Question 1

Which of the following statements about S₁ during cardiac auscultation is true?

Accepted Answer

A) S₁ is louder than S₂ at the base. 
B) S₁ indicates the beginning of diastole. 
C) S₁ coincides with the carotid artery pulse. 
D) S₁ is caused by closure of the semilunar valves. 
A) S₁ is louder than S₂ at the base. 
B) S₁ indicates the beginning of diastole. 
C) S₁ coincides with the carotid artery pulse. 
D) S₁ is caused by closure of the semilunar valves.

Question 2

During cardiovascular assessment,the nurse is aware that a "thrill" is:

Accepted Answer

A) a vibration that is palpable. 
B) palpated in the right epigastric area. 
C) associated with ventricular hypertrophy. 
D) a murmur auscultated at the third intercostal space. 
A) a vibration that is palpable. 
B) palpated in the right epigastric area. 
C) associated with ventricular hypertrophy. 
D) a murmur auscultated at the third intercostal space.

Question 3

The mother of a 10-month-old baby tells the nurse that she has noticed that her son turns blue whenever he is crying and that this is happening more and more frequently.He is also not crawling yet.During examination,the nurse identifies a thrill at the left lower sternal border as well as a loud systolic murmur.What would be the most likely cause of these findings?

Accepted Answer

A) Tetralogy of Fallot 
B) Atrial septal defect 
C) Patent ductus arteriosus 
D) Ventricular septal defect 
A) Tetralogy of Fallot 
B) Atrial septal defect 
C) Patent ductus arteriosus 
D) Ventricular septal defect

Question 4

Which ethnic group in Canada has the highest prevalence of heart disease and stroke?

Accepted Answer

A) People of African descent 
B) People of European descent 
C) Aboriginal people 
D) People of Asian descent 
A) People of African descent 
B) People of European descent 
C) Aboriginal people 
D) People of Asian descent

Question 5

During cardiac assessment on an adult patient in the hospital for "chest pain," the nurse finds the following: jugular vein pulsations 4 cm above sternal angle when he is elevated at 45 degrees,BP 98/60 mm Hg,HR 130 bpm;ankle edema;difficulty breathing when supine;and S₃.Which of the following best explains the cause of these findings?

Accepted Answer

A) Fluid overload 
B) Atrial septal defect 
C) Myocardial infarction 
D) Heart failure 
A) Fluid overload 
B) Atrial septal defect 
C) Myocardial infarction 
D) Heart failure

Question 6

Which of the following best describes what is meant by "atrial kick"?

Accepted Answer

A) The atria contract during systole and attempt to push against closed valves. 
B) The contraction of the atria at the beginning of diastole can be felt as a palpitation. 
C) This is the pressure exerted against the atria as the ventricles contract during systole. 
D) The atria contract toward the end of diastole and push the remaining blood into the ventricles. 
A) The atria contract during systole and attempt to push against closed valves. 
B) The contraction of the atria at the beginning of diastole can be felt as a palpitation. 
C) This is the pressure exerted against the atria as the ventricles contract during systole. 
D) The atria contract toward the end of diastole and push the remaining blood into the ventricles.

Question 7

While assessing the carotid arteries of an older adult with cardiovascular disease,the nurse would:

Accepted Answer

A) palpate the artery in the upper one third of the neck. 
B) listen with the bell of the stethoscope to auscultate for bruits. 
C) palpate both arteries simultaneously to compare amplitude. 
D) instruct the patient to take slow,deep breaths during auscultation. 
A) palpate the artery in the upper one third of the neck. 
B) listen with the bell of the stethoscope to auscultate for bruits. 
C) palpate both arteries simultaneously to compare amplitude. 
D) instruct the patient to take slow,deep breaths during auscultation.

Question 8

When the nurse is auscultating the carotid artery for bruits,which of the following reflects correct technique?

Accepted Answer

A) While listening with the bell of the stethoscope,have the patient take a deep breath and hold it. 
B) While auscultating one side with the bell of the stethoscope,palpate the carotid artery on the other side to check pulsations. 
C) Lightly apply the bell of the stethoscope over the carotid artery;have the patient take a breath,exhale,and hold briefly after exhaling while you listen to it. 
D) Firmly place the bell of the stethoscope over the carotid artery,and have the patient take a breath,exhale,and hold briefly after exhaling while you listen to it. 
A) While listening with the bell of the stethoscope,have the patient take a deep breath and hold it. 
B) While auscultating one side with the bell of the stethoscope,palpate the carotid artery on the other side to check pulsations. 
C) Lightly apply the bell of the stethoscope over the carotid artery;have the patient take a breath,exhale,and hold briefly after exhaling while you listen to it. 
D) Firmly place the bell of the stethoscope over the carotid artery,and have the patient take a breath,exhale,and hold briefly after exhaling while you listen to it.

Question 9

Which of the following best describes the direction of blood flow through the heart?

