Progressive Care Nursing Certification (PCCN) Practice Exam

What condition can hypovolemia lead to in patients with a history of heart failure?

1. Bradycardia

2. Orthostatic hypotension

3. Cardiac arrest

4. Cardiac hypertrophy

The correct answer is: Orthostatic hypotension

Hypovolemia, or decreased blood volume, can significantly impact cardiovascular physiology, particularly in patients with a history of heart failure. In these individuals, the heart may already have a compromised ability to handle fluid shifts and maintain adequate circulation. As blood volume decreases, there is less volume for the heart to pump, which can lead to a significant drop in blood pressure when the patient changes position (i.e., standing up from sitting or lying down). This situation triggers a form of orthostatic hypotension—where blood pressure falls upon standing, causing symptoms such as dizziness or lightheadedness. In patients with heart failure, the body's compensatory mechanisms, like increased heart rate and peripheral vasoconstriction, may not be sufficient to maintain stable blood pressure due to their already altered cardiac function. Therefore, orthostatic hypotension becomes a significant risk, highlighting the context of fluid shifts and the body's ability to compensate under stress. Other options like bradycardia, cardiac arrest, and cardiac hypertrophy are less directly associated with the acute effects of hypovolemia in the context of heart failure. While each of these conditions can occur in patients with heart failure, they do not necessarily arise as an immediate consequence of hypovolemia in the same