HEART FAILURE NCLEX REVIEW
QUESTIONS/ CARDIOVASCULAR NURSING
CARE Q&A WITH RATIONALES |
ASSESSMENT, MEDICATIONS, FLUID
MANAGEMENT & PATIENT EDUCATION
2026/2027
A patient with a recent diagnosis of heart failure has been prescribed furosemide
(Lasix) in an effort to physiologically do what for the patient?
A. Reduce preload.
B. Decrease afterload.
C. Increase contractility.
D. Promote vasodilation. - ............ANSWER..........A. Reduce preload.
Diuretics such as furosemide are used in the treatment of HF to mobilize
edematous fluid, reduce pulmonary venous pressure, and reduce preload. They do
not directly influence afterload, contractility, or vessel tone.
1|Page
,A patient with a diagnosis of heart failure has been started on a nitroglycerin patch
by his primary care provider. What should this patient be taught to avoid?
A. High-potassium foods
B. Drugs to treat erectile dysfunction
C. Nonsteroidal antiinflammatory drugs
D. Over-the-counter H2-receptor blockers - ............ANSWER..........B. Drugs to
treat erectile dysfunction
The use of erectile drugs concurrent with nitrates creates a risk of severe
hypotension and possibly death. High-potassium foods, NSAIDs, and H2-receptor
blockers do not pose a risk in combination with nitrates.
A stable patient with acute decompensated heart failure (ADHF) suddenly becomes
dyspneic. Before positioning the patient on the bedside, what should the nurse
assess first?
A. Urine output
B. Heart rhythm
C. Breath sounds
D. Blood pressure - ............ANSWER..........D. Blood pressure
2|Page
,The nurse should evaluate the blood pressure before dangling the patient on the
bedside because the blood pressure can decrease as blood pools in the periphery
and preload decreases. If the patient's blood pressure is low or marginal, the nurse
should put the patient in the semi-Fowler's position and use other measures to
improve gas exchange.
The patient has heart failure (HF) with an ejection fraction of less than 40%. What
core measures should the nurse expect to include in the plan of care for this patient
(select all that apply)?
A. Left ventricular function is documented.
B. Controlling dysrhythmias will eliminate HF.
C. Prescription for digoxin (Lanoxin) at discharge
D. Prescription for angiotensin-converting enzyme (ACE) inhibitor at discharge
E. Education materials about activity, medications, weight monitoring, and what to
do if symptoms worsen - ............ANSWER..........A, D, E.
The Joint Commission has identified these three core measures for heart failure
patients. Although controlling dysrhythmias will improve CO and workload, it will
not eliminate HF. Prescribing digoxin for all HF patients is no longer done because
there are newer effective drugs and digoxin toxicity occurs easily related to
electrolyte levels and the therapeutic range must be maintained.
3|Page
, After having an MI, the nurse notes the patient has jugular venous distention,
gained weight, developed peripheral edema, and has a heart rate of 108/minute.
What should the nurse suspect is happening?
A. ADHF
B. Chronic HF
C. Left-sided HF
D. Right-sided HF - ............ANSWER..........D. Right-sided HF
An MI is a primary cause of heart failure. The jugular venous distention, weight
gain, peripheral edema, and increased heart rate are manifestations of right-sided
heart failure.
Beyond the first year after a heart transplant, the nurse knows that what is a major
cause of death?
A. Infection
B. Acute rejection
C. Immunosuppression
D. Cardiac vasculopathy - ............ANSWER..........D. Cardiac vasculopathy
4|Page
QUESTIONS/ CARDIOVASCULAR NURSING
CARE Q&A WITH RATIONALES |
ASSESSMENT, MEDICATIONS, FLUID
MANAGEMENT & PATIENT EDUCATION
2026/2027
A patient with a recent diagnosis of heart failure has been prescribed furosemide
(Lasix) in an effort to physiologically do what for the patient?
A. Reduce preload.
B. Decrease afterload.
C. Increase contractility.
D. Promote vasodilation. - ............ANSWER..........A. Reduce preload.
Diuretics such as furosemide are used in the treatment of HF to mobilize
edematous fluid, reduce pulmonary venous pressure, and reduce preload. They do
not directly influence afterload, contractility, or vessel tone.
1|Page
,A patient with a diagnosis of heart failure has been started on a nitroglycerin patch
by his primary care provider. What should this patient be taught to avoid?
A. High-potassium foods
B. Drugs to treat erectile dysfunction
C. Nonsteroidal antiinflammatory drugs
D. Over-the-counter H2-receptor blockers - ............ANSWER..........B. Drugs to
treat erectile dysfunction
The use of erectile drugs concurrent with nitrates creates a risk of severe
hypotension and possibly death. High-potassium foods, NSAIDs, and H2-receptor
blockers do not pose a risk in combination with nitrates.
A stable patient with acute decompensated heart failure (ADHF) suddenly becomes
dyspneic. Before positioning the patient on the bedside, what should the nurse
assess first?
A. Urine output
B. Heart rhythm
C. Breath sounds
D. Blood pressure - ............ANSWER..........D. Blood pressure
2|Page
,The nurse should evaluate the blood pressure before dangling the patient on the
bedside because the blood pressure can decrease as blood pools in the periphery
and preload decreases. If the patient's blood pressure is low or marginal, the nurse
should put the patient in the semi-Fowler's position and use other measures to
improve gas exchange.
The patient has heart failure (HF) with an ejection fraction of less than 40%. What
core measures should the nurse expect to include in the plan of care for this patient
(select all that apply)?
A. Left ventricular function is documented.
B. Controlling dysrhythmias will eliminate HF.
C. Prescription for digoxin (Lanoxin) at discharge
D. Prescription for angiotensin-converting enzyme (ACE) inhibitor at discharge
E. Education materials about activity, medications, weight monitoring, and what to
do if symptoms worsen - ............ANSWER..........A, D, E.
The Joint Commission has identified these three core measures for heart failure
patients. Although controlling dysrhythmias will improve CO and workload, it will
not eliminate HF. Prescribing digoxin for all HF patients is no longer done because
there are newer effective drugs and digoxin toxicity occurs easily related to
electrolyte levels and the therapeutic range must be maintained.
3|Page
, After having an MI, the nurse notes the patient has jugular venous distention,
gained weight, developed peripheral edema, and has a heart rate of 108/minute.
What should the nurse suspect is happening?
A. ADHF
B. Chronic HF
C. Left-sided HF
D. Right-sided HF - ............ANSWER..........D. Right-sided HF
An MI is a primary cause of heart failure. The jugular venous distention, weight
gain, peripheral edema, and increased heart rate are manifestations of right-sided
heart failure.
Beyond the first year after a heart transplant, the nurse knows that what is a major
cause of death?
A. Infection
B. Acute rejection
C. Immunosuppression
D. Cardiac vasculopathy - ............ANSWER..........D. Cardiac vasculopathy
4|Page
