Heart Failure: Pathophysiology, Diagnosis, and Management

Question 1

In systolic heart failure, which pathophysiological mechanism plays a primary role?

Accepted Answer

Impaired contractile function of the heart muscle

Answer

Reduced ability of the left ventricle to relax

Answer

Increased volume of blood entering the ventricle

Answer

Increased resistance to blood flow leaving the ventricle

Question 2

The primary pathophysiological mechanism underlying heart failure is:

Accepted Answer

Systolic and diastolic dysfunction

Answer

Systolic dysfunction

Answer

Diastolic dysfunction

Answer

Reduced cardiac output

Question 3

Which of the following is NOT a compensatory mechanism in response to decreased cardiac output in heart failure?

Accepted Answer

Reduced glomerular filtration rate

Answer

Increased vascular resistance

Answer

Enhanced sympathetic nervous system activity

Answer

Tachycardia

Question 4

What is the primary purpose of dietary sodium restriction in heart failure management?

Accepted Answer

Reduce fluid retention

Answer

Improve cardiac function

Answer

Decrease blood pressure

Answer

Enhance exercise tolerance

Question 5

Which characteristic echocardiographic finding is associated with heart failure with preserved ejection fraction?

Accepted Answer

Thickened left ventricular wall

Answer

Dilated left ventricle

Answer

Reduced left ventricular ejection fraction <50%

Answer

Normal left ventricular size and function

Question 6

A patient with heart failure presents with dyspnea, fatigue, and ankle swelling. Which symptom is primarily associated with left-sided heart failure?

Accepted Answer

Dyspnea

Answer

Fatigue

Answer

Ankle swelling

Answer

Oliguria

Question 7

Which medication class is considered a cornerstone of pharmacological treatment for systolic heart failure?

Accepted Answer

Β-blockers

Answer

Nitrates

Answer

Calcium channel blockers

Answer

Antiarrhythmics

Question 8

A patient with heart failure presents with jugular venous distension, pulmonary edema, and a weak pulse. What is the most likely underlying mechanism for these symptoms?

Accepted Answer

Reduced cardiac output

Answer

Valvular regurgitation

Answer

Pericardial effusion

Answer

Hypervolemia

Question 9

Which of the following is an indicator of a favorable prognosis in patients with heart failure?

Accepted Answer

Increased left ventricular ejection fraction

Answer

Severe symptoms

Answer

Presence of comorbidities

Answer

Advanced age

Question 10

Which of the following clinical manifestations is most frequently associated with left-sided heart failure?

Accepted Answer

Dyspnea

Answer

Lower extremity edema

Answer

Hepatomegaly

Answer

Jugular venous distension

Question 11

Which of the following is a prevalent cause of heart failure with preserved ejection fraction (HFpEF)?

Accepted Answer

Hypertension

Answer

Ischemic heart disease

Answer

Idiopathic dilated cardiomyopathy

Answer

Valvular heart disease

Question 12

Which hemodynamic parameter is typically elevated in patients with left-sided heart failure?

Accepted Answer

Pulmonary capillary wedge pressure (PCWP)

Answer

Arterial blood pressure

Answer

Central venous pressure (CVP)

Answer

Pulmonary artery pressure (PAP)

Question 13

Which of the following is a cardinal symptom of right-sided heart failure?

Accepted Answer

Peripheral edema

Answer

Chest pain

Answer

Shortness of breath

Question 14

Which diagnostic modality is most commonly used to evaluate left ventricular function?

Accepted Answer

Echocardiogram

Answer

Electrocardiogram (ECG)

Answer

Chest X-ray

Answer

Cardiac magnetic resonance imaging (MRI)

Question 15

Which pharmacological agent is a mainstay of treatment for chronic heart failure due to reduced ejection fraction (HFrEF)?

Accepted Answer

ACE inhibitors

Answer

Antibiotics

Answer

Anticoagulants

Answer

Antiarrhythmics

Question 16

Which of the following is a contraindication to the use of digoxin in heart failure?

Accepted Answer

Severe renal impairment

Answer

Systolic blood pressure < 90 mmHg

Answer

Atrial fibrillation with a controlled ventricular rate

Answer

History of acute coronary syndrome (ACS)

Question 17

Which lifestyle modification is recommended for patients with heart failure to improve outcomes?

Accepted Answer

Weight loss

Answer

Increased alcohol intake

Answer

Unrestricted salt intake

Answer

Smoking

Question 18

Which of the following is a potential complication of systolic heart failure?

Accepted Answer

Thromboembolic events

Answer

Seizures

Answer

Anaphylaxis

Question 19

Which of the following is a key nursing intervention for patients with heart failure?

Accepted Answer

Monitoring fluid status

Answer

Providing chemotherapy

Answer

Performing tracheostomy care

Answer

Administering intravenous antibiotics

Question 20

Which of the following is a prognostic indicator in patients with systolic heart failure?

Accepted Answer

Left ventricular ejection fraction (LVEF)

Answer

Hemoglobin A1c

Answer

White blood cell count

Answer

Platelet count

Question 21

A 72-year-old male presents with shortness of breath, fatigue, and swelling in his legs. An echocardiogram reveals an ejection fraction of 35%. Which of the following is the MOST likely underlying cause of his heart failure?

Accepted Answer

Ischemic heart disease

Answer

Hyperthyroidism

Answer

Mitral valve stenosis

Answer

Pulmonary hypertension

Question 22

Which of the following biomarkers is considered the MOST sensitive and specific for diagnosing heart failure?