Accepted Answer

A) Vena cava -> right atrium -> right ventricle -> lungs -> pulmonary artery -> left atrium -> left ventricle 
B) Right atrium -> right ventricle -> pulmonary artery -> lungs -> pulmonary vein -> left atrium -> left ventricle 
C) Aorta -> right atrium -> right ventricle -> lungs -> pulmonary vein -> left atrium -> left ventricle -> vena cava 
D) Right atrium -> right ventricle -> pulmonary vein -> lungs -> pulmonary artery -> left atrium -> left ventricle 
A) Vena cava -> right atrium -> right ventricle -> lungs -> pulmonary artery -> left atrium -> left ventricle 
B) Right atrium -> right ventricle -> pulmonary artery -> lungs -> pulmonary vein -> left atrium -> left ventricle 
C) Aorta -> right atrium -> right ventricle -> lungs -> pulmonary vein -> left atrium -> left ventricle -> vena cava 
D) Right atrium -> right ventricle -> pulmonary vein -> lungs -> pulmonary artery -> left atrium -> left ventricle

Question 10

The nurse is assessing the apical pulse of a 3-month-old infant and finds the rate to be 135 bpm.The nurse interprets this result as:

Accepted Answer

A) normal for this age. 
B) lower than expected. 
C) higher than expected,probably caused by crying. 
D) higher than expected,reflecting persistent tachycardia. 
A) normal for this age. 
B) lower than expected. 
C) higher than expected,probably caused by crying. 
D) higher than expected,reflecting persistent tachycardia.

Question 11

Normal splitting of the second heart sound is associated with:

Accepted Answer

A) expiration. 
B) inspiration. 
C) exercise state. 
D) low resting heart rate. 
A) expiration. 
B) inspiration. 
C) exercise state. 
D) low resting heart rate.

Question 12

While auscultating for heart sounds in a 7-year-old during a "routine physical," the nurse hears the following: an S₃,a soft murmur at left midsternal border,and a venous hum when the child is standing.Which of the following about the findings is true?

Accepted Answer

A) S₃ is indicative of heart disease in children. 
B) These can all be normal findings in a child. 
C) These are indicative of congenital problems. 
D) The venous hum most likely indicates an aneurysm. 
A) S₃ is indicative of heart disease in children. 
B) These can all be normal findings in a child. 
C) These are indicative of congenital problems. 
D) The venous hum most likely indicates an aneurysm.

Question 13

In auscultating for an S₄ with a stethoscope,the nurse would listen with the:

Accepted Answer

A) bell at the base,with the patient leaning forward. 
B) bell at the apex,with the patient in the left lateral position. 
C) diaphragm in the aortic area,with the patient sitting. 
D) diaphragm in the pulmonic area,with the patient in the supine position. 
A) bell at the base,with the patient leaning forward. 
B) bell at the apex,with the patient in the left lateral position. 
C) diaphragm in the aortic area,with the patient sitting. 
D) diaphragm in the pulmonic area,with the patient in the supine position.

Question 14

A 25-year-old woman in her fifth month of pregnancy has a blood pressure (BP)of 100/70 mm Hg.In reviewing her previous examination findings,the nurse notes that her BP in her second month was 124/80 mm Hg.In evaluating this change,what does the nurse know to be true?

Accepted Answer

A) This is the result of peripheral vasodilatation and is an expected change. 
B) Because of increased cardiac output,the BP should be higher at this time. 
C) This is not an expected finding because it would mean a decreased cardiac output. 
D) This would mean a decrease in circulating blood volume,which is dangerous for the fetus. 
A) This is the result of peripheral vasodilatation and is an expected change. 
B) Because of increased cardiac output,the BP should be higher at this time. 
C) This is not an expected finding because it would mean a decreased cardiac output. 
D) This would mean a decrease in circulating blood volume,which is dangerous for the fetus.

Question 15

In assessing a 70-year-old man,the nurse finds the following: BP 140/100 mm Hg;heart rate (HR)104 beats per minute (bpm)and slightly irregular;split S₂.Which of these findings can be explained by expected hemodynamic changes related to aging?

Accepted Answer

A) Increase in resting heart rate 
B) Increase in systolic BP 
C) Decrease in diastolic BP 
D) Increase in diastolic BP 
A) Increase in resting heart rate 
B) Increase in systolic BP 
C) Decrease in diastolic BP 
D) Increase in diastolic BP

Question 16

In the assessment of a newborn infant who is just 5 minutes old,which of the following would be true?

Accepted Answer

A) The left ventricle is larger and weighs more than the right. 
B) The circulation of a newborn is identical to that of an adult. 
C) There is an opening in the atrial septum where blood can flow into the left side of the heart. 
D) The foramen ovale closes just minutes before birth,and the ductus arteriosus closes immediately thereafter. 
A) The left ventricle is larger and weighs more than the right. 
B) The circulation of a newborn is identical to that of an adult. 
C) There is an opening in the atrial septum where blood can flow into the left side of the heart. 
D) The foramen ovale closes just minutes before birth,and the ductus arteriosus closes immediately thereafter.

