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NR 509 / NR509 Advanced Physical Assessment
Week 4 Midterm Exam
Questions with Verified Answers - Chamberlain
Consist of 100 multiple choices Questions with Answers
- The sac that surrounds and protects the heart is called the: a. Pericardium. b. Myocardium. c. Endocardium. d. Pleural space. Ans>>Pericardium.
- The direction of blood flow through the heart is best described by which of these? a. Vena cava - right atrium - right ventricle - lungs - pulmonary
2 / 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 Ans>>Right atrium - right ventricle - pulmonary artery - lungs
- pulmonary vein - left atrium - left ventricle
- The nurse is reviewing the anatomy and physiologic functioning of the heart. Which statement best describes what is meant by atrial kick? a. The atria contract during systole and attempt to push against closed valves. b. Contraction of the atria at the beginning of diastole can be felt as a palpita- tion. c... Atrial kick 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.
4 / a. Atrioventricular (AV) node. b. Sinoatrial (SA) node. c. Bundle of His. d. Bundle branches. Ans>>Sinoatrial (SA) node.
- The electrical stimulus of the cardiac cycle follows which sequence? a. AV node - SA node - bundle of His b. Bundle of His - AV node - SA node c. SA node - AV node - bundle of His - bundle branches d. AV node - SA node - bundle of His - bundle branches Ans>>AV node - SA node
- bundle of His - bundle branches
- The findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. The nurse knows that this finding indicates: a. Decreased fluid volume. b... Increased cardiac
5 / output. c. Narrowing of jugular veins. d. Elevated pressure related to heart failure. Ans>>Elevated pressure related to heart failure.
- When assessing a newborn infant who is 5 minutes old, the nurse knows which of these statements to be true? a. The left ventricle is larger and weighs more than the right ventricle. b. The circulation of a newborn is identical to that of an adult. c. Blood can flow into the left side of the heart through an opening in the atrial septum. d... The foramen ovale closes just minutes before birth, and the ductus arte- riosus closes immediately after. Ans>>Blood can flow into the left side of the heart through an opening in the atrial septum.
- A 25-year-old woman in her fifth month of pregnancy has a blood pressure of 100/70 mm Hg. In reviewing her previous examination, the nurse notes that her blood pressure in her second month was 124/ mm Hg. In evaluating this change, what does the nurse know to be true? a. This decline in blood pressure is the result of peripheral
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- A 45-year-old man is in the clinic for a routine physical examination. During the recording of his health history, the patient states that he has been having difficulty sleeping. "I'll be sleeping great, and then I wake up and feel like I can't get my breath." The nurse's best response to this would be: a. "When was your last electrocardiogram?" b. "It's probably because it's been so hot at night." c. "Do you have any history of problems with your heart?" d. "Have you had a recent sinus infection or upper respiratory infection?" Ans>>"Do you have any history of problems with your heart?"
- In assessing a patient's major risk factors for heart disease, which would the nurse want to include when taking a history? a. Family history, hypertension, stress, and age b. Personality type, high cholesterol, diabetes, and smoking c... Smoking, hypertension, obesity, diabetes, and high cholesterol d. Alcohol consumption, obesity, diabetes, stress, and high cholesterol: c... Smoking, hypertension, obesity, diabetes, and high cholesterol
- The mother of a 3-month-old infant states that her baby has not been
8 / gaining weight. With further questioning, the nurse finds that the infant falls asleep after nursing and wakes up after a short time, hungry again. What other information would the nurse want to have? a. Infant's sleeping position b. Sibling history of eating disorders c. Amount of background noise when eating d. Presence of dyspnea or diaphoresis when sucking Ans>>Presence of dyspnea or diaphoresis when sucking
- In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would: a... Palpate the artery in the upper one third of the neck. b. Listen with the bell of the stethoscope to assess for bruits. c... Simultaneously palpate both arteries to compare amplitude. d. Instruct the patient to take slow deep breaths during auscultation. Ans>>Listen with the bell of the stethoscope to assess for bruits.
- During an assessment of a 68-year-old man with a recent onset of right-sided weakness, the nurse hears a blowing, swishing sound with
10 / d. Fifth left intercostal space at the midclavicular line Ans>>Fifth left intercostal space at the midclavicular line
- The nurse is examining a patient who has possible cardiac enlargement. Which statement about percussion of the heart is true? a. Percussion is a useful tool for outlining the heart's borders. b. Percussion is easier in patients who are obese. c. Studies show that percussed cardiac borders do not correlate well with the true cardiac border. d. Only expert health care providers should attempt percussion of the heart. Ans>>Studies show that percussed cardiac borders do not correlate well with the true cardiac border.