Accepted Answer

B-type natriuretic peptide (BNP)

Answer

Creatinine kinase-MB (CK-MB)

Answer

C-reactive protein (CRP)

Answer

Troponin I

Question 23

A patient with acute decompensated heart failure presents with severe shortness of breath and difficulty breathing when lying down. Which of the following interventions would be MOST appropriate as an immediate treatment?

Accepted Answer

Administer intravenous furosemide

Answer

Recommend a low-sodium diet

Answer

Start a beta-blocker

Answer

Prescribe an angiotensin-converting enzyme (ACE) inhibitor

Question 24

Which of the following medications is indicated for reducing mortality in patients with heart failure with a reduced ejection fraction and symptoms?

Accepted Answer

Spironolactone

Answer

Hydralazine

Answer

Digoxin

Answer

Ivabradine

Question 25

Which of the following physiological changes is a hallmark of heart failure with preserved ejection fraction (HFpEF)?

Accepted Answer

Diastolic dysfunction

Answer

Decreased left ventricular wall thickness

Answer

Reduced afterload

Answer

Increased cardiac output

Question 26

What is the primary mechanism of action of digoxin in the treatment of heart failure?

Accepted Answer

Inhibition of the sodium-potassium ATPase pump

Answer

Vasodilation of peripheral arteries

Answer

Blockade of beta-adrenergic receptors

Answer

Inhibition of angiotensin-converting enzyme (ACE)

Question 27

Which of the following is a common clinical manifestation of right-sided heart failure?

Accepted Answer

Swelling in the legs and feet

Answer

Sudden shortness of breath at night

Answer

Crackling sounds in the lungs

Answer

Difficulty breathing when lying down

Question 28

A patient with heart failure is prescribed a low-sodium diet. What is the recommended daily sodium intake for this patient?

Accepted Answer

Less than 2 grams

Answer

Less than 6 grams

Answer

Less than 4 grams

Answer

Unrestricted sodium intake

Question 29

Which of the following diagnostic tests is essential for assessing the severity of valvular heart disease as a potential cause of heart failure?

Accepted Answer

Echocardiography

Answer

Cardiac catheterization

Answer

Chest X-ray

Answer

Electrocardiogram (ECG)

Question 30

A patient with heart failure presents with shortness of breath, fatigue, and swelling in the legs. Which of the following pathophysiological mechanisms is most likely responsible for these symptoms?

Accepted Answer

Reduced cardiac output leading to impaired tissue perfusion and fluid accumulation.

Answer

Increased blood viscosity causing slower blood flow.

Answer

Elevated blood pressure causing vascular overload.

Question 31

A patient with heart failure is being treated with an ACE inhibitor. What is the primary way ACE inhibitors improve heart failure symptoms?

Accepted Answer

They reduce afterload by blocking angiotensin II production, leading to vasodilation.

Answer

They increase preload by promoting sodium and water retention.

Answer

They enhance contractility by stimulating the sympathetic nervous system.

Question 32

A patient with heart failure is admitted to the hospital with acute pulmonary edema. Which of the following is the most urgent intervention to manage this life-threatening condition?

Accepted Answer

Administering oxygen therapy to improve oxygenation and reduce respiratory distress.

Answer

Prescribing diuretics to promote fluid excretion.

Answer

Restricting fluids to decrease preload.

Question 33

Which diagnostic test is considered the gold standard for evaluating left ventricular function in patients with suspected heart failure?

Accepted Answer

Echocardiography

Answer

Chest X-ray

Answer

Electrocardiogram (ECG)

Question 34

A patient with heart failure has been prescribed a beta-blocker. What is the main way beta-blockers improve heart failure symptoms?

Accepted Answer

They decrease heart rate and contractility, reducing oxygen demand and improving cardiac efficiency.

Answer

They dilate blood vessels, reducing afterload.

Answer

They increase stroke volume by enhancing myocardial contractility.

Question 35

A patient with heart failure is being discharged home. Which lifestyle modifications should be recommended to effectively manage the condition?

Accepted Answer

Regular exercise, dietary sodium restriction, and smoking cessation.

Answer

A high-fat diet to increase calorie intake.

Answer

Increased caffeine intake for energy.

Question 36

A patient with heart failure is experiencing dyspnea at rest. Which medication is most likely to be prescribed to alleviate this symptom?

Accepted Answer

Nitrates

Answer

ACE inhibitors

Answer

Diuretics

Answer

Beta-blockers

Question 37

Which of the following is NOT a risk factor for developing heart failure?

Accepted Answer

Regular exercise

Answer

Diabetes mellitus

Answer

Obesity

Answer

Hypertension

Question 38

A patient with heart failure is complaining of persistent cough and wheezing. What is the most probable cause of these symptoms?

Accepted Answer

Pulmonary congestion and edema due to fluid buildup in the lungs.

Answer

Asthma exacerbation triggered by heart failure.

Answer

Bronchitis caused by a viral infection.

Question 39

A patient with heart failure is being monitored for signs of worsening heart failure. Which assessment is most helpful in detecting early signs of deterioration?

Accepted Answer

Daily weight monitoring to assess fluid retention.

Answer

Annual cholesterol level assessment.

Answer

Monthly blood pressure checks.

Answer

Weekly blood glucose monitoring.