A patient is diagnosed with left-sided heart failure. the nurse expects what assessment finding

This is a quiz that contains NCLEX questions for heart failure. Heart failure is where the heart is too weak to pump efficiently so it can’t provide proper cardiac output to maintain the body’s metabolic needs. In the previous NCLEX review series, I explained about other cardiovascular disorders so be sure to check those reviews out.

There are different types of heart failure, such as left or right-sided heart failure. As the nurse, it is important to understand how patients will present differently with each type of heart failure. In addition, the nurse needs to be aware of the causes, risk factors, and management of heart failure.

The NCLEX exam loves to ask questions about patient education, common side effects of medications, and major signs and symptoms the patient can exhibit with heart failure.

This quiz will test you on:

• Causes of heart failure
• Signs and symptoms of left-sided heart failure vs right-sided heart failure
• Patho of heart failure
• Types of heart failure
• Diagnostic tools used to diagnose heart failure

Lecture on Heart Failure

Heart Failure NCLEX Questions

This NCLEX quiz will test your knowledge on how to care for a patient with heart failure.

• 1. Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:*
  • A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction.
  • B. A 55 year old female with a health history of asthma and hypoparathyroidism.
  • C. A 30 year old male with a history of endocarditis and has severe mitral stenosis.
  • D. A 45 year old female with lung cancer stage 2.
  • E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

• 2. A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. As the nurse providing discharge teaching to the patient, which statement is NOT a correct statement about this condition?*
  • A. "Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough, difficulty breathing while lying down, and weight gain."
  • B. "It is important to monitor your daily weights, fluid and salt intake."
  • C. "Left-sided heart failure can lead to right-sided heart failure, if left untreated."
  • D. "This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema."

• 3. Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply:*
  • A. Jugular venous distention
  • B. Persistent cough
  • C. Weight gain
  • D. Crackles
  • E. Nocturia
  • F. Orthopnea

• 4. A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following are expected findings with this condition?*
  • A. Echocardiogram shows an ejection fraction of 38%.
  • B. Heart catheterization shows an ejection fraction of 65%.
  • C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
  • D. Options A and C are both expected findings with left-sided systolic dysfunction heart failure.

• 5. True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal ejection fraction.*
  • True
  • False

• 6. A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation?*
  • A. “I’ve noticed that I’ve gain 6 lbs in one week.”
  • B. “While I sleep I have to prop myself up with a pillow so I can breathe.”
  • C. “I haven’t noticed any swelling in my feet or hands lately.”
  • D. Options B and C are correct.
  • E. Options A and B are correct.
  • F. Options A, B, and C are all correct.

• 7. Patients with heart failure can experience episodes of exacerbation. All of the patients below have a history of heart failure. Which of the following patients are at MOST risk for heart failure exacerbation?*
  • A. A 55 year old female who limits sodium and fluid intake regularly.
  • B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation.
  • C. A 67 year old female who is being discharged home from heart valve replacement surgery.
  • D. A 78 year old male who has a health history of eczema and cystic fibrosis.

• 8. A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure?*
  • A. K+ 5.6
  • B. BNP 820
  • C. BUN 9
  • D. Troponin <0.02

• 9. Which of the following tests/procedures are NOT used to diagnose heart failure?*
  • A. Echocardiogram
  • B. Brain natriuretic peptide blood test
  • C. Nuclear stress test
  • D. Holter monitoring

• 10. What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath.*
  • A. Left ventricular systolic dysfunction
  • B. Left ventricular ride-sided dysfunction
  • C. Right ventricular diastolic dysfunction
  • D. Left ventricular diastolic dysfunction

• 11. A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention?*
  • A. Encourage the patient to cough and deep breathe.
  • B. Place the patient in Semi-Fowler's position.
  • C. Assist the patient into High Fowler's position.
  • D. Perform chest percussion therapy.

