HEART FAILURE NCLEX EXAM VERSION A
A patient with left-sided heart failure is having difficulty breathing. Which of the
following is the most appropriate nursing intervention?*
A. Encourage the patient to cough and deep breathe.
B. Place the patient in Semi-Fowler’s position.
C. Assist the patient into High Fowler’s position.
D. Perform chest percussion therapy. – ANSWER- C
You’re providing diet discharge teaching to a patient with a history of heart failure.
Which of the following statements made by the patient represents they understood
the diet teaching?*
A. “I will limit my sodium intake to 5-6 grams a day.”
B. “I will be sure to incorporate canned vegetables and fish into my diet.”
C. “I’m glad I can still eat sandwiches because I love bologna and cheese
sandwiches.”
D. “I will limit my consumption of frozen meals.” – ANSWER- D
Select all the correct statements about educating the patient with heart failure:*
A. It is important patients with heart failure notify their physician if they gain
more than 6 pounds in a day or 10 pounds in a week.
B. Patients with heart failure should receive an annual influenza vaccine and be
up-to-date with the pneumonia vaccine.
C. Heart failure patients should limit sodium intake to 2-3 grams per day.
D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and
arrhythmias.
E. Patients with heart failure should limit exercise because of the risks. –
ANSWER- B, C, D
A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting.
A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you
anticipate the physician to order for this patient?*
A. Narcan
B. Aminophylline
C. Digibind
No medication because this is a normal Digoxin level. – ANSWER- C
Which of the following is a late sign of heart failure?*
A. Shortness of breath
B. Orthopnea
C. Edema
D. Frothy-blood tinged sputum – ANSWER- D
These drugs are used as first-line treatment of heart failure. They work by allowing
more blood to flow to the heart which decreases the work load of the heart and
allows the kidneys to secrete sodium. However, some patients can develop a
nagging cough with these types of drugs. This description describes?*
A. Beta-blockers
B. Vasodilators
C. Angiotensin II receptor blockers
D. Angiotensin-converting-enzyme inhibitors – ANSWER- D
A patient with heart failure is taking Losartan and Spironolactone. The patient is
having EKG changes that presents with tall peaked T-waves and flat p-waves.
Which of the following lab results confirms these findings?*
A. Na+ 135
B. BNP 560
C. K+ 8.0
D. K+ 1.5 – ANSWER- C
During your morning assessment of a patient with heart failure, the patient
complains of sudden vision changes that include seeing yellowish-green halos
around the lights. Which of the following medications do you suspect is causing
this issue?*
A. Lisinopril
B. Losartan
C. Lasix
D. Digoxin – ANSWER- D
Select all the correct statements about the pharmacodynamics of Beta-blockers for
the treatment of heart failure:*
A. These drugs produce a negative inotropic effect on the heart by increasing
myocardial contraction.
B. A side effect of these drugs include bradycardia.
C. These drugs are most commonly prescribed for patients with heart failure who
have COPD.
D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure. –
ANSWER- B, D
You are assisting a patient up from the bed to the bathroom. The patient has
swelling in the feet and legs. The patient is receiving treatment for heart failure and
is taking Hydralazine and Isordil. Which of the following is a nursing priority for
this patient while assisting them to the bathroom?*
A. Measure and record the urine voided.
B. Assist the patient up slowing and gradually.
C. Place the call light in the patient’s reach while in the bathroom.
D. Provide privacy for the patient. – ANSWER- B
A patient is taking Digoxin. Prior to administration you check the patient’s apical
pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and
Digoxin level of 5 ng/mL. Which of the following is the correct nursing action?*
A. Hold this dose and administer the second dose at 1800.
B. Administer the dose as ordered.
C. Hold the dose and notify the physician of the digoxin level.
D. Hold this dose until the patient’s potassium level is normal. – ANSWER- C
Which of the following is a common side effect of Spironolactone?*
A. Renal failure
B. Hyperkalemia
C. Hypokalemia
D. Dry cough – ANSWER- B
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