Congestive Heart Failure (CHF) Practice Test

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• What is cardiac remodeling?
• What is the purpose of adding a mineralocorticoid receptor antagonist in HFrEF and what monitoring is required?
• Which beta-blockers have proven mortality benefit in HFrEF?
• Which of the following best reflects signs of improving congestion after starting guideline-directed medical therapy?
• Vericiguat is indicated for reducing hypertrophy, inflammation, and fibrosis in HF patients with EF below what threshold?
• BiVAD refers to a device providing mechanical support for which parts of the heart?
• What is the initial management step for acute decompensated heart failure without shock?
• HFmrEF is defined by EF in which range?
• In acute HF management, which intervention is used to promote IV diuresis?
• For patients who cannot tolerate ACE inhibitors, which of the following is used as a secondary option?
• Ivabradine is indicated in heart failure patients under which combination?
• Which medication class is identified as warranting potassium monitoring when added to RAAS inhibitors in heart failure?
• Hyponatremia in decompensated heart failure is primarily due to which mechanism?
• Which comorbidity commonly requires special attention with diuretic therapy due to risk of dehydration or electrolyte abnormalities?
• In what situation is ultrafiltration considered in HF management?
• When is a beta blocker given in heart failure?
• What is a key monitoring focus when a patient is on diuretics for heart failure?
• Which of the following is NOT listed as a risk factor for heart failure?
• Which monitoring is essential when initiating a mineralocorticoid receptor antagonist in HFrEF?
• Stage A risk factors for heart failure include all of the following except?
• What is the prognostic significance of LV remodeling measurements like LV dilation or LVESV?
• In which patients is hydralazine–isosorbide dinitrate recommended, and what benefit was shown?
• Which of the following is a classic combination of findings in congestive heart failure?
• Which imaging modality is commonly used to support heart failure diagnosis and assess the lungs?
• Stage B HF is defined as ...
• Which are comorbidities of diastolic dysfunction?
• Which practice is recommended to reduce heart failure readmissions after discharge?
• Which therapy provides both resynchronization and defibrillation capabilities?
• Hyponatremia in heart failure is associated with worse outcomes because it reflects what mechanism?
• Which parameter is commonly used to assess volume status in heart failure patients during follow-up?
• Which finding is associated with right-sided heart failure?
• Mechanism and clinical benefit of sacubitril/valsartan in HFrEF is best described by which statement?
• What is the main purpose of using natriuretic peptides beyond diagnosis?
• What is the role of vaccination in heart failure care?
• What is the preferred diuretic strategy when a patient is diuretic-resistant with persistent edema?
• Which statement best describes an implantable cardioverter-defibrillator (ICD)?
• How is alcohol exposure related to cardiomyopathy and heart failure?
• How is HFpEF typically managed, and why is it more challenging?
• Neurohormonal blockade in heart failure aims to achieve what outcome?
• Which biomarker is commonly used to support the diagnosis of heart failure?
• What is the role of left ventricular assist devices (LVADs) in advanced heart failure?
• What is the recommended dosing strategy for starting ACE inhibitors in chronic HFrEF?
• After starting GDMT dose changes, when should renal function and electrolytes be checked?
• What is the treatment approach for HF with improved EF (HFimpEF)?
• Name two common adverse effects and one contraindication of ACE inhibitors.
• What is a typical safety consideration when using SGLT2 inhibitors in heart failure?
• Why is BNP level interpretation age-dependent and what is a typical threshold for ruling out HF in non-elderly patients?
• Which statement best describes how ACC/AHA stages and NYHA functional classes are used in CHF?
• Which symptom of heart failure is typically worsened during the night and may wake a patient from sleep?
• How should electrolytes be monitored when starting MRA therapy?
• What is a major outcome associated with SGLT2 inhibitors in heart failure?
• Cardiorenal syndrome management principle?
• What is the current focus in managing heart failure according to the updated approach?
• BiVAD provides mechanical support to which chambers?
• How do SGLT2 inhibitors fit into HF management?
• What does CRT-D stand for?
• Which lifestyle modification has strong evidence for improving outcomes in CHF?
• A rising NT-proBNP level in a patient with heart failure most likely indicates what?
