NUR 555 QUIZ 5 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS - SNHU.
Question 1
In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have
on stroke volume?
A) Decreases preload and decreases afterload
B) Decreases preload and increases afterload
C) Increases preload and decreases afterload
D) Increases preload and increases afterload
E) Has no effect on preload or afterload
Correct Answer: D) Increases preload and increases afterload
Rationale: Activation of the RAAS increases preload through the effects of aldosterone
secretion, which leads to salt and water retention. RAAS also increases afterload through
vasoconstriction mediated by angiotensin II. While intended to maintain output, in a failing
heart, this often worsens the workload.
Question 2
What is an expected change in the cardiovascular system that occurs with aging?
A) Arteriosclerosis
B) Decreased left ventricular wall tension
C) Arterial stiffening
D) Decreased aortic wall thickness
E) Increased capillary permeability
Correct Answer: C) Arterial stiffening
Rationale: Arterial stiffening occurs with aging even in the absence of clinical hypertension.
It is primarily caused by cross-linking of collagen and loss of elastin in the arterial walls,
leading to increased systolic blood pressure and increased pulse pressure.
Question 3
A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus
paradoxus. What description by the professional is best for how this occurs?
A) Blood ejected from the left atrium and reduction of blood volume in the left ventricle
B) Blood ejected from the right atrium and reduction of blood volume in the right ventricle
C) Diastolic filling pressures of the right ventricle and reduction of blood volume in both
ventricles
D) Diastolic filling pressures of the left ventricle and reduction of blood volume in all four
chambers
E) Increased systolic pressure in the aorta during inspiration
Correct Answer: D) Diastolic filling pressures of the left ventricle and reduction of blood
volume in all four chambers
Rationale: Pulsus paradoxus means that the arterial blood pressure during expiration
, 2
exceeds arterial blood pressure during inspiration by more than 10 mmHg. This clinical
finding reflects impairment of diastolic filling of the left ventricle plus a reduction of blood
volume within all four cardiac chambers due to external pressure from the effusion.
Question 4
What is the major determinant of the resistance that blood encounters as it flows through the
systemic circulation?
A) Force of ventricular contraction
B) Volume of blood in the systemic circulation
C) Muscle layer of the metarterioles
D) Muscle layer of the arterioles
E) Viscosity of the blood in the capillaries
Correct Answer: D) Muscle layer of the arterioles
Rationale: The muscle layer of the arterioles constricts or dilates depending on the
autonomic and chemical stimulation it receives. This change in diameter is the primary
determinant of systemic vascular resistance (SVR). The force of contraction determines
output but not the resistance to flow.
Question 5
A patient has a disorder affecting ventricular depolarization. What ECG finding would the
healthcare professional associate with this condition?
A) QT interval variability
B) Absence of P waves
C) Shortened PR interval
D) Prolonged QRS interval
E) Peaked T waves
Correct Answer: D) Prolonged QRS interval
Rationale: The QRS complex represents the sum of all ventricular muscle cell
depolarizations. If there are problems with this electrical activity, such as a bundle branch
block, there would be a prolongation of the QRS interval.
Question 6
The healthcare professional explains to a student that the amount of volume of blood in the heart
is directly related to the _______ of contraction.
A) Speed
B) Strength
C) Viscosity
D) Pressure
E) Duration
Correct Answer: B) Strength
Rationale: This describes the Frank-Starling Law of the heart. Within physiological limits,
, 3
the greater the stretch of the ventricular muscle fibers (caused by the volume of blood), the
stronger the force of the subsequent contraction will be.
Question 7
During the cardiac cycle, which phase describes the period where the ventricles are contracting
but all valves are closed, and no volume change occurs?
A) Ventricular filling
B) Isovolumetric contraction
C) Ventricular ejection
D) Isovolumetric relaxation
E) Atrial kick
Correct Answer: B) Isovolumetric contraction
Rationale: During isovolumetric contraction, the ventricles begin to contract, raising
pressure until it exceeds atrial pressure (closing the AV valves), but is not yet high enough
to open the semilunar valves. Volume remains constant while pressure spikes.
Question 8
What is the primary effect of chronic sympathetic nervous system activation in heart failure?
A) Peripheral vasodilation
B) Decreased heart rate
C) Increased myocardial oxygen demand and remodeling
D) Enhanced renal perfusion
E) Reduced levels of norepinephrine
Correct Answer: C) Increased myocardial oxygen demand and remodeling
Rationale: In HF, the body releases catecholamines (norepinephrine) to increase heart rate
and contractility. Over time, this increases the heart's oxygen needs and leads to toxic
effects on myocytes, resulting in hypertrophy and apoptosis (remodeling).
Question 9
Which electrolyte imbalance is most likely to cause a "U wave" on an ECG?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
E) Hypomagnesemia
Correct Answer: B) Hypokalemia
Rationale: Hypokalemia (low potassium) delays repolarization of the Purkinje fibers, which
can manifest as a prominent U wave immediately following the T wave on an ECG.
Question 10
The professional knows that the P-wave on the ECG represents which of the following?
