100+ Free CHFN Practice Questions

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Question 1

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A patient's HFrEF is now asymptomatic with LVEF improved from 25% to 48% on GDMT. This patient's classification is now:

HFmrEF, as EF is between 40–49%

HFimpEF (heart failure with improved ejection fraction)

Resolved HF requiring no further monitoring

HFpEF, since EF is now ≥ 45%

to track

2026 Statistics

Key Facts: CHFN Exam

110

Total Questions

100 scored + 10 pretest

2 hrs

Exam Time

AAHFN

30%

Implementation Domain

Largest blueprint domain

1,200 hrs

HF Clinical Hours Required

AAHFN eligibility

$350–450

Exam Fee

AAHFN 2026

3 years

Certification Valid

Recertification cycle

The CHFN exam contains 110 questions (100 scored) over 2 hours. Implementation of pharmacologic and non-pharmacologic therapy is the largest domain at 30%, followed by Assessment at 27%. Eligibility requires an active RN license, ≥ 2 years RN practice, and ≥ 1,200 HF clinical hours in the last 2 years. The CHFN demonstrates nursing expertise in heart failure management including GDMT, ADHF care, device therapy, and self-care education.

Sample CHFN Practice Questions

Try these sample questions to test your CHFN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient with HFrEF has an LVEF of 35%. Which LVEF threshold defines HFrEF according to current guidelines?

A.< 40%

B.< 45%

C.< 50%

D.< 55%

Explanation: HFrEF is defined as symptomatic heart failure with LVEF < 40%. HFmrEF is 40–49% and HFpEF is ≥ 50% per 2022 AHA/ACC/HFSA guidelines.

2Which LVEF range defines heart failure with mildly reduced ejection fraction (HFmrEF)?

A.40–49%

B.< 40%

C.≥ 50%

D.35–45%

Explanation: HFmrEF is defined by LVEF 40–49%. It shares features with both HFrEF and HFpEF and may respond to some HFrEF therapies.

3A patient reports dyspnea climbing one flight of stairs but is comfortable at rest. Which NYHA functional class does this represent?

A.Class II

B.Class I

C.Class III

D.Class IV

Explanation: NYHA Class II: comfortable at rest, slight limitation with ordinary activity such as climbing stairs. Class III involves marked limitation; Class IV involves symptoms at rest.

4According to ACC/AHA staging, which stage describes a patient with structural heart disease but no current or prior HF symptoms?

A.Stage B

B.Stage A

C.Stage C

D.Stage D

Explanation: Stage B: structural heart disease (e.g., reduced EF, LVH) without symptoms. Stage A is pre-HF risk only. Stage C is symptomatic HF. Stage D is refractory/advanced HF.

5Which four drug classes form the cornerstone of GDMT for HFrEF?

A.ARNI/ACEi/ARB, beta-blocker, MRA, SGLT2 inhibitor

B.ACEi, calcium channel blocker, diuretic, digoxin

C.Beta-blocker, ARB, nitrate, ivabradine

D.ARNI, diuretic, antiarrhythmic, anticoagulant

Explanation: 2022 AHA/ACC/HFSA guidelines designate four pillars of HFrEF GDMT: RAAS blockade (ARNI preferred over ACEi/ARB), guideline-recommended beta-blocker, MRA, and SGLT2 inhibitor.

6Sacubitril/valsartan (Entresto) is preferred over ACE inhibitors for HFrEF because it:

A.Inhibits both neprilysin and the RAAS, reducing mortality more than ACEi alone

B.Has fewer electrolyte side effects than ACEi

C.Does not require dose titration unlike ACEi

D.Reduces heart rate more effectively than ACEi

Explanation: ARNI (sacubitril/valsartan) combines neprilysin inhibition (raising natriuretic peptides) with ARB. PARADIGM-HF showed superior reduction in CV death and HF hospitalization versus enalapril.

7Which three beta-blockers have proven mortality benefit in HFrEF and are therefore guideline-recommended?

