Heart failure is one of the most common med-surg diagnoses. These CMSRN questions cover assessment, medications, fluid and weight monitoring, and patient teaching, each with a full rationale.
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Three CMSRN practice questions on heart failure — tap an answer for instant feedback. The app has 5,200+, timed and scored.
Question 1
A patient with heart failure has bilateral pitting edema and crackles in lung bases. Which diuretic combination is most appropriate?
Combination of loop diuretic (furosemide) for acute volume overload plus potassium-sparing diuretic (spironolactone) for aldosterone blockade is most effective in heart failure. This combination prevents hypokalemia and provides synergistic diuresis.
Question 2
What is the priority nursing intervention for a patient experiencing cardiogenic shock post-MI?
In cardiogenic shock, the heart cannot pump effectively. Intra-aortic balloon pump (IABP) helps augment cardiac output and reduce afterload. Fluid boluses can worsen pulmonary edema. Beta blockers would further decrease cardiac output. While oxygen is important, mechanical support is the priority.
Question 3
A patient with heart failure has a BNP level of 850 pg/mL. What does this indicate?
BNP (B-type Natriuretic Peptide) >400 pg/mL indicates heart failure. Levels >800 suggest significant heart failure requiring hospitalization and aggressive treatment. Normal BNP is <100 pg/mL. This elevation confirms decompensated heart failure.
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Question 1
What is the priority nursing intervention for a patient experiencing cardiogenic shock post-MI?
In cardiogenic shock, the heart cannot pump effectively. Intra-aortic balloon pump (IABP) helps augment cardiac output and reduce afterload. Fluid boluses can worsen pulmonary edema. Beta blockers would further decrease cardiac output. While oxygen is important, mechanical support is the priority.
Question 2
A patient with heart failure has a BNP level of 850 pg/mL. What does this indicate?
BNP (B-type Natriuretic Peptide) >400 pg/mL indicates heart failure. Levels >800 suggest significant heart failure requiring hospitalization and aggressive treatment. Normal BNP is <100 pg/mL. This elevation confirms decompensated heart failure.
Question 3
Which finding indicates digoxin toxicity?
Classic signs of digoxin toxicity include visual disturbances (yellow-green halos), GI symptoms (nausea, vomiting), and cardiac effects (bradycardia, heart blocks, arrhythmias). Digoxin causes bradycardia, not tachycardia. Hypokalemia increases toxicity risk.
Question 4
A patient with heart failure is prescribed spironolactone. What lab value requires close monitoring?
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. Potassium levels must be monitored closely, especially when combined with ACE inhibitors or ARBs (also increase potassium). Hold if K+ >5.0 mEq/L.
Question 5
What is the primary benefit of ACE inhibitors in heart failure management?
ACE inhibitors reduce preload (venous return) and afterload (arterial resistance), making it easier for the failing heart to pump. They also prevent harmful ventricular remodeling. They do not increase contractility or heart rate. Spironolactone blocks aldosterone.
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What is the priority nursing intervention for a patient experiencing cardiogenic shock post-MI?…
