Heart Failure
Which symptom would most likely be seen in left-sided heart failure?
A. Jugular vein distention
B. Hepatomegaly
C. Orthopnea
D. Weight gain
C – Orthopnea (difficulty breathing when lying down) is a hallmark of pulmonary congestion from left-sided HF.
Which lab value is most specific for myocardial injury?
A. CK-MB
B. Troponin I
C. BNP
D. Myoglobin
B – Troponin I is highly specific and remains elevated longer.
What lifestyle change is most effective in managing Stage 1 HTN?
A. Avoiding dairy products
B. Reducing sodium to <2g/day
C. Drinking red wine with meals
D. Eating high-protein snacks
B – Sodium restriction is a key component of the DASH diet.
What is the primary action of nitroglycerin during an acute angina attack?
A. Increases heart rate
B. Decreases afterload
C. Vasodilates coronary arteries
D. Reduces cardiac contractility
C – NTG relaxes smooth muscle and increases coronary perfusion.
What is the priority instruction for a patient newly prescribed nitroglycerin?
A. Take with food
B. Store in refrigerator
C. Sit or lie down before taking
D. Swallow whole
C – NTG can cause sudden hypotension; safety is key.
Which finding should a nurse report immediately in a patient with chronic HF?
A. 1+ pitting edema in ankles
B. Weight gain of 3 lbs in 1 days
C. Fatigue after walking up stairs
D. Crackles at lung bases
B – Rapid weight gain suggests fluid retention and possible exacerbation.
A patient has a STEMI. What intervention has the highest priority?
A. Administer beta-blocker
B. Obtain troponin levels
C. Prepare for PCI
D. Place patient on a low-sodium diet
C – PCI should be initiated within 90 minutes of arrival.
Which is a classic symptom of Peripheral Artery Disease (PAD)?
A. Dependent edema
B. Calf pain with walking
C. Cramping that worsens with elevation
D. Bounding pedal pulses
B – Claudication is the hallmark symptom of PAD.
Which medication should be questioned in a patient with heart failure?
A. Lisinopril
B. Furosemide
C. NSAIDs
D. Metoprolol
C – NSAIDs cause fluid retention and worsen HF symptoms.
Which action by the patient with heart failure indicates effective self-management?
A. Eating canned soup daily
B. Weighing weekly
C. Reporting weight gain of 3 lbs in 1 days
D. Using salt substitutes instead of salt
C – Daily weights and reporting early signs of fluid retention are essential.
What is the best indicator that diuretic therapy for acute decompensated heart failure is effective?
A. Blood pressure improves
B. Potassium levels increase
C. Respiratory rate decreases
D. Urine output increases
D – Increased urine output reflects effective fluid removal.
Which ECG change would you expect in a patient with myocardial ischemia?
A. ST elevation
B. Q waves
C. ST depression
D. Peaked T waves
C – ST depression suggests subendocardial ischemia.
A patient with carotid artery disease is at greatest risk for which complication?
A. Kidney failure
B. Stroke
C. Aortic rupture
D. DVT
B – Carotid plaque can embolize and lead to a stroke.
A nurse is teaching a patient about carvedilol for HFrEF. Which statement shows understanding?
A. “I should stop taking this if I feel dizzy.”
B. “This drug will help reduce the workload on my heart.”
C. “This drug increases my heart’s pumping ability.”
D. “I should take this only when I feel symptoms.”
B – Beta-blockers reduce cardiac workload and oxygen demand.
A patient recovering from a STEMI is hesitant about cardiac rehab. Which is the nurse’s best response?
A. “You’re not required to attend.”
B. “It’s mostly for older adults.”
C. “It helps prevent future heart problems and improves survival.”
D. “It’s only exercise and won’t affect your heart.”
C – Cardiac rehab reduces mortality and improves quality of life.
A nurse is caring for a patient with HFrEF. Which pathophysiological mechanism is most involved?
A. Decreased myocardial compliance
B. Preserved ejection fraction
C. Impaired contractility and reduced EF
D. Ventricular hypertrophy with normal EF
C – HFrEF involves reduced contractility and EF ≤ 40%.
A patient with stable angina says, “The pain goes away when I rest.” What is the best nursing explanation?
A. “It is likely due to anxiety.”
B. “This is a normal sign of aging.”
C. “That’s typical of stable angina, which occurs with exertion.”
D. “You’re likely having a heart attack.”
C – Stable angina is predictable and relieved by rest/NTG.
A patient has a known abdominal aortic aneurysm. Which finding is most concerning?
A. BP 142/90
B. Pulsatile abdominal mass
C. Sudden severe back pain
D. Heart rate 88 bpm
C – Sudden pain suggests rupture – a medical emergency.
Which lab value must be closely monitored with ACE inhibitors like lisinopril?
A. Hemoglobin
B. Sodium
C. Potassium
D. Platelets
C – ACE inhibitors can cause hyperkalemia.
Which statement indicates a need for further teaching about hypertension management?
A. “I’ll stop smoking.”
B. “I can double up on my dose if my BP is high.”
C. “I’ll reduce my salt intake.”
D. “I’ll exercise 30 minutes most days.”
B – Never adjust medication doses without provider instruction.
Which teaching statement by a patient with chronic HF indicates the need for further education?
A. “I weigh myself every morning before breakfast.”
B. “I avoid canned soups because of the sodium.”
C. “I’ll take ibuprofen if I get a headache.”
D. “I try to stay active by walking each day.”
C – NSAIDs like ibuprofen are contraindicated in HF due to fluid retention and renal effects.
What assessment finding requires immediate action after cardiac catheterization?
A. Bruising at insertion site
B. Mild back pain
C. Absent distal pulses
D. BP 138/78
C – Absent pulses indicate possible arterial occlusion or bleeding.
Which medication is most important in the management of an aortic aneurysm?
A. Beta-blocker
B. Statin
C. Vasodilator
D. Antihypertensive
D – Aggressive blood pressure control is the cornerstone of aneurysm management.
A patient with heart failure is on digoxin. Which finding requires immediate intervention?
A. Heart rate 88 bpm
B. Potassium 3.1 mEq/L
C. BP 132/84
D. Apical pulse regular
B – Low potassium increases digoxin toxicity risk.
After a CABG, which patient statement requires follow-up?
A. “I use my incentive spirometer every hour.”
B. “I still feel tired, but I’m walking daily.”
C. “I’ve been eating lots of high-protein snacks.”
D. “I avoid all medications unless I’m in pain.”
D – Patients must take prescribed medications to prevent complications.