- The nurse is preparing to auscultate for heart sounds. Which technique is correct? a. Listening to the sounds at the aortic, tricuspid, pulmonic, and mitral areas b. Listening by inching the stethoscope in a rough Z pattern, from the base of
11 / the heart across and down, then over to the apex c. Listening to the sounds only at the site where the apical pulse is felt to be the strongest d. Listening for all possible sounds at a time at each specified area Ans>>Listening by inching the stethoscope in a rough Z pattern, from the base of the heart across and down, then over to the apex
- While counting the apical pulse on a 16-year-old patient, the nurse notices an irregular rhythm. His rate speeds up on inspiration and slows on expiration. What would be the nurse's response? a. Talk with the patient about his intake of caffeine. b. Perform an electrocardiogram after the examination. c. No further response is needed because sinus arrhythmia can occur normal- ly. d. Refer the patient to a cardiologist for further testing. Ans>>No further response is needed because sinus arrhythmia can occur normally.
- When listening to heart sounds, the nurse knows that the S1: a. Is louder than the S2 at the base of the heart. b. Indicates the beginning of diastole. c... Coincides with the carotid artery pulse. d. Is caused by the closure of the semilunar valves.: c... Coincides with
13 / Ans>>Murmur at the second left intercostal space when supine
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- While auscultating heart sounds on a 7-year-old child for a routine physical examination, the nurse hears an S3, a soft murmur at the left midsternal border, and a venous hum when the child is standing. What would be a correct interpretation of these findings? a. S3 is indicative of heart disease in children. b. These findings can all be normal in a child. c. These findings are indicative of congenital problems. d. The venous hum most likely indicates an aneurysm. Ans>>These findings can all be normal in a child.
- During the precordial assessment on an patient who is 8 months pregnant, the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line. This finding would indicate: a. Right ventricular hypertrophy. b. Increased volume and size of the heart as a result of pregnancy. c. Displacement of the heart from elevation of the diaphragm. d. Increased blood flow through the internal mammary artery. Ans>>Displacement of the heart from elevation of the diaphragm.
- In assessing for an S4 heart sound with a stethoscope, the nurse would listen with the:
16 / Ans>>Atrial gallop.
- The nurse is performing a cardiac assessment on a 65-year-old patient 3 days after her myocardial infarction (MI). Heart sounds are normal when she is supine, but when she is sitting and leaning forward, the nurse hears a high-pitched, scratchy sound with the diaphragm of the stethoscope at the apex. It disappears on inspiration. The nurse suspects:
17 / a. Increased cardiac output. b. Another MI. c. Inflammation of the precordium. d. Ventricular hypertrophy resulting from muscle damage. Ans>>Inflammation of the precordium.
- The mother of a 10-month-old infant tells the nurse that she has noticed that her son becomes blue when he is crying and that the frequency of this is increasing. He is also not crawling yet. During the examination the nurse palpates a thrill at the left lower sternal border and auscultates a loud systolic murmur in the same area. What would be the most likely cause of these findings? a. Tetralogy of Fallot b. Atrial septal defect c. Patent ductus arteriosus d. Ventricular septal defect Ans>>Tetralogy of Fallot
- A 30-year-old woman with a history of mitral valve problems states that she has been "very tired." She has started waking up at night and feels like her "heart is pounding." During the assessment, the nurse palpates a thrill and lift at the fifth left intercostal space midclavicular line. In the same area, the nurse also auscultates a blowing, swishing
19 / c. Exercise state. d. Low resting heart rate. Ans>>Inspiration.
- During a cardiovascular assessment, the nurse knows that a thrill is: a. Vibration that is palpable. b. Palpated in the right epigastric area. c. Associated with ventricular hypertrophy. d. Murmur auscultated at the third intercostal space. Ans>>Vibration that is palpa- ble.
- During a cardiovascular assessment, the nurse knows that an S heart sound is: a. Heard at the onset of atrial diastole. b. Usually a normal finding in the older adult. c. Heard at the end of ventricular diastole. d. Heard best over the second left intercostal space with the individual sitting upright. Ans>>Heard at the end of ventricular diastole.
- During an assessment, the nurse notes that the patient's apical impulse is laterally displaced and is palpable over a wide area. This finding indicates: a. Systemic hypertension.
20 / b. Pulmonic hypertension. c. Pressure overload, as in aortic stenosis. d. Volume overload, as in heart failure. Ans>>Volume overload, as in heart failure.
- When the nurse is auscultating the carotid artery for bruits, which of these statements reflects the correct technique? a. While listening with the bell of the stethoscope, the patient is asked to take a deep breath and hold it. b. While auscultating one side with the bell of the stethoscope, the carotid artery is palpated on the other side to check pulsations. c. While lightly applying the bell of the stethoscope over the carotid artery and listening, the patient is asked to take a breath, exhale, and briefly hold it. d. While firmly placing the bell of the stethoscope over the carotid artery and listening, the patient is asked to take a breath, exhale, and briefly hold it. Ans>>While lightly applying the bell of the stethoscope over the carotid artery and listening, the patient is asked to take a breath, exhale, and briefly hold it.
- The nurse is preparing for a class on risk factors for hypertension and reviews recent statistics. Which racial group has the highest