A.Carvedilol, metoprolol succinate, bisoprolol

B.Atenolol, propranolol, labetalol

C.Metoprolol tartrate, carvedilol, nebivolol

D.Bisoprolol, atenolol, carvedilol

Explanation: Only carvedilol (CAPRICORN), metoprolol succinate (MERIT-HF), and bisoprolol (CIBIS-II) demonstrated mortality reduction in HFrEF RCTs and are guideline-specified.

8A patient with HFrEF and CKD (eGFR 38) is prescribed spironolactone. Which lab finding would require dose reduction or discontinuation?

A.Serum potassium 5.8 mEq/L

B.Serum sodium 134 mEq/L

C.BNP 450 pg/mL

D.Creatinine 1.4 mg/dL (stable)

Explanation: MRAs (spironolactone, eplerenone) cause potassium retention. K+ > 5.5 mEq/L requires dose reduction; > 6.0 mEq/L requires discontinuation due to life-threatening hyperkalemia risk.

9SGLT2 inhibitors (dapagliflozin, empagliflozin) reduce HF hospitalizations primarily through which mechanism?

A.Osmotic diuresis, natriuresis, and reduction of cardiac preload/afterload

B.Beta-adrenergic blockade reducing myocardial oxygen demand

C.Neprilysin inhibition increasing natriuretic peptides

D.Aldosterone antagonism reducing sodium retention

Explanation: SGLT2 inhibitors cause glucosuria-driven osmotic diuresis and natriuresis, reducing filling pressures. They benefit both HFrEF and HFpEF (DAPA-HF, EMPEROR-Reduced, EMPEROR-Preserved).

10Ivabradine is indicated as add-on therapy for HFrEF when a patient has which specific condition?

A.Sinus rhythm, HR ≥ 70 bpm, on maximally tolerated beta-blocker

B.Atrial fibrillation with rapid ventricular response

C.Sinus bradycardia with HR < 60 bpm

D.Hypertension refractory to three antihypertensives

Explanation: Ivabradine inhibits the If channel, slowing SA node firing. It is indicated for HFrEF (EF ≤ 35%), sinus rhythm, resting HR ≥ 70 bpm despite maximally tolerated beta-blocker (SHIFT trial).

About the CHFN Exam

The CHFN certification validates advanced nursing knowledge in heart failure care, based on the 2022 AHA/ACC/HFSA HF guidelines. The exam covers five domains: Implementation (30%), Assessment (27%), Evaluation (20%), Planning (15%), and Professional Standards (8%). It consists of 110 items (100 scored, 10 unscored pretest) and tests competency in GDMT pharmacology, HF classification, ADHF management, device therapy, patient education, comorbidity management, and transitions of care.

Questions

110 scored questions

Time Limit

2 hours

Passing Score

Minimum score set via Angoff method (not publicly disclosed as a fixed number)

Exam Fee

$350–450 (AAHFN Certification Board / AMP)

CHFN Exam Content Outline

30%

Implementation

GDMT for HFrEF (ARNI, ACEi/ARB, beta-blockers, MRA, SGLT2 inhibitors, ivabradine, hydralazine-ISDN, diuretics), HFpEF and HFmrEF pharmacotherapy, non-pharmacologic strategies (patient education, dietary/fluid management, activity), device screening (CRT/ICD), advanced therapy referral (transplant, LVAD), self-care skill development

27%

Assessment

Patient history (comorbidities, risk factors, device history), signs and symptoms (dyspnea, edema, fluid overload, poor perfusion), physical exam (S3, JVD, crackles), lab interpretation (BNP/NT-proBNP, renal function, electrolytes, CBC, thyroid), cardiac diagnostics (echo, ECG, right heart catheterization, chest X-ray)

20%

Evaluation

Evaluating GDMT effectiveness (dose, tolerance, adherence), outpatient monitoring (daily weight, BP, home telemetry), NYHA class and ACC/AHA stage reassessment, palliative and end-of-life goal evaluation, teaching comprehension re-assessment, care transitions evaluation

