Deck 6: Assessing the Cardiovascular System

Question 1

Which heart problem is responsible for an early systolic murmur?

A) Pericarditis
B) Turbulent venous flow
C) Ventricular septal defect (VSD)
D) Myocardial infarction (MI)

Answer 1

Ventricular septal defect (VSD)

Question 2

Which of the following factors may affect a patient's risk for heart disease?

A) Age
B) Gender
C) Ethnicity
D) All of the above

Answer 2

All of the above

Question 3

The nurse auscultates an S₃ gallop rhythm in an adult. Which disorder is this indicative of?

A) Atrial fibrillation
B) Heart failure
C) Ventricular tachycardia
D) Atrial septal defect

Answer 3

Heart failure

Question 4

At which auscultatory site would S₁ best be heard?

A) Aortic
B) Pulmonic
C) Erb point
D) Mitral

Question 5

The nurse auscultates an S₂ sound during a cardiovascular system assessment. Which conclusion by the nurse is most appropriate?

A) Normal finding
B) Mitral valve stenosis
C) Pericarditis
D) Hypertension

Question 6

An older adult patient is admitted to the critical care unit with uncontrolled hypertension. The patient's point of maximal impulse (PMI) is enlarged and displaced laterally. Which is the normal size of the left ventricular impulse (LVI)?

A) <1 cm
B) No greater than 2 cm
C) Between 3 and 4 cm
D) >4 cm

Question 7

The nurse detects a widely abnormal split S₂. At which auscultatory site would this be heard?

A) Aortic
B) Pulmonic
C) Tricuspid
D) Mitral

Question 8

Which is often the cause of an additional heart sound heard during pregnancy?

A) A mammary soufflé
B) Friction rub
C) Venous hum
D) S₄ gallop

Question 9

Ethnic variations have an impact on severity of coronary artery disease (CAD). Which individual is more likely to suffer from CAD?

A) Japanese American male
B) Puerto Rican female
C) African American female
D) White female

Question 10

The nurse is assessing a patient's heart sounds. Which pitch is expected for the S₂ sound?

A) Vibrating
B) Grating
C) Low
D) High

Question 11

Turbulent blood flow within the heart is heard as a murmur. Which is the cause of the murmur?

A) Increased blood volume
B) Constricted blood vessels
C) Flow from a normal vessel to a dilated one
D) All of the above

Question 12

Which location does the nurse use to assess S₁?

A) Base left
B) Base right
C) Apex
D) Left lower sternal border

Question 13

The S₁ heart sound is made during which part of the cardiac cycle?

A) Systolic
B) Diastolic
C) Early diastolic
D) Midsystolic

Question 14

The nurse auscultates a widely split S₂ heart sound. Which is this assessment finding indicative of?

A) Atrial fibrillation
B) Left bundle branch block (LBBB)
C) Right bundle branch block (RBBB)
D) Ventricular fibrillation

Question 15

To measure jugular venous pressure, the patient should be placed in which position?

A) Supine
B) High Fowler's
C) Semi-Fowler's
D) Prone

Question 16

The nurse notes an opening snap when auscultating a patient's heart sounds. Which does this finding indicate?

A) Atrial fibrillation
B) Pulmonary hypertension
C) Emphysema
D) Mitral stenosis

Question 17

Which action by the nurse will allow bruits to be heard most accurately?

A) Using a fetoscope
B) Using the diaphragm of the stethoscope
C) Using the bell of the stethoscope
D) Using the unassisted ear

Question 18

The nurse notes an elevated jugular venous pressure (JVP). Which disease process can cause this assessment finding?

A) Hypovolemia
B) Constrictive pericarditis
C) Right ventricular hypertrophy
D) Abnormal venous wave forms

Question 19

The S₃ rhythm often accompanies which heart problem?

A) Heart failure
B) Mitral stenosis
C) Pulmonary hypertension
D) Myocardial infarction (MI)

Question 20

At which auscultatory site would S₂ best be heard?

A) Mitral
B) Tricuspid
C) Erb point
D) Aortic area

Question 21

An S₃ heart sound may be a normal finding in patients younger than ________________years of age.

Question 22

The nurse is conducting a health history for a patient who presents for a cardiovascular assessment. Which drugs would likely cause the patient's heart rate to be more than 100 beats per minute? Select all that apply.

A) Nitrates
B) Isoproterenol
C) Nicotine
D) Digoxin
E) Procainamide

Question 23

When auscultating heart sounds, what is the best way to differentiate S₁ and S₂?

A) Time S₁ with a visible pulsation at the apex
B) Time S₁ with the carotid pulsation
C) Time S₁ as the louder sound at the base
D) Time the difference between S₁ and S₂ and the next S₁

Question 24

At which auscultatory site would a normal split S₁ occur?

A) Aortic
B) Pulmonic
C) Tricuspid
D) Mitral

Question 25

The nurse notes mitral regurgitation during auscultation of heart sounds. Which are characteristic of this finding? Select all that apply.

A) Best auscultated at apical area
B) Described as blowing, harsh, or musical
C) May mask S₁
D) Localized to a small area
E) Described as a rough, low-pitched sound

Question 26

Native Americans younger than ________________years have twice the mortality rate from heart disease as other groups.

Question 27

Diastolic murmurs or murmurs greater than or equal to a grade ________________are usually significant of pathology.

Question 28

The nurse knows that a systolic murmur less than or equal to a grade ________________auscultated during a cardiovascular assessment is usually innocent.

Question 29

The nurse notes a low-pitch early systolic murmur during a cardiovascular assessment. Which quality will the nurse document when recording this murmur in the patient's medical record?

A) Rough
B) Harsh
C) Blowing
D) Rumbling
Completion
Complete each statement.

Question 30

The nurse is preparing to conduct a cardiovascular assessment. Which piece of equipment is not required?

A) Stethoscope
B) Pen light
C) Scale
D) Otoscope

Question 31

The nurse assesses an S₄ gallop rhythm during a cardiovascular assessment. Which is the reason for this heart sound?

A) Pulmonary hypertension
B) Mitral stenosis
C) Aortic stenosis
D) Pericarditis

Question 32

Which finding is abnormal when conducting inspection as part of a cardiovascular assessment?

A) Visible carotid pulsations
B) No neck vein distention
C) Large pulsations in the neck
D) Positive pulsation at the apex

Question 33

The nurse is preparing to assess the apical pulse, which is found in the ____________________th intercostal space.

Question 34

Which extra heart sound might the nurse anticipate for a patient with a history of hypertension?

A) S₃
B) S₄
C) Ejection click
D) Opening snap

Question 35

The nurse is assessing a patient who presents with a heart rate of less than 60 beats per minute. Which are possible causes for this assessment finding? Select all that apply.

A) Sinus bradycardia
B) Atrial fibrillation
C) Heart block
D) Myocardial infarction
E) Hyperkalemia

Question 36

The nurse is preparing to conduct a cardiovascular assessment. Which positions are appropriate for the patient to assume during cardiac auscultation? Select all that apply.

A) Sitting
B) Trendelenburg
C) Supine
D) Sims'
E) Left lateral recumbent

Question 37

The nurse educator is teaching a group of nursing students about jugular pulsations. Which statements will the educator include in the presentation? Select all that apply.

A) "Jugular pulsations are easily obliterated."
B) "Jugular pulsations are affected by position."
C) "Jugular pulsations are affected by respirations."
D) "Jugular pulsations are affected by weight."
E) "Jugular pulsations are assessed with a stethoscope."