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ATI RN HEART FAILURE
ADULT MEDICAL-SURGICAL PROCTORED
EXAM & PHARMACOLOGY
HEART FAILURE & CARDIOVASCULAR
PREP EXAM-STYLE REVIEW
HEART FAILURE / CARDIOVASCULAR
MED-SURG REVIEW & PREP EXAM
PREP EXAM-STYLE QUESTIONS &
ANSWERS REVIEW
ATI MED-SURG CARDIOVASCULAR
BLUEPRINT
2023 NCLEX-STYLE
,Question 1: Monitoring Adverse Effects of Digoxin and
Furosemide
A nurse is caring for a client who has a history of heart failure and has recently been
prescribed both digoxin and furosemide to improve cardiac output and reduce fluid
overload. During the morning assessment, the client reports feeling dizzy and unsteady
when standing from the bed to walk to the bathroom. The nurse understands that these
medications can alter fluid balance and blood pressure. Which of the following findings
should the nurse recognize as an adverse effect related to these medications?
1. Shortness of breath
2. Lightheadedness
3. Dry cough
4. Metallic taste
Correct Answer: 2. Lightheadedness
Rationale:
Digoxin and furosemide can both contribute to hypotension and electrolyte imbalances,
which may lead to dizziness or lightheadedness when changing positions. Furosemide is
a loop diuretic that causes fluid loss and can lower blood pressure rapidly, especially in
older adults. Digoxin may also contribute to altered cardiac conduction and decreased
perfusion if toxicity develops. The nurse should monitor orthostatic blood pressure
changes and assess for falls risk. Early recognition of lightheadedness is important to
prevent injury and worsening cardiovascular instability.
Question 2: Manifestations of Left-Sided Heart Failure
A nurse is assessing a client admitted with worsening left-sided heart failure. The client
reports fatigue, weakness, and difficulty performing activities of daily living due to
decreased endurance. Upon examination, the nurse notices diminished peripheral
circulation and cool extremities. Which of the following findings should the nurse expect
with left-sided heart failure?
, 1. Increased abdominal girth
2. Weak peripheral pulses
3. Jugular venous neck distention
4. Dependent edema
Correct Answer: 2. Weak peripheral pulses
Rationale:
Left-sided heart failure results in decreased cardiac output, which reduces blood flow to
peripheral tissues. Weak peripheral pulses occur because the left ventricle cannot
effectively pump blood into systemic circulation. Clients often exhibit fatigue, cool
extremities, delayed capillary refill, and decreased activity tolerance. Increased
abdominal girth, jugular venous distention, and dependent edema are more commonly
associated with right-sided heart failure due to systemic venous congestion.
Recognizing signs specific to left-sided failure helps guide appropriate treatment
interventions.
Question 3: Teaching for Worsening Heart Failure
A nurse is providing discharge teaching to a client who has chronic heart failure and is
preparing to return home. The nurse emphasizes the importance of monitoring for signs
of fluid retention and worsening cardiac function. The client asks which findings should
be reported immediately to the healthcare provider. Which of the following findings
should the nurse instruct the client to report?
1. Weight gain of 2 lb in 24 hr
2. Increase of 10 mm Hg in systolic blood pressure
3. Dyspnea with exertion
4. Dizziness when rising quickly
Correct Answer: 1. Weight gain of 2 lb in 24 hr
, Rationale:
A sudden weight gain of 2 lb or more within 24 hours is a significant indicator of fluid
retention and worsening heart failure. Rapid fluid accumulation often occurs before
visible edema or severe respiratory symptoms develop. Early reporting allows the
provider to adjust medications such as diuretics before the condition progresses.
Dyspnea with exertion may already be expected in chronic heart failure, while dizziness
when standing can occur from medications or position changes. Daily weights are one
of the most reliable methods for monitoring fluid status in heart failure clients.
Question 4: Laboratory Findings in Peripheral Arterial Disease
A nurse is reviewing lipid panel laboratory results for several clients diagnosed with
peripheral arterial disease (PAD). The nurse understands that elevated LDL cholesterol
and low HDL cholesterol increase the risk for progression of atherosclerosis and vascular
complications. Which client should receive additional dietary teaching related to
cardiovascular risk reduction?
1. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dL
2. Cholesterol 185 mg/dL, HDL 50 mg/dL, LDL 120 mg/dL
3. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL
4. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
Correct Answer: 3. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL
Rationale:
This client has significantly elevated LDL cholesterol and extremely low HDL cholesterol,
both of which greatly increase the risk for atherosclerosis progression. LDL contributes
to plaque formation within arterial walls, while HDL helps remove cholesterol from
circulation. An HDL level below 40 mg/dL and LDL above 100 mg/dL place the client at
increased cardiovascular risk. Dietary modifications, exercise, smoking cessation, and
medication adherence are important interventions for improving lipid levels. Early
ATI RN HEART FAILURE
ADULT MEDICAL-SURGICAL PROCTORED
EXAM & PHARMACOLOGY
HEART FAILURE & CARDIOVASCULAR
PREP EXAM-STYLE REVIEW
HEART FAILURE / CARDIOVASCULAR
MED-SURG REVIEW & PREP EXAM
PREP EXAM-STYLE QUESTIONS &
ANSWERS REVIEW
ATI MED-SURG CARDIOVASCULAR
BLUEPRINT
2023 NCLEX-STYLE
,Question 1: Monitoring Adverse Effects of Digoxin and
Furosemide
A nurse is caring for a client who has a history of heart failure and has recently been
prescribed both digoxin and furosemide to improve cardiac output and reduce fluid
overload. During the morning assessment, the client reports feeling dizzy and unsteady
when standing from the bed to walk to the bathroom. The nurse understands that these
medications can alter fluid balance and blood pressure. Which of the following findings
should the nurse recognize as an adverse effect related to these medications?
1. Shortness of breath
2. Lightheadedness
3. Dry cough
4. Metallic taste
Correct Answer: 2. Lightheadedness
Rationale:
Digoxin and furosemide can both contribute to hypotension and electrolyte imbalances,
which may lead to dizziness or lightheadedness when changing positions. Furosemide is
a loop diuretic that causes fluid loss and can lower blood pressure rapidly, especially in
older adults. Digoxin may also contribute to altered cardiac conduction and decreased
perfusion if toxicity develops. The nurse should monitor orthostatic blood pressure
changes and assess for falls risk. Early recognition of lightheadedness is important to
prevent injury and worsening cardiovascular instability.
Question 2: Manifestations of Left-Sided Heart Failure
A nurse is assessing a client admitted with worsening left-sided heart failure. The client
reports fatigue, weakness, and difficulty performing activities of daily living due to
decreased endurance. Upon examination, the nurse notices diminished peripheral
circulation and cool extremities. Which of the following findings should the nurse expect
with left-sided heart failure?
, 1. Increased abdominal girth
2. Weak peripheral pulses
3. Jugular venous neck distention
4. Dependent edema
Correct Answer: 2. Weak peripheral pulses
Rationale:
Left-sided heart failure results in decreased cardiac output, which reduces blood flow to
peripheral tissues. Weak peripheral pulses occur because the left ventricle cannot
effectively pump blood into systemic circulation. Clients often exhibit fatigue, cool
extremities, delayed capillary refill, and decreased activity tolerance. Increased
abdominal girth, jugular venous distention, and dependent edema are more commonly
associated with right-sided heart failure due to systemic venous congestion.
Recognizing signs specific to left-sided failure helps guide appropriate treatment
interventions.
Question 3: Teaching for Worsening Heart Failure
A nurse is providing discharge teaching to a client who has chronic heart failure and is
preparing to return home. The nurse emphasizes the importance of monitoring for signs
of fluid retention and worsening cardiac function. The client asks which findings should
be reported immediately to the healthcare provider. Which of the following findings
should the nurse instruct the client to report?
1. Weight gain of 2 lb in 24 hr
2. Increase of 10 mm Hg in systolic blood pressure
3. Dyspnea with exertion
4. Dizziness when rising quickly
Correct Answer: 1. Weight gain of 2 lb in 24 hr
, Rationale:
A sudden weight gain of 2 lb or more within 24 hours is a significant indicator of fluid
retention and worsening heart failure. Rapid fluid accumulation often occurs before
visible edema or severe respiratory symptoms develop. Early reporting allows the
provider to adjust medications such as diuretics before the condition progresses.
Dyspnea with exertion may already be expected in chronic heart failure, while dizziness
when standing can occur from medications or position changes. Daily weights are one
of the most reliable methods for monitoring fluid status in heart failure clients.
Question 4: Laboratory Findings in Peripheral Arterial Disease
A nurse is reviewing lipid panel laboratory results for several clients diagnosed with
peripheral arterial disease (PAD). The nurse understands that elevated LDL cholesterol
and low HDL cholesterol increase the risk for progression of atherosclerosis and vascular
complications. Which client should receive additional dietary teaching related to
cardiovascular risk reduction?
1. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dL
2. Cholesterol 185 mg/dL, HDL 50 mg/dL, LDL 120 mg/dL
3. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL
4. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
Correct Answer: 3. Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL
Rationale:
This client has significantly elevated LDL cholesterol and extremely low HDL cholesterol,
both of which greatly increase the risk for atherosclerosis progression. LDL contributes
to plaque formation within arterial walls, while HDL helps remove cholesterol from
circulation. An HDL level below 40 mg/dL and LDL above 100 mg/dL place the client at
increased cardiovascular risk. Dietary modifications, exercise, smoking cessation, and
medication adherence are important interventions for improving lipid levels. Early
