Cardiac preload and afterload nursing quiz!
Preload and afterload both play an important role in cardiac output. When studying cardiovascular disorders, it is essential to know the meaning of these terms.
This quiz is part of an NCLEX review series over cardiovascular nursing. So, be sure to check out those other reviews too!
Before taking the quiz, don’t forget to watch the lecture on preload and afterload.
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Preload vs. Afterload Nursing Quiz
1. Which statement below best describes the term cardiac preload?
A. The pressure the ventricles stretch at the end of systole.
B. The amount the ventricles stretch at the end of diastole.
C. The pressure the ventricles must work against to pump blood out of the heart.
D. The strength of the myocardial cells to shorten with each beat.
The answer is B. Cardiac preload is the amount the ventricles stretch at the end of diastole (the filling or relaxation phase of the heart).
2. Select the statement below that best describes cardiac afterload:
A. It’s the volume amount that fills the ventricles at the end of diastole.
B. It’s the volume the ventricles must work against to pump blood out of the body.
C. It’s the amount of blood the left ventricle pumps per beat.
D. It’s the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.
The answer is D. Cardiac afterload is the pressure the ventricles must work against to pump blood out of the heart by opening up through the semilunar valves. So, it’s the pressure the ventricles must overcome to open the semilunar valves to push blood out of the heart.
3. What two factors are used to calculate cardiac output? Select all that apply:
A. Heart rate
B. Blood pressure
C. Stroke volume
D. Mean arterial pressure
The answers are A and C. Cardiac output is calculated by taking the heart rate and multiplying it by stroke volume. CO = HR x SV
4. A patient with hypovolemic shock is given IV fluids. IV fluids will help _________ cardiac output by:
A. decrease; decreasing preload
B. increase, increasing preload
C. increase, decreasing afterload
D. decrease, increasing contractility
The answer is B. IV fluids will increase venous return to the heart. This will increase the amount of fluid that will fill the ventricles at the end of diastole…hence increasing preload and increasing cardiac output.
5. ___________ is the amount of blood pumped by the left ventricle with each beat.
A. Cardiac output
B. Preload
C. Afterload
D. Stroke volume
The answer is D. Stroke volume is the amount of blood pumped by the left ventricle with each beat.
6. Stroke volume plays an important part in cardiac output. Select all the factors below that influence stroke volume:
A. Heart rate
B. Preload
C. Contractility
D. Afterload
E. Blood pressure
The answers are B, C, and D. Preload, afterload, and contractility all have a role with influencing stroke volume.
7. Which treatments below would decrease cardiac preload? Select all that apply:
A. IV fluid bolus
B. Norepinephrine
C. Nitroglycerin
D. Furosemide
The answers are C and D. Nitroglycerin is a vasodilator that will dilate vessels, which will decrease venous return to the heart and this will decrease preload. Furosemide is a diuretic which will remove extra fluid from the body via the kidneys. This will decrease venous return to the heart and decrease preload. An IV fluid bolus and Norepinephrine (a vasoconstrictor) will increase venous return to the heart and increase preload.
8. A patient has a blood pressure of 220/140. The physician prescribes a vasodilator. This medication will?
A. Decrease the patient’s blood pressure and increase cardiac afterload
B. Decrease the patient’s blood pressure and decrease cardiac afterload
C. Decrease the patient’s blood pressure and increase cardiac preload
D. Increase the patient’s blood pressure but decrease cardiac output.
The answer is B. The patient has a high systemic vascular resistance…as evidence by the patient’s blood blood….there is vasoconstriction and this is resulting in the high blood pressure. Therefore, right now, the cardiac afterload is high because the ventricle must overcome this high pressure in order to pump blood out of the heart. If a vasodilator is given, it will decrease the blood pressure (hence the systemic vascular resistance) and this will decrease the cardiac afterload. The amount of the pressure the ventricle must pump against will decrease (cardiac afterload decrease) because the blood pressure will go down (hence the systemic vascular resistance).
9. What conditions below can result in an increased cardiac afterload? Select all that apply:
A. Vasoconstriction
B. Aortic stenosis
C. Vasodilation
D. Dehydration
E. Pulmonary Hypertension
The answers are A, B, and E. Vasoconstriction increases systemic vascular resistance which will increase cardiac afterload. It will increase the pressure the ventricle must pump against to open the semilunar valves to get blood out of the heart. Aortic stenosis creates an outflow of blood obstruction for the ventricle (specifically the left ventricle) and this will increase the pressure the ventricle must pump against to get blood out through the aortic valve. Pulmonary hypertension increases pulmonary vascular resistance which will increase the pressure the right ventricle must overcome to open the pulmonic valve to get blood out of the heart….all of this increase cardiac afterload.
10. True or False: Pulmonary and systemic vascular resistance both play a role with influencing cardiac afterload.
The answer is True. If pulmonary vascular resistance or systemic vascular resistance is high, it will create an increased cardiac afterload. If pulmonary vascular resistance or systemic vascular resistance is low, it will create a decreased cardiac afterload.
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