• Which diuretic is commonly added to loop diuretics to overcome diuretic resistance?
• What is the primary pathophysiologic mechanism driving the progression of chronic heart failure?
• Which class of drugs reduces mortality in HFrEF by inhibiting the RAAS system and is often started first?
• Which statement best defines heart failure?
• In HF, diuretics are indicated for
• Which heart failure phenotype is generally associated with the worst prognosis?
• If a patient cannot tolerate ACE inhibitors due to cough or angioedema, which class should be used?
• Which EF phenotype is associated with the best prognosis among the primary phenotypes?
• Which statement about cardiac remodeling is NOT accurate?
• Why are diuretics used in CHF and what is a key risk with overdiuresis?
• What is the initial pharmacologic approach to an acute decompensated heart failure with pulmonary edema and high blood pressure?
• When starting RAAS inhibitors in heart failure, which monitoring parameter should be prioritized to prevent electrolyte disturbances?
• Which class of medication is teratogenic and should be avoided in pregnancy?
• The PARADIGM-HF trial compared which agent against enalapril to show superiority?
• Which histologic feature is associated with diastolic dysfunction?
• What is the management approach for tachycardia-induced cardiomyopathy?
• Which EF cutoffs define HFrEF, HFpEF, and HFmrEF?
• After hospital discharge, diuretic dosing should be adjusted to achieve what goal?
• How does age affect BNP levels in HF evaluation?
• What is the primary difference in systolic function between HFrEF and HFpEF?
• In which patient population is CRT most beneficial?
• LVAD stands for which device?
• What is the role of sacubitril/valsartan in HFrEF and what trial supports it?
• In decompensated heart failure, hyponatremia is associated with what prognosis?
• Which device completely replaces heart function?
• When should ARBs be used in HF management?
• What is the main indication for an ICD in CHF?
• What is the rationale for using beta-blockers in symptomatic heart failure with reduced ejection fraction?
• What role do noninvasive ventilation and oxygen therapy play in ADHF with respiratory distress?
• Which of the following is a sign of heart failure?
• When should an ACE inhibitor be started in chronic HFrEF?
• Which two prognostic risk scores are commonly used in heart failure to estimate mortality risk?
• When is an MRA recommended for heart failure?
• Which beta-blockers are proven to improve survival in HFrEF?
• How do management priorities differ between HFrEF and HFpEF?
• When is digoxin considered in CHF management?
• Which condition is considered an indication for heart transplantation in advanced heart failure?
• Name two common etiologies that most often lead to HFrEF in adults.
• Which statement about SGLT2 inhibitors in heart failure is correct?
• What to consider when choosing between ACE inhibitors and ARBs in a patient with HF?
• Cardiac resynchronization therapy delivers stimulation to which ventricles?
• Which statement correctly describes NYHA Class I?
• Ivabradine is indicated for which patient with heart failure?
• In HF, what device therapy is indicated for patients with LV conduction delay and reduced EF to improve synchrony?
• Which statement about diuretic therapy in CHF is true?
• In NYHA functional classification, which statement describes Class III?
• Which statement best describes pregnancy considerations in heart failure management?
• Which adaptive mechanisms contribute to heart failure progression in both systolic and diastolic dysfunction?
• HFpEF is characterized by which combination?
• Neurohormonal blockade includes which of the following classes?
• Which echo finding confirms HFrEF?
• Sacubitril/valsartan is categorized as which type of HF medication?
• Which combination of characteristics is typically used to determine CRT eligibility?
• What is the rationale for IV iron therapy in iron-deficient heart failure?
• Which statement best describes adverse effects of spironolactone compared with eplerenone?
• How often should guideline-directed medical therapy doses be titrated in stable patients?
• Which are comorbidities of systolic dysfunction?
• Which device is indicated when advanced heart failure is refractory to medical therapy and provides mechanical circulatory support?
• Artificial heart is indicated in which situation?
• Which statement about natriuretic peptide levels is true in heart failure management?
• Stage A HF is defined as ...
• What is the primary therapy for RAAS inhibition in heart failure?
• Left ventricular assist devices can serve as which of the following in advanced heart failure?
• What criteria define the use of ivabradine in HFrEF?
