RN Nursing · Heart Failure · Practice question
Acute cardiac client's resistance to left ventricular filling has caused acute blood to back up into the t's circulatory system. Which health problem is likely to result?
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Right-sided heart failure (HF)
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✓
Acute pulmonary edema
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High output heart failure (HF)
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Left-sided HF
Answer & explanation
Correct: Acute pulmonary edema
When resistance to left ventricular filling increases, as occurs with conditions such as diastolic dysfunction or severe left ventricular failure, blood cannot adequately empty from the pulmonary vasculature into the left ventricle. This causes pressure to back up into the pulmonary circulation, forcing fluid out of the pulmonary capillaries and into the alveolar spaces, resulting in acute pulmonary edema. Pulmonary edema is the direct consequence of increased left-sided filling resistance backing blood into the pulmonary system. Right-sided heart failure results from backup of blood into the systemic venous circulation, typically caused by right ventricular dysfunction or pulmonary hypertension, not from impaired left ventricular filling per se. High-output heart failure occurs when the heart cannot meet elevated metabolic demands despite normal or increased cardiac output, such as in severe anemia or hyperthyroidism, and is not related to increased filling resistance. Left-sided heart failure as a general category is the broader underlying problem, but the specific sequela described — blood backing into the pulmonary circulatory system — is most precisely identified as acute pulmonary edema, making it the most specific and correct answer. Recognizing this distinction helps the nurse anticipate signs such as severe dyspnea, crackles, frothy pink sputum, and hypoxia.
Study note
Heart Failure: A Nursing Overview
What heart failure is, how left-sided and right-sided failure differ, and the nursing priority that catches fluid overload earliest.
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