2026 UPDATED QUESTIONS DOWNLOAD
ATI Adult Med-Surg- Heart Failure Nursing Care – 350
Questions on Hemodynamics, Meds, and Patient Education
This is the ultimate study guide for the ATI Adult Med-Surg Heart Failure content. It features 350
detailed practice questions covering Left-Sided vs. Right-Sided failure, critical
pharmacology (Digoxin, Furosemide, ACE inhibitors), and nursing assessments (BNP,
JVD, S3 sounds). Each question includes a scan-ready italicized rationale, making this a
must-have resource for nursing students aiming for a Level 3 on their proctored exam.
A nurse is caring for a client with an acute exacerbation of heart failure. Which
action should the nurse take first?
A. Weigh the client.
B. Administer an IV loop diuretic.
C. Assess the client’s lung sounds.
D. Obtain a 12-lead ECG.
Correct Answer: C
Rationale: Following the nursing process, assessment is always the first step. In an
acute heart failure event, the nurse must first determine the severity of pulmonary
congestion to prioritize airway and breathing interventions.
A nurse is teaching a client about a 2-gram sodium diet. Which food selection by the
client indicates an understanding of the teaching?
A. Frozen pepperoni pizza
B. Canned vegetable juice
C. Roasted turkey breast with steamed carrots
D. Cottage cheese with sliced peaches
Correct Answer: C
Rationale: Fresh, unprocessed meats and vegetables are naturally low in sodium.
Frozen meals, canned juices, and many dairy products (like cottage cheese) are
significantly high in added sodium.
Which laboratory result is the most reliable marker for differentiating heart failure
from pulmonary disease in a client with dyspnea?
A. Arterial Blood Gas (ABG)
B. B-type Natriuretic Peptide (BNP)
C. Hemoglobin and Hematocrit
,2026 UPDATED QUESTIONS DOWNLOAD
D. Serum Albumin
Correct Answer: B
Rationale: BNP is released specifically in response to ventricular stretch. High levels
(>100 pg/mL) indicate heart failure, whereas normal levels in a dyspneic client suggest
a respiratory cause like COPD or pneumonia.
A nurse is monitoring a client receiving IV furosemide. Which finding is a priority to
report to the provider?
A. Urine output of 60 mL/hr
B. Muscle weakness and leg cramps
C. Blood pressure of 118/72 mmHg
D. Daily weight loss of 2 lbs
Correct Answer: B
Rationale: Muscle weakness and cramps are early signs of hypokalemia, a common
and dangerous side effect of loop diuretics that can lead to fatal cardiac dysrhythmias.
A client with heart failure is prescribed digoxin 0.125 mg daily. Which finding should
the nurse identify as an early sign of toxicity?
A. Constipation
B. Photosensitivity
C. Anorexia and nausea
D. High-pitched tinnitus
Correct Answer: C
Rationale: Gastrointestinal symptoms, specifically loss of appetite (anorexia), nausea,
and vomiting, are typically the very first signs of digoxin toxicity, often appearing before
cardiac or visual changes.
A nurse is assessing a client with right-sided heart failure. Which finding should the
nurse expect?
A. S3 heart sound
B. Crackles in the lung bases
C. Jugular venous distention (JVD)
D. Frothy, pink-tinged sputum
Correct Answer: C
Rationale: Right-sided heart failure leads to systemic congestion. JVD, peripheral
edema, and hepatomegaly are classic signs, whereas crackles and pink sputum are
signs of left-sided (pulmonary) failure.
A nurse is preparing to discharge a client with heart failure. Which instruction is the
most important for the nurse to include?
A. "Check your pulse for 15 seconds every day."
,2026 UPDATED QUESTIONS DOWNLOAD
B. "Notify the provider for a weight gain of 2 lbs in 24 hours."
C. "Increase your intake of citrus fruits to improve immunity."
D. "Restrict your activity to bed rest for the next two weeks."
Correct Answer: B
Rationale: Daily weight monitoring is the most sensitive way to detect fluid retention
before it becomes a life-threatening emergency. A gain of 2-3 lbs in a day requires
immediate medical adjustment of medications.
What is the primary purpose of an ACE inhibitor, such as enalapril, in a heart failure
client?
A. To increase the heart rate.
B. To promote the retention of water.
C. To reduce afterload by causing vasodilation.
D. To increase the force of myocardial contraction.
Correct Answer: C
Rationale: ACE inhibitors prevent the constriction of blood vessels, lowering the
resistance (afterload) the heart must pump against, which helps the weakened heart
eject blood more efficiently.
A nurse is assessing a client with left-sided heart failure. Which finding should the
nurse expect?
