
Administer IV diuretics
Apply oxygen
Obtain arterial blood gases
Notify the provider
Which blood pressure reflects adequate perfusion?
80/40
125/52
100/50
82/46
Which assessment finding requires the nurse to hold lisinopril?
BP 166/92
BP 84/48
HR 88
SpO2 98%
Which patient should the nurse assess first?
Chronic heart failure patient with mild edema
Hypertension patient requesting discharge paperwork
New onset dyspnea and crackles
Patient asking about medication timing
Which medication primarily reduces afterload?
Furosemide
Digoxin
Lisinopril
IV fluids
Which statement shows correct understanding of heart failure management?
I will weigh myself weekly.
I should call my provider for rapid weight gain.
Salt only affects my blood pressure.
I stop my medications when symptoms improve.
Patient profile: 68-year-old male with hypertension and chronic heart failure; home medications include metoprolol, furosemide, and lisinopril. Initial assessment: BP 86/50, HR 110, RR 28, SpO2 88% on room air, crackles bilaterally, and decreased urine output. What should the nurse do first?
Administer IV furosemide
Apply oxygen
Administer lisinopril
Obtain daily weight
Patient profile: 68-year-old male with hypertension and chronic heart failure; home medications include metoprolol, furosemide, and lisinopril. Initial assessment: BP 86/50, HR 110, RR 28, SpO2 88% on room air, crackles bilaterally, and decreased urine output. Which medication should the nurse hold at this time? Select all that apply.
Furosemide
Lisinopril
Metoprolol
Oxygen
Patient profile: 68-year-old male with hypertension and chronic heart failure; home medications include metoprolol, furosemide, and lisinopril. Initial assessment: BP 86/50, HR 110, RR 28, SpO2 88% on room air, crackles bilaterally, and decreased urine output. Why should these medications be held?
They increase afterload.
They decrease preload and blood pressure.
They increase heart rate.
They worsen oxygenation.
After oxygen therapy, the patient's SpO2 improves to 94% and BP increases to 98/62. What is the next best action?
Administer IV diuretics
Reassess lung sounds and vital signs
Prepare for discharge
Encourage oral fluids
Which finding indicates improved cardiac output?
Bounding pulses
Increased urine output
Persistent crackles
Decreased SpO2
A patient with heart failure is admitted with shortness of breath. Which finding requires immediate nursing action?
Peripheral edema
Crackles in lung bases
SpO2 86% on room air
Weight gain of 3 lb in one week
A stable patient with chronic heart failure reports increased fatigue. What should the nurse do first?
Administer prescribed diuretics
Obtain vital signs
Call the provider
Restrict fluids
Which blood pressure provides adequate mean arterial pressure?
90/40
100/50
82/60
88/46
Which assessment finding would cause the nurse to hold furosemide?
Potassium 3.4
Blood pressure 86/48
Crackles in lungs
Weight gain overnight
Which symptom is most consistent with right-sided heart failure?
Pulmonary crackles
Frothy sputum
Jugular vein distention
Decreased oxygen saturation
Which patient is experiencing acute decompensated heart failure?
Gradual weight gain over months
Sudden dyspnea and pink frothy sputum
Chronic peripheral edema
Mild fatigue with activity
Which patient should the nurse see first?
HF patient with 2+ edema
HTN patient with BP 150/92
HF patient with RR 32 and crackles
Stable patient requesting pain medication
Which medication improves survival in chronic heart failure?
Furosemide
Digoxin
Metoprolol
Nitroglycerin
A patient with HF has decreased urine output. This finding indicates:
Improved renal perfusion
Decreased cardiac output
Fluid volume deficit
Medication effectiveness
Which statement by a heart failure patient requires further teaching?
"I weigh myself every morning."
"I report weight gain to my provider."
"I skip my meds when I feel better."
"I limit high-sodium foods."
When is supplemental oxygen most appropriate for a heart failure patient?
Edema present
SpO2 below 90%
Elevated blood pressure
Weight gain
Which condition increases afterload?
Vasodilation
Hypertension
Diuretics
Decreased preload
Which vital sign requires the nurse to hold metoprolol?
BP 148/88
HR 56
RR 18
SpO2 95%
Which finding best indicates worsening fluid overload?
