Med-Surg Nursing (ATI) Next-Gen NCLEX Style Exam –
Chapter 38: Heart Failure & Circulatory Assist Devices
1. Compare the pathophysiology of heart failure with reduced ejection fraction (HFrEF) and
heart failure with preserved ejection fraction (HFpEF).**
1. Which statement best describes heart failure with reduced ejection fraction (HFrEF)?
a) The heart has difficulty filling with blood due to stiff ventricles.
b) The left ventricle has a normal ejection fraction but cannot relax properly.
c) The heart cannot pump blood effectively due to weakened ventricular contraction.
d) The primary cause is usually pulmonary hypertension.
2. Which of the following statements about heart failure with preserved ejection
fraction (HFpEF) is correct?
a) It is caused by impaired ventricular relaxation and filling.
b) It is primarily caused by coronary artery disease.
c) It leads to a significantly reduced ejection fraction.
d) It is more common in young, athletic individuals.
3. True or False: Ejection fraction (EF) is **always** decreased in all types of heart failure.
**2. Relate the compensatory mechanisms involved in HF to the development of ADHF and
chronic HF.**
4. The compensatory mechanisms in heart failure include which of the following? **(Select
all that apply.)**
a) Activation of the renin-angiotensin-aldosterone system (RAAS)
b) Increased parasympathetic nervous system activity
, c) Ventricular remodeling
d) Release of natriuretic peptides
e) Decreased sympathetic nervous system activation
5. A client with chronic heart failure develops acute decompensated heart failure (ADHF).
Which symptoms indicate worsening fluid overload? **(Select all that apply.)**
a) Pink, frothy sputum
b) Bilateral crackles in the lungs
c) Sudden weight loss
d) Jugular vein distension
e) Bradycardia
6. True or False: Chronic activation of compensatory mechanisms in heart failure
eventually worsens myocardial function and contributes to disease progression.
**3. Describe appropriate nursing and interprofessional care to manage the patient with
ADHF.**
7. A nurse is caring for a client with acute decompensated heart failure (ADHF).
Which interventions are **priority**? **(Select all that apply.)**
a) Administering IV furosemide
b) Positioning the client in high Fowler’s
c) Encouraging fluid intake of at least 3 liters per day
d) Providing supplemental oxygen as needed
e) Administering IV beta-blockers immediately
8. A nurse is monitoring a client receiving IV nitroglycerin for ADHF. What is the
**priority** assessment?
a) Monitor for signs of hypotension
Chapter 38: Heart Failure & Circulatory Assist Devices
1. Compare the pathophysiology of heart failure with reduced ejection fraction (HFrEF) and
heart failure with preserved ejection fraction (HFpEF).**
1. Which statement best describes heart failure with reduced ejection fraction (HFrEF)?
a) The heart has difficulty filling with blood due to stiff ventricles.
b) The left ventricle has a normal ejection fraction but cannot relax properly.
c) The heart cannot pump blood effectively due to weakened ventricular contraction.
d) The primary cause is usually pulmonary hypertension.
2. Which of the following statements about heart failure with preserved ejection
fraction (HFpEF) is correct?
a) It is caused by impaired ventricular relaxation and filling.
b) It is primarily caused by coronary artery disease.
c) It leads to a significantly reduced ejection fraction.
d) It is more common in young, athletic individuals.
3. True or False: Ejection fraction (EF) is **always** decreased in all types of heart failure.
**2. Relate the compensatory mechanisms involved in HF to the development of ADHF and
chronic HF.**
4. The compensatory mechanisms in heart failure include which of the following? **(Select
all that apply.)**
a) Activation of the renin-angiotensin-aldosterone system (RAAS)
b) Increased parasympathetic nervous system activity
, c) Ventricular remodeling
d) Release of natriuretic peptides
e) Decreased sympathetic nervous system activation
5. A client with chronic heart failure develops acute decompensated heart failure (ADHF).
Which symptoms indicate worsening fluid overload? **(Select all that apply.)**
a) Pink, frothy sputum
b) Bilateral crackles in the lungs
c) Sudden weight loss
d) Jugular vein distension
e) Bradycardia
6. True or False: Chronic activation of compensatory mechanisms in heart failure
eventually worsens myocardial function and contributes to disease progression.
**3. Describe appropriate nursing and interprofessional care to manage the patient with
ADHF.**
7. A nurse is caring for a client with acute decompensated heart failure (ADHF).
Which interventions are **priority**? **(Select all that apply.)**
a) Administering IV furosemide
b) Positioning the client in high Fowler’s
c) Encouraging fluid intake of at least 3 liters per day
d) Providing supplemental oxygen as needed
e) Administering IV beta-blockers immediately
8. A nurse is monitoring a client receiving IV nitroglycerin for ADHF. What is the
**priority** assessment?
a) Monitor for signs of hypotension
