American Public University System NURS 330 Midterm Exam (pdf) |
2026/2027 | Q&A | Nursing
1. A patient is diagnosed with heart failure. The nurse understands that a key
compensatory mechanism in heart failure is:
A) Increased cardiac output
B) Decreased systemic vascular resistance
C) Activation of the renin-angiotensin-aldosterone system (RAAS)
D) Decreased preload
Correct Answer: Activation of the renin-angiotensin-aldosterone system
(RAAS)
Rationale: In heart failure, decreased cardiac output triggers the RAAS as a
compensatory mechanism. RAAS activation leads to vasoconstriction and
fluid retention, which initially helps maintain blood pressure but eventually
worsens heart failure.
2. The nurse is calculating a patient's cardiac output. Which of the following
formulas is correct?
A) Cardiac Output = Heart Rate x Stroke Volume
B) Cardiac Output = Blood Pressure x Heart Rate
C) Cardiac Output = Stroke Volume / Heart Rate
D) Cardiac Output = Systemic Vascular Resistance x Heart Rate
Correct Answer: Cardiac Output = Heart Rate x Stroke Volume
Rationale: Cardiac output (CO) is the volume of blood pumped by the heart
per minute. It is calculated by multiplying the heart rate (HR) by the stroke
volume (SV).
3. A patient's stroke volume is 70 mL and heart rate is 80 beats per minute.
What is the patient's cardiac output?
A) 4.0 L/min
B) 5.6 L/min
,C) 6.4 L/min
D) 7.2 L/min
Correct Answer: 5.6 L/min
Rationale: Cardiac output = Heart Rate x Stroke Volume = 80 beats/min × 70
mL/beat = 5,600 mL/min = 5.6 L/min.
4. Which of the following factors directly affects preload?
A) Contractility
B) Afterload
C) Venous return and blood volume
D) Heart rate
Correct Answer: Venous return and blood volume
Rationale: Preload is the degree of stretch of the ventricular muscle at the
end of diastole. It is primarily determined by venous return and blood
volume.
5. Afterload is affected by which of the following?
A) Venous return
B) Blood volume
C) Systemic vascular resistance
D) Heart rate
Correct Answer: Systemic vascular resistance
Rationale: Afterload is the resistance the left ventricle must overcome to
eject blood. It is primarily influenced by systemic vascular resistance (SVR),
which is affected by vessel diameter, blood pressure, and blood viscosity.
6. The nurse assesses a patient's heart sounds and hears a low-pitched
sound in early diastole, best heard with the bell of the stethoscope at the
apex. This is known as:
,A) S1
B) S2
C) S3
D) S4
Correct Answer: S3
Rationale: An S3 heart sound is a low-pitched, ventricular filling sound that
occurs in early diastole. It is often heard with the bell of the stethoscope at
the apex and may indicate heart failure or volume overload.
7. The "lub" sound of the heart (S1) is caused by the closure of which valves?
A) Aortic and pulmonic
B) Tricuspid and mitral (bicuspid)
C) Aortic and tricuspid
D) Pulmonic and mitral
Correct Answer: Tricuspid and mitral (bicuspid)
Rationale: S1, the "lub" sound, is caused by the closure of the
atrioventricular (AV) valves—the tricuspid and mitral (bicuspid) valves—at
the beginning of ventricular systole.
8. The "dub" sound of the heart (S2) is caused by the closure of which
valves?
A) Tricuspid and mitral
B) Aortic and pulmonic
C) Aortic and tricuspid
D) Pulmonic and mitral
Correct Answer: Aortic and pulmonic
Rationale: S2, the "dub" sound, is caused by the closure of the semilunar
valves—the aortic and pulmonic valves—at the beginning of ventricular
diastole.
, 9. Blood pressure is calculated using which formula?
A) Blood Pressure = Cardiac Output x Systemic Vascular Resistance
B) Blood Pressure = Heart Rate x Stroke Volume
C) Blood Pressure = Preload x Afterload
D) Blood Pressure = Contractility x Heart Rate
Correct Answer: Blood Pressure = Cardiac Output x Systemic Vascular
Resistance
Rationale: Blood pressure is the product of cardiac output (CO) and systemic
vascular resistance (SVR).
10. A patient with hypertension has an elevated blood pressure. The nurse
understands that hypertension can result from:
A) Decreased cardiac output and decreased SVR
B) Increased cardiac output and/or increased SVR
C) Decreased stroke volume and decreased heart rate
D) Increased venous return and decreased SVR
Correct Answer: Increased cardiac output and/or increased SVR
Rationale: Hypertension is often the result of an increased cardiac output,
increased systemic vascular resistance (SVR), or both.
11. According to the treatment guidelines referenced in the course, which
class of medication has the best evidence (Grade A) for treating
hypertension?