SOLUTIONS - SNHU.
Question 1
In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have
on stroke volume?
A) Decreases preload and decreases afterload
B) Decreases preload and increases afterload
C) Increases preload and decreases afterload
D) Increases preload and increases afterload
E) Has no effect on preload or afterload
Correct Answer: D) Increases preload and increases afterload
Rationale: Activation of the RAAS increases preload through the effects of aldosterone
secretion, which leads to salt and water retention. RAAS also increases afterload through
vasoconstriction mediated by angiotensin II. While intended to maintain output, in a failing
heart, this often worsens the workload.
Question 2
What is an expected change in the cardiovascular system that occurs with aging?
A) Arteriosclerosis
B) Decreased left ventricular wall tension
C) Arterial stiffening
D) Decreased aortic wall thickness
E) Increased capillary permeability
Correct Answer: C) Arterial stiffening
Rationale: Arterial stiffening occurs with aging even in the absence of clinical hypertension.
It is primarily caused by cross-linking of collagen and loss of elastin in the arterial walls,
leading to increased systolic blood pressure and increased pulse pressure.
Question 3
A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus
paradoxus. What description by the professional is best for how this occurs?
A) Blood ejected from the left atrium and reduction of blood volume in the left ventricle
B) Blood ejected from the right atrium and reduction of blood volume in the right ventricle
C) Diastolic filling pressures of the right ventricle and reduction of blood volume in both
ventricles
D) Diastolic filling pressures of the left ventricle and reduction of blood volume in all four
chambers
E) Increased systolic pressure in the aorta during inspiration
Correct Answer: D) Diastolic filling pressures of the left ventricle and reduction of blood
volume in all four chambers
Rationale: Pulsus paradoxus means that the arterial blood pressure during expiration
, 2
exceeds arterial blood pressure during inspiration by more than 10 mmHg. This clinical
finding reflects impairment of diastolic filling of the left ventricle plus a reduction of blood
volume within all four cardiac chambers due to external pressure from the effusion.
Question 4
What is the major determinant of the resistance that blood encounters as it flows through the
systemic circulation?
A) Force of ventricular contraction
B) Volume of blood in the systemic circulation
C) Muscle layer of the metarterioles
D) Muscle layer of the arterioles
E) Viscosity of the blood in the capillaries
Correct Answer: D) Muscle layer of the arterioles
Rationale: The muscle layer of the arterioles constricts or dilates depending on the
autonomic and chemical stimulation it receives. This change in diameter is the primary
determinant of systemic vascular resistance (SVR). The force of contraction determines
output but not the resistance to flow.
Question 5
A patient has a disorder affecting ventricular depolarization. What ECG finding would the
healthcare professional associate with this condition?
A) QT interval variability
B) Absence of P waves
C) Shortened PR interval
D) Prolonged QRS interval
E) Peaked T waves
Correct Answer: D) Prolonged QRS interval
Rationale: The QRS complex represents the sum of all ventricular muscle cell
depolarizations. If there are problems with this electrical activity, such as a bundle branch
block, there would be a prolongation of the QRS interval.
Question 6
The healthcare professional explains to a student that the amount of volume of blood in the heart
is directly related to the _______ of contraction.
A) Speed
B) Strength
C) Viscosity
D) Pressure
E) Duration
Correct Answer: B) Strength
Rationale: This describes the Frank-Starling Law of the heart. Within physiological limits,
, 3
the greater the stretch of the ventricular muscle fibers (caused by the volume of blood), the
stronger the force of the subsequent contraction will be.
Question 7
During the cardiac cycle, which phase describes the period where the ventricles are contracting
but all valves are closed, and no volume change occurs?
A) Ventricular filling
B) Isovolumetric contraction
C) Ventricular ejection
D) Isovolumetric relaxation
E) Atrial kick
Correct Answer: B) Isovolumetric contraction
Rationale: During isovolumetric contraction, the ventricles begin to contract, raising
pressure until it exceeds atrial pressure (closing the AV valves), but is not yet high enough
to open the semilunar valves. Volume remains constant while pressure spikes.
Question 8
What is the primary effect of chronic sympathetic nervous system activation in heart failure?
A) Peripheral vasodilation
B) Decreased heart rate
C) Increased myocardial oxygen demand and remodeling
D) Enhanced renal perfusion
E) Reduced levels of norepinephrine
Correct Answer: C) Increased myocardial oxygen demand and remodeling
Rationale: In HF, the body releases catecholamines (norepinephrine) to increase heart rate
and contractility. Over time, this increases the heart's oxygen needs and leads to toxic
effects on myocytes, resulting in hypertrophy and apoptosis (remodeling).
Question 9
Which electrolyte imbalance is most likely to cause a "U wave" on an ECG?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
E) Hypomagnesemia
Correct Answer: B) Hypokalemia
Rationale: Hypokalemia (low potassium) delays repolarization of the Purkinje fibers, which
can manifest as a prominent U wave immediately following the T wave on an ECG.
Question 10
The professional knows that the P-wave on the ECG represents which of the following?
