,NUR 242 Exam 4 | Medical-Surgical Nursing
Concepts (2026/2027) PDF | Galen College
1. A nurse is reviewing cardiac output with a student. Which formula represents
cardiac output?
A) Heart rate divided by stroke volume
B) Heart rate multiplied by stroke volume
C) Stroke volume divided by heart rate
D) Heart rate plus stroke volume
Correct Answer: Heart rate multiplied by stroke volume
Rationale: Cardiac output equals heart rate times stroke volume. It reflects the
amount of blood pumped by the left ventricle in one minute. An increase in
either heart rate or stroke volume raises cardiac output.
2. The nurse explains that preload refers to which cardiac property?
A) The pressure the left ventricle must overcome to eject blood
B) The amount of blood ejected with each contraction
C) The degree of myocardial fiber stretch at the end of diastole
D) The number of times the heart beats per minute
Correct Answer: The degree of myocardial fiber stretch at the end of diastole
Rationale: Preload is determined by the volume of blood returning to the heart
and the stretch of the ventricular muscle fibers before contraction. It is assessed
by central venous pressure.
,3. A client's blood pressure is 120/80 mm Hg. The nurse calculates the mean
arterial pressure as:
A) 93 mm Hg
B) 80 mm Hg
C) 100 mm Hg
D) 107 mm Hg
Correct Answer: 93 mm Hg
Rationale: MAP = (2 × diastolic + systolic) / 3 = (2 × 80 + 120) / 3 = 93. MAP must
be at least 60 mm Hg to perfuse vital organs.
4. Afterload is best described as the:
A) Amount of blood returning to the right atrium
B) Force of ventricular contraction
C) Degree of myocardial stretch before contraction
D) Resistance the ventricle must overcome to eject blood
Correct Answer: Resistance the ventricle must overcome to eject blood
Rationale: Afterload is the pressure the heart must work against to pump blood
into the circulation. Systemic vascular resistance is a major component.
Vasodilators reduce afterload.
, 5. The nurse assesses a client for orthostatic hypotension. Which finding meets
the diagnostic criteria?
A) Systolic drop of 10 mm Hg and heart rate unchanged upon standing
B) Systolic drop of 25 mm Hg with a heart rate increase upon standing
C) Diastolic drop of 5 mm Hg without symptoms
D) No change in blood pressure with position change
Correct Answer: Systolic drop of 25 mm Hg with a heart rate increase upon
standing
Rationale: Orthostatic hypotension is a decrease of more than 20 mm Hg
systolic or 10 mm Hg diastolic accompanied by a compensatory heart rate
increase within three minutes of standing.
6. Which type of medication is prescribed to decrease preload in a client with
heart failure?
A) Furosemide, a loop diuretic
B) Digoxin, a cardiac glycoside
C) Epinephrine, a vasopressor
D) Atropine, an anticholinergic
Correct Answer: Furosemide, a loop diuretic
Rationale: Diuretics reduce circulating blood volume, which decreases venous
return and preload. Nitrates also decrease preload by dilating veins. Digoxin
improves contractility.
Concepts (2026/2027) PDF | Galen College
1. A nurse is reviewing cardiac output with a student. Which formula represents
cardiac output?
A) Heart rate divided by stroke volume
B) Heart rate multiplied by stroke volume
C) Stroke volume divided by heart rate
D) Heart rate plus stroke volume
Correct Answer: Heart rate multiplied by stroke volume
Rationale: Cardiac output equals heart rate times stroke volume. It reflects the
amount of blood pumped by the left ventricle in one minute. An increase in
either heart rate or stroke volume raises cardiac output.
2. The nurse explains that preload refers to which cardiac property?
A) The pressure the left ventricle must overcome to eject blood
B) The amount of blood ejected with each contraction
C) The degree of myocardial fiber stretch at the end of diastole
D) The number of times the heart beats per minute
Correct Answer: The degree of myocardial fiber stretch at the end of diastole
Rationale: Preload is determined by the volume of blood returning to the heart
and the stretch of the ventricular muscle fibers before contraction. It is assessed
by central venous pressure.
,3. A client's blood pressure is 120/80 mm Hg. The nurse calculates the mean
arterial pressure as:
A) 93 mm Hg
B) 80 mm Hg
C) 100 mm Hg
D) 107 mm Hg
Correct Answer: 93 mm Hg
Rationale: MAP = (2 × diastolic + systolic) / 3 = (2 × 80 + 120) / 3 = 93. MAP must
be at least 60 mm Hg to perfuse vital organs.
4. Afterload is best described as the:
A) Amount of blood returning to the right atrium
B) Force of ventricular contraction
C) Degree of myocardial stretch before contraction
D) Resistance the ventricle must overcome to eject blood
Correct Answer: Resistance the ventricle must overcome to eject blood
Rationale: Afterload is the pressure the heart must work against to pump blood
into the circulation. Systemic vascular resistance is a major component.
Vasodilators reduce afterload.
, 5. The nurse assesses a client for orthostatic hypotension. Which finding meets
the diagnostic criteria?
A) Systolic drop of 10 mm Hg and heart rate unchanged upon standing
B) Systolic drop of 25 mm Hg with a heart rate increase upon standing
C) Diastolic drop of 5 mm Hg without symptoms
D) No change in blood pressure with position change
Correct Answer: Systolic drop of 25 mm Hg with a heart rate increase upon
standing
Rationale: Orthostatic hypotension is a decrease of more than 20 mm Hg
systolic or 10 mm Hg diastolic accompanied by a compensatory heart rate
increase within three minutes of standing.
6. Which type of medication is prescribed to decrease preload in a client with
heart failure?
A) Furosemide, a loop diuretic
B) Digoxin, a cardiac glycoside
C) Epinephrine, a vasopressor
D) Atropine, an anticholinergic
Correct Answer: Furosemide, a loop diuretic
Rationale: Diuretics reduce circulating blood volume, which decreases venous
return and preload. Nitrates also decrease preload by dilating veins. Digoxin
improves contractility.