A. Ascites
B. Dependent edema
C. Shortness of breath while lying flat
D. Enlarged liver
Correct Answer: C
Rationale: Shortness of breath when lying flat (orthopnea) is a hallmark of left-sided
failure due to fluid shifting from the lower body into the lungs when the client reclines.
A client is prescribed spironolactone for heart failure. Which medication in the
client’s history should the nurse report to the provider?
A. Furosemide
B. Potassium chloride supplements
C. Warfarin
D. Digoxin
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. Taking it alongside potassium
supplements significantly increases the risk of life-threatening hyperkalemia.
A nurse is caring for a client with heart failure and a prescription for digoxin. The
nurse should hold the dose if the apical pulse is:
, 2026 UPDATED QUESTIONS DOWNLOAD
A. 52 bpm
B. 68 bpm
C. 82 bpm
D. 110 bpm
Correct Answer: A
Rationale: Digoxin should be held and the provider notified if the apical heart rate is
below 60 bpm in an adult, as the medication further slows the heart's conduction.
Which clinical finding indicates that a client with heart failure is responding
effectively to diuretic therapy?
A. Improved apical pulse regularlity.
B. Increased respiratory rate.
C. Decreased central venous pressure (CVP).
D. Increased serum creatinine.
Correct Answer: C
Rationale: CVP measures fluid volume and pressure in the right atrium. A decrease
indicates that excess fluid is being successfully removed from the vascular system.
A nurse is assessing a client with acute pulmonary edema. Which breath sound is
most likely to be heard?
A. Stridor
B. High-pitched wheezing
C. Coarse crackles
D. Pleural friction rub
Correct Answer: C
Rationale: Pulmonary edema involves fluid in the alveoli. As air moves through this fluid,
it creates a "popping" or "bubbling" sound known as coarse crackles.
A client with heart failure has been prescribed carvedilol. What is a common side
effect the nurse should include in the teaching?
A. Insomnia
B. Dizziness or orthostatic hypotension
C. Increased urinary frequency
D. Dry, persistent cough
Correct Answer: B
Rationale: Beta-blockers like carvedilol can cause a drop in blood pressure, especially
when changing positions, increasing the risk for falls.
What is the significance of an S3 heart sound in an adult client with heart failure?
A. It indicates the heart is beating too fast.
B. It is a normal finding in the elderly.
ATI Adult Med-Surg- Heart Failure Nursing Care – 350
Questions on Hemodynamics, Meds, and Patient Education
This is the ultimate study guide for the ATI Adult Med-Surg Heart Failure content. It features 350
detailed practice questions covering Left-Sided vs. Right-Sided failure, critical
pharmacology (Digoxin, Furosemide, ACE inhibitors), and nursing assessments (BNP,
JVD, S3 sounds). Each question includes a scan-ready italicized rationale, making this a
must-have resource for nursing students aiming for a Level 3 on their proctored exam.
A nurse is caring for a client with an acute exacerbation of heart failure. Which
action should the nurse take first?
A. Weigh the client.
B. Administer an IV loop diuretic.
C. Assess the client’s lung sounds.
D. Obtain a 12-lead ECG.
Correct Answer: C
Rationale: Following the nursing process, assessment is always the first step. In an
acute heart failure event, the nurse must first determine the severity of pulmonary
congestion to prioritize airway and breathing interventions.
A nurse is teaching a client about a 2-gram sodium diet. Which food selection by the
client indicates an understanding of the teaching?
A. Frozen pepperoni pizza
B. Canned vegetable juice
C. Roasted turkey breast with steamed carrots
D. Cottage cheese with sliced peaches
Correct Answer: C
Rationale: Fresh, unprocessed meats and vegetables are naturally low in sodium.
Frozen meals, canned juices, and many dairy products (like cottage cheese) are
significantly high in added sodium.
Which laboratory result is the most reliable marker for differentiating heart failure
from pulmonary disease in a client with dyspnea?
A. Arterial Blood Gas (ABG)
B. B-type Natriuretic Peptide (BNP)
C. Hemoglobin and Hematocrit
,2026 UPDATED QUESTIONS DOWNLOAD
D. Serum Albumin
Correct Answer: B
Rationale: BNP is released specifically in response to ventricular stretch. High levels
(>100 pg/mL) indicate heart failure, whereas normal levels in a dyspneic client suggest
a respiratory cause like COPD or pneumonia.
A nurse is monitoring a client receiving IV furosemide. Which finding is a priority to
report to the provider?