A) Beta-blockers
B) ACE inhibitors
C) Thiazide diuretics
D) Calcium channel blockers
Correct Answer: Thiazide diuretics
2026/2027 | Q&A | Nursing
1. A patient is diagnosed with heart failure. The nurse understands that a key
compensatory mechanism in heart failure is:
A) Increased cardiac output
B) Decreased systemic vascular resistance
C) Activation of the renin-angiotensin-aldosterone system (RAAS)
D) Decreased preload
Correct Answer: Activation of the renin-angiotensin-aldosterone system
(RAAS)
Rationale: In heart failure, decreased cardiac output triggers the RAAS as a
compensatory mechanism. RAAS activation leads to vasoconstriction and
fluid retention, which initially helps maintain blood pressure but eventually
worsens heart failure.
2. The nurse is calculating a patient's cardiac output. Which of the following
formulas is correct?
A) Cardiac Output = Heart Rate x Stroke Volume
B) Cardiac Output = Blood Pressure x Heart Rate
C) Cardiac Output = Stroke Volume / Heart Rate
D) Cardiac Output = Systemic Vascular Resistance x Heart Rate
Correct Answer: Cardiac Output = Heart Rate x Stroke Volume
Rationale: Cardiac output (CO) is the volume of blood pumped by the heart
per minute. It is calculated by multiplying the heart rate (HR) by the stroke
volume (SV).
3. A patient's stroke volume is 70 mL and heart rate is 80 beats per minute.
What is the patient's cardiac output?
A) 4.0 L/min
B) 5.6 L/min
,C) 6.4 L/min
D) 7.2 L/min
Correct Answer: 5.6 L/min
Rationale: Cardiac output = Heart Rate x Stroke Volume = 80 beats/min × 70
mL/beat = 5,600 mL/min = 5.6 L/min.
4. Which of the following factors directly affects preload?
A) Contractility
B) Afterload
C) Venous return and blood volume
D) Heart rate
Correct Answer: Venous return and blood volume
Rationale: Preload is the degree of stretch of the ventricular muscle at the
end of diastole. It is primarily determined by venous return and blood
volume.
5. Afterload is affected by which of the following?
A) Venous return
B) Blood volume
C) Systemic vascular resistance
D) Heart rate
Correct Answer: Systemic vascular resistance
Rationale: Afterload is the resistance the left ventricle must overcome to
eject blood. It is primarily influenced by systemic vascular resistance (SVR),
which is affected by vessel diameter, blood pressure, and blood viscosity.
6. The nurse assesses a patient's heart sounds and hears a low-pitched
sound in early diastole, best heard with the bell of the stethoscope at the
apex. This is known as:
,A) S1
B) S2
C) S3
D) S4
Correct Answer: S3
Rationale: An S3 heart sound is a low-pitched, ventricular filling sound that
occurs in early diastole. It is often heard with the bell of the stethoscope at
the apex and may indicate heart failure or volume overload.
7. The "lub" sound of the heart (S1) is caused by the closure of which valves?
A) Aortic and pulmonic
B) Tricuspid and mitral (bicuspid)
C) Aortic and tricuspid
D) Pulmonic and mitral
Correct Answer: Tricuspid and mitral (bicuspid)
Rationale: S1, the "lub" sound, is caused by the closure of the
atrioventricular (AV) valves—the tricuspid and mitral (bicuspid) valves—at
the beginning of ventricular systole.
8. The "dub" sound of the heart (S2) is caused by the closure of which
valves?
A) Tricuspid and mitral
B) Aortic and pulmonic
C) Aortic and tricuspid
D) Pulmonic and mitral
Correct Answer: Aortic and pulmonic
Rationale: S2, the "dub" sound, is caused by the closure of the semilunar
valves—the aortic and pulmonic valves—at the beginning of ventricular
diastole.
, 9. Blood pressure is calculated using which formula?
A) Blood Pressure = Cardiac Output x Systemic Vascular Resistance
B) Blood Pressure = Heart Rate x Stroke Volume
C) Blood Pressure = Preload x Afterload
D) Blood Pressure = Contractility x Heart Rate
Correct Answer: Blood Pressure = Cardiac Output x Systemic Vascular
Resistance
Rationale: Blood pressure is the product of cardiac output (CO) and systemic
vascular resistance (SVR).
10. A patient with hypertension has an elevated blood pressure. The nurse
understands that hypertension can result from:
A) Decreased cardiac output and decreased SVR
B) Increased cardiac output and/or increased SVR
C) Decreased stroke volume and decreased heart rate
D) Increased venous return and decreased SVR
Correct Answer: Increased cardiac output and/or increased SVR
Rationale: Hypertension is often the result of an increased cardiac output,
increased systemic vascular resistance (SVR), or both.
11. According to the treatment guidelines referenced in the course, which
class of medication has the best evidence (Grade A) for treating
hypertension?
A) Beta-blockers
B) ACE inhibitors
C) Thiazide diuretics
D) Calcium channel blockers
Correct Answer: Thiazide diuretics