• Which drug class is included in guideline-directed medical therapy for HFrEF?
• What is the mechanism of loop diuretics in CHF and their main therapeutic effect?
• What is the recommended daily sodium intake target for most heart failure patients?
• Why is weight monitoring recommended for HF patients?
• When is an ICD recommended in HF?
• Which statement is true regarding BP targets in heart failure management?
• What is the role of SGLT2 inhibitors in heart failure, regardless of diabetes status?
• What is the pathophysiology of systolic dysfunction (HFrEF)?
• What does a combined resynchronization therapy and defibrillator device provide?
• What timeframe is recommended for early post-discharge follow-up after heart failure hospitalization?
• In heart failure evaluation, what is the role of Cardiac MRI?
• In heart failure with atrial fibrillation, management includes which of the following?
• Which factor would favor choosing an ARB over an ACE inhibitor in heart failure management?
• What is a key management goal for HF patients with hyponatremia?
• How does hypertensive heart disease contribute to HF development?
• Which of the following is an adaptive mechanism involving oxidative stress?
• Which statement correctly identifies HF type and EF range?
• Which statement about noninvasive ventilation in acute heart failure management is accurate?
• HFpEF management in current guidelines is best described by which statement?
• Which NYHA class describes mild symptoms with ordinary activity?
• For HFpEF, what is considered a primary disease-modifying therapy?
• What is the role and safety profile of SGLT2 inhibitors in heart failure?
• Systolic dysfunction in heart failure is defined as HF with reduced ejection fraction (HFrEF) with EF ≤40%.
• Which of the following beta-blockers has not been shown to improve mortality in heart failure patients?
• BNP and NT-proBNP are especially useful in CHF for?
• What medication slows heart rate without affecting blood pressure and reduces hospitalization in heart failure?
• Which imaging modality provides information about myocardial viability and fibrosis in heart failure?
• In ACC/AHA classification, which stage corresponds to structural heart disease with no symptoms?
• What is a major lifestyle modification recommended for HF patients?
• Which ACC/AHA stage description correctly matches progression of heart failure from risk to advanced disease?
• Which of the following is a primary non-pharmacologic strategy to manage fluid status in heart failure?
• What do MAGGIC Risk Score and Seattle Heart Failure Model estimate?
• Which medication is particularly considered in HFrEF patients with concomitant atrial fibrillation to reduce hospitalizations?
• Stage C HF is defined as ...
• Left ventricular assist devices (LVADs) are used in advanced heart failure for which purpose?
• Which of the following are basic signs indicating congestive volume overload?
• Which statement about B-type natriuretic peptide (BNP) is true in the context of heart failure?
• Atrial fibrillation affects BNP/NT-proBNP interpretation by doing what?
• How can you detect cardiac remodeling?
• Which LVEF range defines heart failure with mid-range ejection fraction (HFmrEF)?
• Which statement describes LVAD use in advanced heart failure?
• In CRT candidates, which QRS pattern is commonly observed?
• Cor pulmonale is best described as ...
• To overcome diuretic resistance in congestive heart failure, which approach is commonly recommended?
• What is the purpose of vaccination in heart failure care?
• On physical examination, which combination of findings suggests fluid overload in heart failure?
• Which test is routinely included in the initial evaluation of heart failure alongside imaging?
• Stage D HF is defined as ...
• Which parameter is also a prognostic marker in HF besides LV dilation and LVESV?
• HFrEF is defined by EF in which range?
• Which GDMT statement for heart failure with reduced ejection fraction is true?
• Which test is commonly used as a biomarker to differentiate heart failure–related dyspnea from other causes?
• Which of the following is included in HFmrEF treatment as disease-modifying therapy?
• What does an echocardiogram provide in heart failure?
• Which device is indicated to prevent sudden cardiac death in advanced heart failure when the ejection fraction is ≤ 35% and life expectancy > 1 year?
• In patients who cannot tolerate ACE inhibitors, which is used as an alternative RAAS blocker?
• Which histopathologic finding is associated with systolic dysfunction?
• Which of the following is NOT listed as an adaptive mechanism contributing to HF progression?
• Which parameter duration is a typical criterion for cardiac resynchronization therapy?
