NSG3160 Health Assessment Exam 2
Practice Questions Actual Exam 2026/2027 |
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SECTION 1: CARDIOVASCULAR ASSESSMENT (15 Questions)
Q1: During cardiac auscultation, the nurse places the stethoscope at the 5th intercostal space,
midclavicular line. Which area is being auscultated?
A. Aortic area
B. Pulmonic area
C. Erb's point
D. Mitral area (apex)
Correct Answer: D. [CORRECT]
Rationale: The mitral area (apex) is located at the 5th intercostal space, left midclavicular line,
and is the point of maximal impulse (PMI) where the apical pulse is best heard and S1 is loudest.
Q2: A nurse auscultates a patient's heart and hears a low-pitched, extra heart sound immediately
after S2. This sound is best heard with the bell of the stethoscope. What is this sound?
A. S3 (ventricular gallop)
B. S4 (atrial gallop)
C. Murmur
D. Pericardial friction rub
Correct Answer: A. [CORRECT]
Rationale: S3 is a low-pitched sound heard after S2, best heard with the bell at the apex. It may
be normal in children and young adults but indicates heart failure in older adults due to rapid
ventricular filling into a dilated ventricle.
,2
Q3: Which valve closure produces the first heart sound (S1)?
A. Aortic and pulmonic valves
B. Mitral and tricuspid valves
C. Aortic and mitral valves
D. Pulmonic and tricuspid valves
Correct Answer: B. [CORRECT]
Rationale: S1 is produced by the closure of the mitral and tricuspid (atrioventricular) valves at
the beginning of systole, marking the start of ventricular contraction and best heard at the apex.
Q4: A nurse assesses the carotid arteries and finds a unilateral bruit. What does this finding
indicate?
A. Normal finding
B. Turbulent blood flow from arterial narrowing
C. Venous insufficiency
D. Cardiac valve regurgitation
Correct Answer: B. [CORRECT]
Rationale: A carotid bruit indicates turbulent blood flow through a narrowed artery, typically
from atherosclerotic plaque buildup, and requires further evaluation for cerebrovascular disease
risk.
Q5: When assessing jugular venous pressure (JVP), at what angle should the head of the bed be
positioned for optimal visualization?
A. 15-30 degrees
B. 45-90 degrees
C. Flat (0 degrees)
D. 90 degrees only
Correct Answer: B. [CORRECT]
Rationale: JVP is best assessed with the head of the bed elevated 45-90 degrees to visualize the
internal jugular vein pulsations above the clavicle, with the right internal jugular providing the
most accurate estimate of right atrial pressure.
Ordered Response Question - Cardiac Auscultation Sequence:
Q6: Place the following cardiac auscultation areas in the correct order for a systematic
assessment.
, 3
A. Pulmonic area (2nd LICS, left sternal border)
B. Aortic area (2nd RICS, right sternal border)
C. Tricuspid area (4th LICS, left sternal border)
D. Mitral area (5th LICS, midclavicular line)
E. Erb's point (3rd LICS, left sternal border)
Correct Order: B, A, E, C, D. [CORRECT]
Rationale: Systematic cardiac auscultation proceeds from aortic (2nd RICS), to pulmonic (2nd
LICS), to Erb's point (3rd LICS), to tricuspid (4th LICS), to mitral (5th LICS) to ensure all valve
areas are assessed without skipping locations.
Q7: A patient presents with a harsh, crescendo-decrescendo systolic murmur heard best at the
right 2nd intercostal space radiating to the carotid arteries. What is the likely origin?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Correct Answer: B. [CORRECT]
Rationale: A harsh systolic murmur at the right 2nd intercostal space radiating to the carotids is
characteristic of aortic stenosis, as the sound travels along the path of blood flow through the
narrowed valve into the aorta and carotid arteries.
Q8: Which ECG finding indicates normal sinus rhythm?
A. P wave before every QRS complex, regular rhythm, rate 60-100 bpm
B. Absent P waves, irregular rhythm
C. P wave after every QRS complex
D. Regular rhythm, rate 150 bpm
Correct Answer: A. [CORRECT]
Rationale: Normal sinus rhythm requires a P wave before every QRS complex indicating
sinoatrial node initiation, regular R-R intervals, and a ventricular rate between 60-100 beats per
minute.
Q9: When palpating the precordium, the nurse feels a thrill at the left lower sternal border. What
does this indicate?