A. Urine output of 60 mL/hr
B. Muscle weakness and leg cramps
C. Blood pressure of 118/72 mmHg
D. Daily weight loss of 2 lbs
Correct Answer: B
Rationale: Muscle weakness and cramps are early signs of hypokalemia, a common
and dangerous side effect of loop diuretics that can lead to fatal cardiac dysrhythmias.
A client with heart failure is prescribed digoxin 0.125 mg daily. Which finding should
the nurse identify as an early sign of toxicity?
A. Constipation
B. Photosensitivity
C. Anorexia and nausea
D. High-pitched tinnitus
Correct Answer: C
Rationale: Gastrointestinal symptoms, specifically loss of appetite (anorexia), nausea,
and vomiting, are typically the very first signs of digoxin toxicity, often appearing before
cardiac or visual changes.
A nurse is assessing a client with right-sided heart failure. Which finding should the
nurse expect?
A. S3 heart sound
B. Crackles in the lung bases
C. Jugular venous distention (JVD)
D. Frothy, pink-tinged sputum
Correct Answer: C
Rationale: Right-sided heart failure leads to systemic congestion. JVD, peripheral
edema, and hepatomegaly are classic signs, whereas crackles and pink sputum are
signs of left-sided (pulmonary) failure.
A nurse is preparing to discharge a client with heart failure. Which instruction is the
most important for the nurse to include?
A. "Check your pulse for 15 seconds every day."
,2026 UPDATED QUESTIONS DOWNLOAD
B. "Notify the provider for a weight gain of 2 lbs in 24 hours."
C. "Increase your intake of citrus fruits to improve immunity."
D. "Restrict your activity to bed rest for the next two weeks."
Correct Answer: B
Rationale: Daily weight monitoring is the most sensitive way to detect fluid retention
before it becomes a life-threatening emergency. A gain of 2-3 lbs in a day requires
immediate medical adjustment of medications.
What is the primary purpose of an ACE inhibitor, such as enalapril, in a heart failure
client?
A. To increase the heart rate.
B. To promote the retention of water.
C. To reduce afterload by causing vasodilation.
D. To increase the force of myocardial contraction.
Correct Answer: C
Rationale: ACE inhibitors prevent the constriction of blood vessels, lowering the
resistance (afterload) the heart must pump against, which helps the weakened heart
eject blood more efficiently.
A nurse is assessing a client with left-sided heart failure. Which finding should the
nurse expect?
A. Ascites
B. Dependent edema
C. Shortness of breath while lying flat
D. Enlarged liver
Correct Answer: C
Rationale: Shortness of breath when lying flat (orthopnea) is a hallmark of left-sided
failure due to fluid shifting from the lower body into the lungs when the client reclines.
A client is prescribed spironolactone for heart failure. Which medication in the
client’s history should the nurse report to the provider?
A. Furosemide
B. Potassium chloride supplements
C. Warfarin
D. Digoxin
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. Taking it alongside potassium
supplements significantly increases the risk of life-threatening hyperkalemia.
A nurse is caring for a client with heart failure and a prescription for digoxin. The
nurse should hold the dose if the apical pulse is:
, 2026 UPDATED QUESTIONS DOWNLOAD
A. 52 bpm
B. 68 bpm
C. 82 bpm
D. 110 bpm
Correct Answer: A
Rationale: Digoxin should be held and the provider notified if the apical heart rate is
below 60 bpm in an adult, as the medication further slows the heart's conduction.
Which clinical finding indicates that a client with heart failure is responding
effectively to diuretic therapy?
A. Improved apical pulse regularlity.
B. Increased respiratory rate.
C. Decreased central venous pressure (CVP).
D. Increased serum creatinine.
Correct Answer: C
Rationale: CVP measures fluid volume and pressure in the right atrium. A decrease
indicates that excess fluid is being successfully removed from the vascular system.
A nurse is assessing a client with acute pulmonary edema. Which breath sound is
most likely to be heard?
A. Stridor
B. High-pitched wheezing
C. Coarse crackles
D. Pleural friction rub
Correct Answer: C
Rationale: Pulmonary edema involves fluid in the alveoli. As air moves through this fluid,
it creates a "popping" or "bubbling" sound known as coarse crackles.
A client with heart failure has been prescribed carvedilol. What is a common side
effect the nurse should include in the teaching?
A. Insomnia
B. Dizziness or orthostatic hypotension
C. Increased urinary frequency
D. Dry, persistent cough
Correct Answer: B
Rationale: Beta-blockers like carvedilol can cause a drop in blood pressure, especially
when changing positions, increasing the risk for falls.
What is the significance of an S3 heart sound in an adult client with heart failure?
A. It indicates the heart is beating too fast.
B. It is a normal finding in the elderly.