• Which EF range defines heart failure with preserved ejection fraction (HFpEF)?
• In HFpEF, guideline-directed medical therapy (GDMT) has what level of mortality benefit?
• Which symptom is commonly reported in heart failure?
• Which heart sound is often associated with heart failure?
• What is the pathophysiology of diastolic dysfunction (HFrEF)?
• Which imaging modality is commonly used to assess left ventricular ejection fraction and volumes to monitor prognosis in heart failure?
• In African American patients with heart failure, which therapy added to standard therapy has shown mortality reduction?
• Which finding is associated with left-sided heart failure?
• Which therapy combines neprilysin inhibition with angiotensin receptor blockade and may offer superior efficacy?
• What is the consequence of cardiac remodeling?
• Which condition tends to lower BNP/NT-proBNP levels, potentially masking heart failure?
• What is the hallmark symptom relief expectation with diuretic therapy in CHF?
• Which test is commonly used to diagnose heart failure and assess its severity?
• How should heart failure patients be monitored after discharge to reduce readmission?
• When is an SGLT2 inhibitor indicated for heart failure?
• What is the role of hydralazine–isosorbide dinitrate therapy in HF?
• Which of the following is a cause of heart failure?
• Which comorbidity is more commonly linked to diastolic dysfunction than to systolic dysfunction?
• What is listed as a secondary therapy for HFpEF?
• In patients with renal dysfunction, how should ACE inhibitors or ARBs be managed?
• What is the effect of sacubitril/valsartan on cardiovascular outcomes in symptomatic HFrEF?
• HFpEF is primarily characterized by which of the following?
• In HFpEF, which comorbidity often drives symptom burden and treatment decisions?
• Peripartum cardiomyopathy is best described as?
• Which device delivers shocks to terminate life-threatening arrhythmias?
• Which is a recognized short-term goal of heart failure treatment?
• Which of the following is a long-term goal of heart failure treatment?
• Which EF threshold is typically considered for ICD consideration after GDMT optimization?
• Which therapy may have better efficacy than an ACE inhibitor or an ARB in heart failure?
• Which vaccinations should a patient with CHF routinely receive?
• Which therapy has demonstrated mortality reduction in African American patients with heart failure when added to standard therapy?
• What is the effect of noninvasive ventilation on cardiogenic pulmonary edema?
• In acute HF treatment, which statement about vasodilatory therapy is listed?
• Which of the following is listed as diuretic therapy for HFmrEF?
• What is a common and appropriate approach to edema in HFpEF?
• What is tachycardia-induced cardiomyopathy and its management?
• For CRT, which QRS duration and morphology predict benefit?
• Which factor does NOT affect BNP/NT-proBNP interpretation?
• Which CRT pattern is most likely to benefit?
• Which statement best reflects the role of noninvasive ventilation in acute cardiogenic pulmonary edema from heart failure?
• In HF therapy, what is the role of digoxin?
• Cardiac resynchronization therapy is indicated for which condition?
• What electrolyte abnormality is a key safety concern with MRA therapy in HF?
• Which histopathologic finding is associated with diastolic dysfunction?
• What is the indication for ventricular assist devices (VAD) in heart failure?
• Which statement best describes the neurohormonal response in heart failure?
• Which meds should be used with caution in HF due to potential negative inotropic effects?
• What is the role of MRA therapy (spironolactone or eplerenone) in HFrEF and what is a major electrolyte concern?
• HFpEF is characterized by which combination?
• Name a biomarker commonly used to diagnose heart failure and monitor prognosis, and what does its level indicate?
• Which class specifically targets aldosterone-mediated effects in heart failure?
• Which of the following is NOT a cardinal symptom of congestive heart failure?
• In heart failure, what is the typical blood pressure target range?
• What is the clinical significance of an elevated jugular venous pressure in heart failure?
• Which statement describes guideline-directed medical therapy for HFrEF?
• What is the key clinical goal of adjusting diuretic therapy after discharge?
• Which statement best differentiates acute decompensated heart failure from chronic stable heart failure pathophysiology?
• Which adverse effect is particularly associated with ACE inhibitors and may occur with ARBs and requires monitoring?