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Comprehensive Cardiovascular Assessment: Heart and Neck Vessels, Auscultation of S1/S2, S3/S4, Murmurs, Friction Rubs, Thrills, Carotid and Jugular Evaluation, Apical Impulse Palpation, ECG Interpretation, Peripheral Perfusion, Cardiac Risk Factor Educati

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Comprehensive Cardiovascular Assessment: Heart and Neck Vessels, Auscultation of S1/S2, S3/S4, Murmurs, Friction Rubs, Thrills, Carotid and Jugular Evaluation, Apical Impulse Palpation, ECG Interpretation, Peripheral Perfusion, Cardiac Risk Factor Education, Coronary Artery Disease Prevention, Heart Failure Indicators, Mitral and Aortic Valve Assessment, Erb’s Point, Auscultation Techniques with Bell and Diaphragm, Health Promotion and High-Yield NCLEX Cardiovascular Review Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 1. While auscultating the client's heart at the third intercostal space and on the left sternal border, the nurse notes a high-pitched, scratchy sound that increases with exhalation with the client leaning forward. The nurse should document which of the following? A) Pericardial friction rub B) Midsystolic click C) Summation gallop D) Aortic ejection click A) Pericardial friction rub The anterior chest area that overlies the heart and great vessels precordium 2. During chest auscultation, the nurse hears a quiet murmur immediately upon placing the stethoscope on the client's chest. The nurse interprets this as which grade? A) 1 B) 2 C) 3 D) 4 B) 2 The bicuspid, or mitral, valve is located between the left atrium and the left ventricle 3. A group of students is reviewing the structures of the heart, noting that the thickest layer of the heart is made up of contractile muscle cells. The students are correct in identifying this layer as which of the following? A) Myocardium B) Epicardium C) Endocardium D) Pericardium A) Myocardium The semilunar valves are located at the exit of each ventricle at the beginning of the great vessels 4. A nurse is reviewing the electrical conduction system of the heart in preparation for assessing a client with a conduction problem. The nurse should be aware that the electrical signal originates in which of the following locations? A) Bundle of His B) Purkinje fibers C) Sinoatrial node D) AV node C) Sinoatrial node The sinoatrial node of the heart is located on the posterior wall of the right atrium 5. The nurse is analyzing the data from the assessment of a client's heart and neck vessels. The client's first heart sound corresponds with what event in the cardiac cycle? A) Isometric contraction B) Closure of the semilunar valves C) Beginning of diastole D) Closure of the atrioventricular valves D) Closure of the atrioventricular valves The P-wave phase of the electrocardium (ECG) represents conduction of the impulse throughout the atria 6. The nurse is assessing a client who is in uncompensated right-sided heart failure. What assessment finding should the nurse anticipate? A) Increased jugular venous pressure B) Bradycardia C) Decreased blood pressure D) Dysrhythmias A) Increased jugular venous pressure Area of auscultation located at the second ICS and left sternal border. Pulmonic 7. The nurse is assessing a client with a cardiac condition who complains of not sleeping well and of having to get up frequently at night to urinate. The nurse should recognize what implication of this statement? A) The client may have developed a cardiac conduction problem. B) The client may be experiencing symptoms of heart failure. C) The client's cardiac problem is being adequately compensated for. D) The client may be at increased risk for myocardial infarction. B) The client may be experiencing symptoms of heart failure. part of the stethoscope used to auscultate normal heart sounds Diaphragm localized area of tissue necrosis caused by prolonged anoxia Infarct 8. The nurse is assessing a client's heart and neck vessels. Which technique would be most appropriate to use when examining the client's jugular venous pulse? A) Perform the exam with the client in a supine position. B) Have the client look straight ahead with chin slightly lifted. C) Have the client sit up at a 90-degree angle. D) Inspect the suprasternal notch or around the clavicles. D) Inspect the suprasternal notch or around the clavicles. 9. The nurse is preparing to assess a client's apical impulse. The nurse should palpate at which location? A) Second intercostal space, left sternal border B) Third intercostal space, left axillary line C) Fourth intercostal space, left sternal border D) Fifth intercostal space, left midclavicular line D) Fifth intercostal space, left midclavicular line As

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Comprehensive Cardiovascular Assessment: Heart
and Neck Vessels, Auscultation of S1/S2, S3/S4,
Murmurs, Friction Rubs, Thrills, Carotid and Jugular
Evaluation, Apical Impulse Palpation, ECG
Interpretation, Peripheral Perfusion, Cardiac Risk
Factor Education, Coronary Artery Disease
Prevention, Heart Failure Indicators, Mitral and
Aortic Valve Assessment, Erb’s Point, Auscultation
Techniques with Bell and Diaphragm, Health
Promotion and High-Yield NCLEX Cardiovascular
Review Exam Questions Verified and Provided with
Complete A+ Graded Rationales Latest Updated
2026


1. While auscultating the client's heart at the third intercostal space and on the left sternal
border, the nurse notes a high-pitched, scratchy sound that increases with exhalation with the
client leaning forward. The nurse should document which of the following?
A) Pericardial friction rub
B) Midsystolic click
C) Summation gallop
D) Aortic ejection click

A) Pericardial friction rub

The anterior chest area that overlies the heart and great vessels

precordium

2. During chest auscultation, the nurse hears a quiet murmur immediately upon placing the
stethoscope on the client's chest. The nurse interprets this as which grade?
A) 1
B) 2
C) 3
D) 4

B) 2

, The bicuspid, or mitral, valve is located

between the left atrium and the left ventricle

3. A group of students is reviewing the structures of the heart, noting that the thickest layer of
the heart is made up of contractile muscle cells. The students are correct in identifying this layer
as which of the following?
A) Myocardium
B) Epicardium
C) Endocardium
D) Pericardium

A) Myocardium

The semilunar valves are located

at the exit of each ventricle at the beginning of the great vessels

4. A nurse is reviewing the electrical conduction system of the heart in preparation for assessing
a client with a conduction problem. The nurse should be aware that the electrical signal
originates in which of the following locations?
A) Bundle of His
B) Purkinje fibers
C) Sinoatrial node
D) AV node

C) Sinoatrial node

The sinoatrial node of the heart is located on the

posterior wall of the right atrium

5. The nurse is analyzing the data from the assessment of a client's heart and neck vessels. The
client's first heart sound corresponds with what event in the cardiac cycle?
A) Isometric contraction
B) Closure of the semilunar valves
C) Beginning of diastole
D) Closure of the atrioventricular valves

D) Closure of the atrioventricular valves

The P-wave phase of the electrocardium (ECG) represents

conduction of the impulse throughout the atria

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