NSG 322 EXAM REVIEW QUESTIONS WITH
ACCURATE SOLUTIONS 2026
▶ Lt vs. Rt sided of Heart Failure. Answer: Lt sided: inability of the Lt
ventricle to pump enough blood, causing fluid build up back into Lt atria and
lungs
sx: pulmonary
Rt sided: inefficient pumping of the Rt side of the heart, causing fluid
buildup in the abd, legs and feet.
Sx: incr venous pressure, ascites, edema
▶ Acute Heart Failure. Answer: An emergency in which pt was previously
asymptomatic. Adaptive mechanisms that previously maintained can no
longer keep up.
Sx: incr RR< hRR, sputum, SOB, dyspnea, crackles/wheeze, anxiety, decr
sats
▶ Chronic Heart Failure. Answer: Long term syndrome in which a pt
exhibits symptoms, usually results from pre-existing condition
Hypertrophy due to chronic increased wall stress
▶ Pathophysiology of Heart Failure. Answer: Damaged cardiac muscle
Decreased contractility/SV
Compensatory Measures:
Increased HR, Lt ventricular hypertrophy, dilation, neurohormonal.
Tissue death (due to dilation)
All chambers dilate (palliative)
▶ Compensatory Measures of Heart Failure. Answer: Increased HR
Dilation: relaxes to allow bigger stretch
, Neurohormonal: renin angiotensin cycle (actually makes things worse as
fluid builds up when the body already had too much fluid to process)
▶ Renin Angiotensin Cycle. Answer: BP drops
Juxtaglomerular cells in the kidney release renin.
Renin converts angiotensin into angiotensin I -> angiotensin II, aldosterone
secreted.
Fluid and salt retention increases BP
▶ S3. Answer: Ventricular gallop
Produced in early systole during passive filling phase of LV when blood
flows from the atrium to the noncompliant ventricle, may be normal finding.
"Ken ... tuck-y"
"F*CK ... you're screwed"
▶ S4. Answer: atrial gallop; late diastole as blood enters the ventricles
during active filling phase. Always abnormal, sign of CHF
""Ten-ne ... see"
"Well f*ck ... you"
▶ Pharmacological Management of Heart Failure. Answer: ACE Inhibitor
ARB
B-blocker
Diuretics
Inotropics (help with contractility)
▶ Normal pH. Answer: 7.35 - 7.45
▶ Normal Bicarbonate. Answer: 22 - 26 mmol/L
▶ Normal PCO2. Answer: 35 - 45 mmHg
▶ pH Respiratory Compensation. Answer: Takes minutes
Hypo or hyperventilation to expel or retain CO2, which alters pH.
Hypoventilation: acidosis
Hyperventilation: alkalosis
ACCURATE SOLUTIONS 2026
▶ Lt vs. Rt sided of Heart Failure. Answer: Lt sided: inability of the Lt
ventricle to pump enough blood, causing fluid build up back into Lt atria and
lungs
sx: pulmonary
Rt sided: inefficient pumping of the Rt side of the heart, causing fluid
buildup in the abd, legs and feet.
Sx: incr venous pressure, ascites, edema
▶ Acute Heart Failure. Answer: An emergency in which pt was previously
asymptomatic. Adaptive mechanisms that previously maintained can no
longer keep up.
Sx: incr RR< hRR, sputum, SOB, dyspnea, crackles/wheeze, anxiety, decr
sats
▶ Chronic Heart Failure. Answer: Long term syndrome in which a pt
exhibits symptoms, usually results from pre-existing condition
Hypertrophy due to chronic increased wall stress
▶ Pathophysiology of Heart Failure. Answer: Damaged cardiac muscle
Decreased contractility/SV
Compensatory Measures:
Increased HR, Lt ventricular hypertrophy, dilation, neurohormonal.
Tissue death (due to dilation)
All chambers dilate (palliative)
▶ Compensatory Measures of Heart Failure. Answer: Increased HR
Dilation: relaxes to allow bigger stretch
, Neurohormonal: renin angiotensin cycle (actually makes things worse as
fluid builds up when the body already had too much fluid to process)
▶ Renin Angiotensin Cycle. Answer: BP drops
Juxtaglomerular cells in the kidney release renin.
Renin converts angiotensin into angiotensin I -> angiotensin II, aldosterone
secreted.
Fluid and salt retention increases BP
▶ S3. Answer: Ventricular gallop
Produced in early systole during passive filling phase of LV when blood
flows from the atrium to the noncompliant ventricle, may be normal finding.
"Ken ... tuck-y"
"F*CK ... you're screwed"
▶ S4. Answer: atrial gallop; late diastole as blood enters the ventricles
during active filling phase. Always abnormal, sign of CHF
""Ten-ne ... see"
"Well f*ck ... you"
▶ Pharmacological Management of Heart Failure. Answer: ACE Inhibitor
ARB
B-blocker
Diuretics
Inotropics (help with contractility)
▶ Normal pH. Answer: 7.35 - 7.45
▶ Normal Bicarbonate. Answer: 22 - 26 mmol/L
▶ Normal PCO2. Answer: 35 - 45 mmHg
▶ pH Respiratory Compensation. Answer: Takes minutes
Hypo or hyperventilation to expel or retain CO2, which alters pH.
Hypoventilation: acidosis
Hyperventilation: alkalosis
