NR 324: Adult Health II HESI Benchmark Final Exam Practice Exam All-Inclusive Certification Study Guide: Extensive Practice Questions, Complete Test Bank Review, Detailed Knowledge Assessment, and Final Exam Prep Manual

A patient’s left ventricle contains 120 mL of blood immediately before contraction and 50 mL immediately after contraction. Which value represents the patient’s stroke volume? A. 50 mL B. 70 mL C. 120 mL D. 170 mL Correct Answer: B. 70 mL Rationale: Stroke volume is the amount of blood ejected by the ventricle during each heartbeat. It is calculated by subtracting end-systolic volume from end-diastolic volume: 120 mL − 50 mL = 70 mL The 50 mL represents the blood remaining after contraction, while 120 mL represents the ventricular volume before contraction. Question 2 A patient has a heart rate of 80 beats/minute and a stroke volume of 75 mL/beat. What is the patient’s cardiac output? A. 4.0 L/min B. 5.0 L/min C. 6.0 L/min D. 8.0 L/min Correct Answer: C. 6.0 L/min Rationale: Cardiac output is calculated by multiplying heart rate by stroke volume: 80 beats/min × 75 mL/beat = 6,000 mL/min = 6.0 L/min This value falls within the usual adult cardiac output range of approximately 4–8 L/min. Question 3 A patient has a cardiac output of 4.8 L/min and a body surface area of 2.0 m². How should the nurse interpret the patient’s cardiac index? A. 1.2 L/min/m², indicating severe impairment B. 2.4 L/min/m², indicating reduced cardiac performance C. 4.8 L/min/m², indicating normal cardiac function D. 9.6 L/min/m², indicating excessive cardiac output Correct Answer: B. 2.4 L/min/m², indicating reduced cardiac performance Rationale: Cardiac index is calculated by dividing cardiac output by body surface area: 4.8 L/min ÷ 2.0 m² = 2.4 L/min/m² This value is below the commonly expected range of approximately 2.5–4.0 L/min/m² and may indicate reduced cardiac performance. Question 4 A patient experiences a sudden decrease in arterial blood pressure after standing. Which regulatory systems respond most directly to restore cardiovascular stability? A. Thyroid hormones and pancreatic enzymes B. Autonomic nervous system and arterial baroreceptors C. Skeletal muscles and lymphatic vessels D. Hepatic enzymes and gastrointestinal receptors Correct Answer: B. Autonomic nervous system and arterial baroreceptors Rationale: Arterial baroreceptors detect changes in blood pressure and communicate with cardiovascular centers in the brainstem. A sudden decrease in blood pressure activates sympathetic responses, increasing heart rate, cardiac contractility, and vascular tone. Chemoreceptors may also contribute when oxygen, carbon dioxide, or pH levels change. Question 5 Which age-related cardiovascular change most directly contributes to increased systolic blood pressure in an older adult? A. Increased arterial elasticity B. Increased number of pacemaker cells C. Thickening and stiffening of arterial walls D. Increased sensitivity of beta-adrenergic receptors Correct Answer: C. Thickening and stiffening of arterial walls Rationale: Aging is associated with increased collagen, decreased elastin, and progressive arterial stiffening. Less-compliant arteries cannot expand effectively during ventricular systole, resulting in increased systolic blood pressure and a widened pulse pressure. Pacemaker cell numbers and beta-adrenergic responsiveness generally decrease with age. Question 6 An older patient reports dizziness shortly after eating a large meal. Which age-related cardiovascular problem should the nurse consider first? A. Postprandial hypotension B. Sustained ventricular tachycardia C. Acute pericarditis D. Hypertensive emergency Correct Answer: A. Postprandial hypotension Rationale: Postprandial hypotension is a decrease in blood pressure after eating and occurs more commonly in older adults. Blood is redirected toward the gastrointestinal system, while age-related impairment of autonomic and baroreceptor responses may limit the body’s ability to compensate. Question 7 Which information represents subjective cardiovascular assessment data? A. Presence of an S3 heart sound B. Strength of peripheral pulses C. Patient’s description of exertional chest discomfort D. Difference between right and left arm blood pressures Correct Answer: C. Patient’s description of exertional chest discomfort Rationale: Subjective data consist of symptoms and information reported by the patient, such as chest pain, dyspnea, fatigue, medication use, and previous cardiovascular treatment. Heart sounds, pulse strength, and blood-pressure measurements are objective findings obtained through physical assessment. Question 8 Which assessment finding represents objective cardiovascular data? A. The patient reports palpitations at night. B. The patient states that chest pressure lasts 10 minutes. C. The nurse auscultates bilateral carotid bruits. D. The patient describes a family history of hypertension. Correct Answer: C. The nurse auscultates bilateral carotid bruits. Rationale: Objective data are observable or measurable findings obtained through physical examination or diagnostic testing. A carotid bruit detected through auscultation is objective information. Reports of palpitations, chest-pressure duration, and family history are subjective data because they are provided by the patient. Question 9 Which finding meets the usual diagnostic definition of orthostatic hypotension? A. A 10 mm Hg increase in systolic pressure after sitting B. A 20 mm Hg decrease in systolic pressure after standing C. A 5 mm Hg decrease in diastolic pressure while lying down D. A 10 mm Hg increase in diastolic pressure after standing Correct Answer: B. A 20 mm Hg decrease in systolic pressure after standing Rationale: Orthostatic hypotension is generally defined as a decrease of at least 20 mm Hg in systolic blood pressure or at least 10 mm Hg in diastolic blood pressure within three minutes of standing. Symptoms may include dizziness, weakness, or syncope. Question 10 A patient presents with dyspnea, bilateral crackles, peripheral edema, and rapid weight gain. Which laboratory result would most strongly support suspected heart failure? A. Decreased B-type natriuretic peptide B. Increased B-type natriuretic peptide C. Decreased serum sodium alone D. Increased hemoglobin concentration Correct Answer: B. Increased B-type natriuretic peptide Rationale: B-type natriuretic peptide (BNP) is released by ventricular muscle in response to increased ventricular pressure and stretching. An elevated BNP supports the diagnosis of heart failure when considered together with the patient’s clinical findings. Sodium abnormalities may occur with heart failure but are less specific, while hemoglobin concentration does not directly indicate ventricular strain. Which lipid profile is most favourable for reducing the risk of coronary artery disease? A. Total cholesterol 185 mg/dL and HDL cholesterol 55 mg/dL B. Total cholesterol 240 mg/dL and HDL cholesterol 30 mg/dL C. Total cholesterol 215 mg/dL and HDL cholesterol 35 mg/dL D. Total cholesterol 260 mg/dL and HDL cholesterol 38 mg/dL Correct Answer: A. Total cholesterol 185 mg/dL and HDL cholesterol 55 mg/dL Rationale: A total cholesterol level below 200 mg/dL and a higher HDL level are generally favourable. HDL assists with transporting cholesterol away from peripheral tissues and is considered protective. The remaining profiles show elevated total cholesterol combined with low HDL levels, increasing cardiovascular risk. LDL treatment targets depend on the patient’s overall cardiovascular risk.