• 12. You're providing diet discharge teaching to a patient with a history of heart failure. Which of the following statements made by the patient represents they understood the diet teaching?*
  • A. "I will limit my sodium intake to 5-6 grams a day."
  • B. "I will be sure to incorporate canned vegetables and fish into my diet."
  • C. "I'm glad I can still eat sandwiches because I love bologna and cheese sandwiches."
  • D. "I will limit my consumption of frozen meals."

• 13. Select all the correct statements about educating the patient with heart failure:*
  • A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a day or 10 pounds in a week.
  • B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine.
  • C. Heart failure patients should limit sodium intake to 2-3 grams per day.
  • D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias.
  • E. Patients with heart failure should limit exercise because of the risks.

• 14. A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient?*
  • A. Narcan
  • B. Aminophylline
  • C. Digibind
  • No medication because this is a normal Digoxin level.

• 15. Which of the following is a late sign of heart failure?*
  • A. Shortness of breath
  • B. Orthopnea
  • C. Edema
  • D. Frothy-blood tinged sputum

• 16. These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes?*
  • A. Beta-blockers
  • B. Vasodilators
  • C. Angiotensin II receptor blockers
  • D. Angiotensin-converting-enzyme inhibitors

• 17. A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings?*
  • A. Na+ 135
  • B. BNP 560
  • C. K+ 8.0
  • D. K+ 1.5

• 18. During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue?*
  • A. Lisinopril
  • B. Losartan
  • C. Lasix
  • D. Digoxin

• 19. Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of heart failure:*
  • A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction.
  • B. A side effect of these drugs include bradycardia.
  • C. These drugs are most commonly prescribed for patients with heart failure who have COPD.
  • D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.

• 20. You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom?*
  • A. Measure and record the urine voided.
  • B. Assist the patient up slowing and gradually.
  • C. Place the call light in the patient's reach while in the bathroom.
  • D. Provide privacy for the patient.

• 21. A patient is taking Digoxin. Prior to administration you check the patient's apical pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of the following is the correct nursing action?*
  • A. Hold this dose and administer the second dose at 1800.
  • B. Administer the dose as ordered.
  • C. Hold the dose and notify the physician of the digoxin level.
  • D. Hold this dose until the patient’s potassium level is normal.

• 22. Which of the following is a common side effect of Spironolactone?*
  • A. Renal failure
  • B. Hyperkalemia
  • C. Hypokalemia
  • D. Dry cough

• 23. The physician’s order says to administered Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a nursing priority?*
  • A. Administer the Lasix as ordered
  • B. Notify the physician of the BNP level
  • C. Assess the patient for edema
  • D. Hold the dose and notify the physician about the potassium level

(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)

NCLEX Practice Questions for Heart Failure

1. Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:

A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction.

B. A 55 year old female with a health history of asthma and hypoparathyroidism.

C. A 30 year old male with a history of endocarditis and has severe mitral stenosis.

D. A 45 year old female with lung cancer stage 2.

E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

2. A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. As the nurse providing discharge teaching to the patient, which statement is NOT a correct statement about this condition?

A. “Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough, difficulty breathing while lying down, and weight gain.”

B. “It is important to monitor your daily weights, fluid and salt intake.”

C. “Left-sided heart failure can lead to right-sided heart failure, if left untreated.”

D. “This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema.”

3. Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply:

A. Jugular venous distention

B. Persistent cough

C. Weight gain

D. Crackles

E. Nocturia

F. Orthopnea

4. A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following are expected findings with this condition?

A. Echocardiogram shows an ejection fraction of 38%.

B. Heart catheterization shows an ejection fraction of 65%.

C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.

D. Options A and C are both expected findings with left sided systolic dysfunction heart failure.

5. True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal ejection fraction.

6. A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation?

A. “I’ve noticed that I’ve gain 6 lbs in one week.”

B. “While I sleep I have to prop myself up with a pillow so I can breathe.”

C. “I haven’t noticed any swelling in my feet or hands lately.”

D. Options B and C are correct.

E. Options A and B are correct.

F. Options A, B, and C are all correct.

7. Patients with heart failure can experience episodes of exacerbation. All of the patients below have a history of heart failure. Which of the following patients are at MOST risk for heart failure exacerbation?

