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1. Which one of the following statements accurately describes heart failure with reduced ejection fraction (HFrEF):

A. Patients have an estimated ejection fraction ≤ 40% B. The left ventricle takes on a cubical shape, thus hindering inefficient contraction C. It is also known as diastolic HF D. Systemic blood circulation remains unaffected

2. HW was recently discharged from the hospital after being treated for a HF exacerbation, making it the third HF event this year. The team believes this may have been the result of his uncontrolled atrial fibrillation. They are considering a rhythm control strategy and would like to begin an antiarrhythmic agent. Which one of the following would be the most appropriate treatment selection for HW:

A. Flecainide B. Sotalol C. Amiodarone D. Propafenone

3. Which one of the following is a provision recognized by The Joint Commission (TJC) as a mandate for all patients admitted to the hospital for HF:

A. Initiating of a diuretic so that patients can experience quick relief for edema. B. Removing all possible drugs that can exacerbate or induce HF C. Initiating stress ulcer prophylaxis D. Providing discharge education

4. Which of the following clinical trials demonstrated improvements in survival in New York Heart Association (NYHA) Class II patients with HFrEF who received eplerenone, in addition to standard guideline-directed medical therapy (GDMT), when compared with placebo:

A. EMPHASIS-HF B. A-HeFT C. RALES D. ACCORD-Lipid

5. MR visits your HF clinic for follow-up. He has a history of HFrEF (EF = 35%), diabetes, and hypertension. His current medications include metoprolol succinate 100 mg daily, furosemide 20 mg twice a day (BID), metformin 1000 mg BID, and a multivitamin. Angiotensin-converting-enzyme inhibitors (ACEIs) make him cough a great deal. Vital signs include a heart rate (HR) of 60 beats per minute and a blood pressure of 155/85 mm Hg. Pertinent labs include SCr 0.8 mg/dL and a K 3.7 mEq/L. He states he is compliant with medications and diet, but still reporting some limitations in his daily activities from fatigue. What would be the most appropriate intervention to make to fully optimize MR's medication regimen?

A. Add enalapril 10 mg BID B. Increase metoprolol to 200 mg daily C. Add amlodipine 5 mg daily D. Add candesartan 4 mg daily

6. The position of the Centers for Medicare & Medicaid Services (CMS) on HF management is to do which one of the following:

A. Provide additional funding for institutions in need B. Halt reimbursements for hospitals with frequent readmissions C. Revoke accreditation from institutions who fail to comply with HF core measures D. Assist hospital administrators in recruiting staff trained to manage patients with HF

7. According to the ACC/AHA staging system, which one of the following patients would likely fall under stage C:

A. MR, a woman 58 years of age, with a history of poorly controlled hypertension and chronic obstructive pulmonary disease (COPD) B. GT, a man 45 years of age, with an EF 10%, awaiting LVAD placement C. WD, a woman 55 years of age, with a history of diabetes, diagnosed with HFpEF about 3 years ago D. BW, a chronic smoker 60 years of age who was recently diagnosed with asymptomatic mitral regurgitation

8. Mortality benefits have been demonstrated after treatment with which one of the following drugs/drug classes for the management of HFrEF:

A. Digoxin B. Amlodipine C. Enalapril D. Omega-3 fatty acids

9. HT has been in the hospital because of pulmonary congestion caused by new-onset HF. The pharmacist would likely be involved with all of the following activities except:

A. Communicate with the pharmacist at the ambulatory clinic associated with your institution about HT's hospital visit in order to ensure a smooth transition B. Provide a 5 minute overview of what HF entails once HT is ready for discharge C. Review HT's home medication list to detect for potential drugs that could induce or exacerbate HF D. If required, make recommendations to the medical team to order evidence-based driven therapies

10. Which one of the following statements is TRUE regarding statin therapy in the management of HF:

A. They should be used as apart of GDMT for all patients with HFrEF B. They have been associated with a mortality reduction in patients with HFpEF. C. They should only be recommended in those patients with concomitant conditions, such as atherosclerotic cardiovascular disease (ASCVD) D. They are useful adjunctive agents for improving morbidity, but not mortality.