Question 17

A heart sound heard during the interval between the second heart sound (S₂)and the next first sound (S₁)is a(n):

Accepted Answer

A) systolic sound. 
B) diastolic sound. 
C) atrial filling sound. 
D) ventricular contraction sound. 
A) systolic sound. 
B) diastolic sound. 
C) atrial filling sound. 
D) ventricular contraction sound.

Question 18

During the assessment of a 68-year-old man with a recent onset of right-sided weakness,the nurse hears a blowing,swishing sound with the bell of the stethoscope over the left carotid artery.This finding would indicate:

Accepted Answer

A) a valvular disorder. 
B) blood flow turbulence. 
C) fluid volume overload. 
D) ventricular hypertrophy. 
A) a valvular disorder. 
B) blood flow turbulence. 
C) fluid volume overload. 
D) ventricular hypertrophy.

Question 19

Which of the following statements about the apical impulse is true?

Accepted Answer

A) It is palpable in all adults. 
B) It occurs with the onset of diastole. 
C) Its location may be indicative of heart size. 
D) It should normally be palpable in the anterior axillary line. 
A) It is palpable in all adults. 
B) It occurs with the onset of diastole. 
C) Its location may be indicative of heart size. 
D) It should normally be palpable in the anterior axillary line.

Question 20

The component of the conduction system referred to as the pacemaker of the heart is the:

Accepted Answer

A) atrioventricular (AV)node. 
B) sinoatrial (S
A) node. 
C) bundle of His. 
D) bundle branches. 
A) atrioventricular (AV)node. 
B) sinoatrial (S
A) node. 
C) bundle of His. 
D) bundle branches.

Exam 20: Heart and Neck Vessels

Which of the following statements about S₁ during cardiac auscultation is true?

During cardiovascular assessment,the nurse is aware that a "thrill" is:

Which ethnic group in Canada has the highest prevalence of heart disease and stroke?

Which of the following best describes what is meant by "atrial kick"?

While assessing the carotid arteries of an older adult with cardiovascular disease,the nurse would:

When the nurse is auscultating the carotid artery for bruits,which of the following reflects correct technique?

Which of the following best describes the direction of blood flow through the heart?

The nurse is assessing the apical pulse of a 3-month-old infant and finds the rate to be 135 bpm.The nurse interprets this result as:

Normal splitting of the second heart sound is associated with:

While auscultating for heart sounds in a 7-year-old during a "routine physical," the nurse hears the following: an S₃,a soft murmur at left midsternal border,and a venous hum when the child is standing.Which of the following about the findings is true?

In auscultating for an S₄ with a stethoscope,the nurse would listen with the:

A 25-year-old woman in her fifth month of pregnancy has a blood pressure (BP)of 100/70 mm Hg.In reviewing her previous examination findings,the nurse notes that her BP in her second month was 124/80 mm Hg.In evaluating this change,what does the nurse know to be true?

In assessing a 70-year-old man,the nurse finds the following: BP 140/100 mm Hg;heart rate (HR)104 beats per minute (bpm)and slightly irregular;split S₂.Which of these findings can be explained by expected hemodynamic changes related to aging?

In the assessment of a newborn infant who is just 5 minutes old,which of the following would be true?

A heart sound heard during the interval between the second heart sound (S₂)and the next first sound (S₁)is a(n):

During the assessment of a 68-year-old man with a recent onset of right-sided weakness,the nurse hears a blowing,swishing sound with the bell of the stethoscope over the left carotid artery.This finding would indicate:

Which of the following statements about the apical impulse is true?

The component of the conduction system referred to as the pacemaker of the heart is the:

Critical Thinking and Evidence-Informed Assessment

Health Promotion in the Context of Health Assessment

Cultural Competence: Cultural Care and Social Considerations in Health Assessment

The Interview

The Complete Health History

Mental Health Assessment

Substance Use in the Context of Health Assessment

Interpersonal Violence Assessment

Assessment Techniques and the Clinical Setting

General Survey, measurement, and Vital Signs

Pain Assessment

Nutritional Assessment and Nursing Practice

Skin, hair, and Nails

Head and Neck, including Regional Lymphatic System

Eyes

Ears

Nose, mouth, and Throat

Breasts and Regional Lymphatic System

Thorax and Lungs

Peripheral Vascular System and Lymphatic System

Abdomen

Anus,rectum and Prostate

Musculoskeletal System

Neurological System

Male Genitourinary System

Female Genitourinary System

The Complete Health Assessment: Putting It All Together

Bedside Assessment of the Hospitalized Patient

Pregnancy

Functional Assessment of the Older Adult

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