A. A 55 year old female who limits sodium and fluid intake regularly.

B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation.

C. A 67 year old female who is being discharged home from heart valve replacement surgery.

D. A 78 year old male who has a health history of eczema and cystic fibrosis.

8. A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure?

A. K+ 5.6

B. BNP 820

C. BUN 9

D. Troponin <0.02

9. Which of the following tests/procedures are NOT used to diagnose heart failure?

A. Echocardiogram

B. Brain natriuretic peptide blood test

C. Nuclear stress test

D. Holter monitoring

10. What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath.

A. Left ventricular systolic dysfunction

B. Left ventricular ride-sided dysfunction

C. Right ventricular diastolic dysfunction

D. Left ventricular diastolic dysfunction

11. A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention?

A. Encourage the patient to cough and deep breathe.

B. Place the patient in Semi-Fowler’s position.

C. Assist the patient into High Fowler’s position.

D. Perform chest percussion therapy.

12. You’re providing diet discharge teaching to a patient with a history of heart failure. Which of the following statements made by the patient represents they understood the diet teaching?

A. “I will limit my sodium intake to 5-6 grams a day.”

B. “I will be sure to incorporate canned vegetables and fish into my diet.”

C. “I’m glad I can still eat sandwiches because I love bologna and cheese sandwiches.”

D. “I will limit my consumption of frozen meals.”

13. Select all the correct statements about educating the patient with heart failure:

A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a day or 10 pounds in a week.

B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine.”

C. Heart failure patients should limit sodium intake to 2-3 grams per day.

D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias.

E. Patients with heart failure should limit exercise because of the risks.

14. A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient?

A. Narcan

B. Aminophylline

C. Digibind

D. No medication because this is a normal Digoxin level.

15. Which of the following is a late sign of heart failure?

A. Shortness of breath

B. Orthopnea

C. Edema

D. Frothy-blood tinged sputum

16. These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes?

A. Beta-blockers

B. Vasodilators

C. Angiotensin II receptor blockers

D. Angiotensin-converting-enzyme inhibitors

17. A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings?

A. Na+ 135

B. BNP 560

C. K+ 8.0

D. K+ 1.5

18. During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue?

A. Lisinopril

B. Losartan

C. Lasix

D. Digoxin

19. Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of heart failure:

A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction.

B. A side effect of these drugs include bradycardia.

C. These drugs are most commonly prescribed for patients with heart failure who have COPD.

D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.

20. You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom?

A. Measure and record the urine voided.

B. Assist the patient up slowing and gradually.

C. Place the call light in the patient’s reach while in the bathroom.

D. Provide privacy for the patient.

21. A patient is taking Digoxin. Prior to administration you check the patient’s apical pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of the following is the correct nursing action?

A. Hold this dose and administer the second dose at 1800.

B. Administer the dose as ordered.

C. Hold the dose and notify the physician of the Digoxin level.

D. Hold this dose until the patient’s potassium level is normal.

22. Which of the following is a common side effect of Spironolactone?

A. Renal failure

B. Hyperkalemia

C. Hypokalemia

D. Dry cough

23. The physician’s order says to administered Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a nursing priority?

A. Administer the Lasix as ordered

B. Notify the physician of the BNP level

C. Assess the patient for edema

D. Hold the dose and notify the physician about the potassium level

Answer Key:

1. A, C, E
2. D
3. B, D, F
4. D
5. True
6. E
7. B
8. B
9. D
10. D
11. C
12. D
13. B, C, D
14. C
15. D
16. D
17. C
18. D
19. B, D
20. B
21. C
22. B
23. D
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