15%

Planning

Clinical status determination (HFrEF/HFpEF/HFmrEF/HFimpEF, NYHA class, ACC/AHA stage, six-minute walk, quality-of-life measures), individualized care plan development, shared decision-making, frailty assessment, social determinants of health integration

Professional Standards

Role of certification, continuing education, legal parameters (HIPAA, consent, negligence), ethical principles (autonomy, beneficence, justice, non-maleficence), quality improvement, interdisciplinary collaboration, SBAR communication, evidence-based practice, identifying disparities

How to Pass the CHFN Exam

What You Need to Know

Passing score: Minimum score set via Angoff method (not publicly disclosed as a fixed number)
Exam length: 110 questions
Time limit: 2 hours
Exam fee: $350–450

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CHFN Study Tips from Top Performers

1Master the 2022 HF guideline GDMT four pillars: ARNI, beta-blocker, MRA, SGLT2 inhibitor with contraindications and monitoring parameters

2Know HF classification LVEF cutoffs: HFrEF < 40%, HFmrEF 40–49%, HFpEF ≥ 50%, HFimpEF (prior HFrEF now ≥ 40%)

3Understand ACC/AHA Stages A–D and correlate with NYHA functional classes I–IV

4Study diuretic resistance and sequential nephron blockade strategy (loop + thiazide-like)

5Learn Forrester hemodynamic subsets for acute HF management (warm/cold, wet/dry)

6Know BNP/NT-proBNP cutoffs: BNP < 100 rules out ADHF, > 400 supports it; gray zone 100–400

7Understand CRT eligibility: LVEF ≤ 35%, LBBB ≥ 150 ms, NYHA II–III on GDMT

8Review the 36-hour ACEi washout requirement before starting ARNI

9Study patient education: daily weight monitoring technique, sodium < 2,000–3,000 mg/day, action plan thresholds

10Learn palliative care integration from Stage C; ICD deactivation ethics at end of life

Frequently Asked Questions

What is the CHFN exam?

The CHFN (Certified Heart Failure Nurse) is a specialty certification offered by the AAHFN Certification Board. It validates advanced nursing knowledge in heart failure care based on the 2022 AHA/ACC/HFSA guidelines. It covers HF classification, pharmacology, ADHF management, device therapy, patient education, and transitions of care.

What are the CHFN eligibility requirements?

To sit for the CHFN, you must: (1) hold a current, active RN license; (2) have practiced full-time as an RN for at least 2 years (~4,160 hours); (3) have a minimum of 1,200 HF clinical hours in the last 2 years; and (4) have completed 30 hours of accredited CE within the last 2 years, of which at least 15 hours must be HF-specific.

How many questions are on the CHFN exam?

The CHFN exam contains 110 questions total — 100 scored multiple-choice questions plus 10 unscored pretest items being field-tested for future use. You have 2 hours to complete the exam.

What content domains does the CHFN exam cover?

The CHFN exam covers five domains per the 2024 content outline: Implementation (30%), Assessment (27%), Evaluation (20%), Planning (15%), and Professional Standards (8%). Implementation is the largest domain, covering GDMT pharmacology and non-pharmacologic strategies.

How is the CHFN passing score determined?

The CHFN uses the Angoff method, where subject-matter experts estimate item difficulty for the 'minimally competent practitioner.' These estimates are averaged to set the minimum passing score. The exact scaled score is not publicly published by AAHFN.

How long is CHFN certification valid?

CHFN certification is valid for 3 years. Recertification options include: Option 1 (professional development — CE hours) or Option 2 (re-taking the examination). Recertification requires a minimum of 600 HF practice hours in the preceding 3 years.

How should I prepare for the CHFN exam?

Study the 2022 AHA/ACC/HFSA heart failure guidelines and AAHFN content outline. Focus on GDMT four pillars, HF classification (HFrEF/HFpEF/HFmrEF), ADHF management, device therapy indications (CRT/ICD), patient education (sodium/fluid restriction, daily weight monitoring), and transitions of care. AAHFN offers an official review course and Core Curriculum textbook.