Daily weight gain
Increased appetite
Decreased heart rate
Warm skin
A heart failure patient becomes anxious and restless. What is the nurse's best initial action?
Administer PRN anxiolytic
Check oxygen saturation
Encourage deep breathing
Call the provider
Which test best evaluates ejection fraction?
Chest X-ray
12-lead ECG
Echocardiogram
BNP level
A BNP level is elevated in a patient with known heart failure. How should the nurse interpret this?
It is unexpected
It confirms myocardial infarction
It is consistent with heart failure
It rules out fluid overload
Crackles heard in a heart failure patient indicate:
Bronchoconstriction
Pulmonary congestion
Pneumonia
Air trapping
Which finding is most concerning?
Chronic fatigue
Mild ankle edema
Pink, frothy sputum
Weight gain over one month
Which outcome best shows effective diuretic therapy?
Decreased heart rate
Increased urine output
Improved appetite
Lower BNP
Digoxin Safety: Which finding requires the nurse to hold digoxin?
Potassium 3.1 mEq/L
Heart rate 82 bpm
Blood pressure 148/96
Oxygen saturation 96%
Digoxin Effect: Digoxin improves cardiac output by:
Reducing preload
Increasing heart rate
Increasing contractility
Decreasing afterload
Furosemide Priority: Which outcome best indicates effective furosemide therapy?
Decreased BNP
Increased urine output
Lower heart rate
Improved appetite
Furosemide Hold: Which assessment finding would cause the nurse to hold furosemide?
Crackles in lungs
Weight gain
Blood pressure 84/46
Peripheral edema
Hydrochlorothiazide Teaching: Which statement indicates correct understanding of hydrochlorothiazide therapy?
"I should avoid potassium-rich foods."
"This medication helps to remove excess fluid."
"I take this medication at bedtime."
"This medication slows my heart rate."
ACE Inhibitor Action: Lisinopril benefits heart failure patients by:
Increasing heart rate
Reducing preload and afterload
Increasing fluid retention
Stimulating the sympathetic nervous system
Lisinopril Hold: Which finding requires the nurse to hold lisinopril?
BP 152/90
Potassium 5.8 mEq/L
Heart rate 88 bpm
Oxygen saturation 95%
Beta-Blocker Safety: Which vital sign requires the nurse to hold metoprolol?
BP 148/82
HR 56 bpm
RR 20
SpO2 94%
Metoprolol Effect: Metoprolol is classified as:
Positive inotrope
Negative chronotrope
Vasodilator
Diuretic
ARB Use: Losartan is most appropriate for a patient who:
Has acute pulmonary edema
Cannot tolerate ACE inhibitors
Needs immediate preload reduction
Has bradycardia
Losartan Monitoring: Which lab value is most important to monitor in a patient taking losartan?
Sodium
Potassium
Calcium
Magnesium
Nitroglycerin Priority: Before administering nitroglycerin, the nurse should assess:
Lung sounds
Blood glucose
Blood pressure
Temperature
Nitroglycerin Effect: Nitroglycerin primarily helps heart failure patients by:
Increasing contractility
Reducing preload
Increasing heart rate
Increasing fluid retention
Statin Purpose: Atorvastatin is prescribed primarily to:
Treat acute heart failure
Improve ejection fraction
Reduce cardiovascular risk
Lower preload
Statin Teaching: Which statement by the patient taking atorvastatin requires further teaching?
"I will report muscle pain."
"I take this medication at night."
"This medication relieves chest pain."
"This helps lower my cholesterol."
Medication Priority: A heart failure patient is hypotensive. Which medication should the nurse question?
Digoxin
Atorvastatin
Nitroglycerin
Metoprolol
Preload Reducer: Which medication most aggressively reduces preload?
Metoprolol
Furosemide
Atorvastatin
Digoxin
Chronotropic Effect: Which medication directly slows heart rate?
Furosemide
Nitroglycerin
Metoprolol
Losartan
Digoxin Toxicity: Which symptom is most concerning for digoxin toxicity?
Headache
Blurred or yellow vision
Weight loss
Increased appetite
Medication Selection: Which medication improves mortality in chronic heart failure?
Furosemide
Nitroglycerin
Metoprolol
Hydrochlorothiazide
