NR509 comprehensive study
questions and answers updated 100 %
Which of these statements describes the closure of the valves in a normal cardiac cycle?
a. The aortic valve closes slightly before the tricuspid valve.
b. The pulmonic valve closes slightly before the aortic valve.
c. The tricuspid valve closes slightly later than the mitral valve.
d. Both the tricuspid and pulmonic valves close at the same time.
c. The tricuspid valve closes slightly later than the mitral valve.
The component of the conduction system referred to as the pacemaker of the heart is the:
a. Atrioventricular (AV) node.
b. Sinoatrial (SA) node.
c. Bundle of His.
d. Bundle branches.
b. 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
d. 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 output.
c. Narrowing of jugular veins.
d. Elevated pressure related to heart failure.
d. 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 arteriosus closes
immediately after.
c. 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 124/80 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 vasodilatation and is an
expected change.
1|P age
,b. Because of increased cardiac output, the blood pressure should be higher at this time.
c. This change in blood pressure is not an expected finding because it means a decrease in
cardiac output.
d. This decline in blood pressure means a decrease in circulating blood volume, which is
dangerous for the fetus.
a. This decline in blood pressure is the result of peripheral vasodilatation and is an expected
change.
b. The sac that surrounds and protects the heart is called the:
a. Pericardium.
b. Myocardium.
c. Endocardium.
d. Pleural space.
c. a. Pericardium.
d. The direction of blood flow through the heart is best described by which of these?
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
e. b. Right atrium - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium
- left ventricle
f. 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 palpitation.
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.
g. d. The atria contract toward the end of diastole and push the remaining blood into the
ventricles.
h. When listening to heart sounds, the nurse knows the valve closures that can be
heard best at the base of the heart are:
a. Mitral and tricuspid.
b. Tricuspid and aortic.
c. Aortic and pulmonic.
d. Mitral and pulmonic.
i. c. Aortic and pulmonic.
In assessing a 70-year-old man, the nurse finds the following: blood pressure 140/100 mm
Hg; heart rate 104 beats per minute and slightly irregular; and the split S2 heart sound.
Which of these findings can be explained by expected hemodynamic changes related to
age?
2|P age
,a. Increase in resting heart rate
b. Increase in systolic blood pressure
c. Decrease in diastolic blood pressure
d... Increase in diastolic blood pressure
b. Increase in systolic blood pressure
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?"
c. "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 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
d. 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.
b. 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 the bell of the stethoscope over the left carotid
artery. This finding would indicate:
a. Valvular disorder.
b. Blood flow turbulence.
c. Fluid volume overload.
d. Ventricular hypertrophy.
b. Blood flow turbulence.
During an inspection of the precordium of an adult patient, the nurse notices the chest
moving in a forceful manner along the sternal border. This finding most likely suggests
3|P age
, a(n):
a. Normal heart.
b. Systolic murmur.
c... Enlargement of the left ventricle.
d. Enlargement of the right ventricle.
d. Enlargement of the right ventricle.
During an assessment of a healthy adult, where would the nurse expect to palpate the
apical impulse?
a. Third left intercostal space at the midclavicular line
b. Fourth left intercostal space at the sternal border
c. Fourth left intercostal space at the anterior axillary line
d. Fifth left intercostal space at the midclavicular line
d. 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.
c. 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 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
b. 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 normally.
d. Refer the patient to a cardiologist for further testing.
c. 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 the carotid artery pulse.
During the cardiac auscultation, the nurse hears a sound immediately occurring after the
S2 at the second left intercostal space. To further assess this sound, what should the nurse
do?
4|P age
questions and answers updated 100 %
Which of these statements describes the closure of the valves in a normal cardiac cycle?
a. The aortic valve closes slightly before the tricuspid valve.
b. The pulmonic valve closes slightly before the aortic valve.
c. The tricuspid valve closes slightly later than the mitral valve.
d. Both the tricuspid and pulmonic valves close at the same time.
c. The tricuspid valve closes slightly later than the mitral valve.
The component of the conduction system referred to as the pacemaker of the heart is the:
a. Atrioventricular (AV) node.
b. Sinoatrial (SA) node.
c. Bundle of His.
d. Bundle branches.
b. 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
d. 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 output.
c. Narrowing of jugular veins.
d. Elevated pressure related to heart failure.
d. 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 arteriosus closes
immediately after.
c. 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 124/80 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 vasodilatation and is an
expected change.
1|P age
,b. Because of increased cardiac output, the blood pressure should be higher at this time.
c. This change in blood pressure is not an expected finding because it means a decrease in
cardiac output.
d. This decline in blood pressure means a decrease in circulating blood volume, which is
dangerous for the fetus.
a. This decline in blood pressure is the result of peripheral vasodilatation and is an expected
change.
b. The sac that surrounds and protects the heart is called the:
a. Pericardium.
b. Myocardium.
c. Endocardium.
d. Pleural space.
c. a. Pericardium.
d. The direction of blood flow through the heart is best described by which of these?
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
e. b. Right atrium - right ventricle - pulmonary artery - lungs - pulmonary vein - left atrium
- left ventricle
f. 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 palpitation.
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.
g. d. The atria contract toward the end of diastole and push the remaining blood into the
ventricles.
h. When listening to heart sounds, the nurse knows the valve closures that can be
heard best at the base of the heart are:
a. Mitral and tricuspid.
b. Tricuspid and aortic.
c. Aortic and pulmonic.
d. Mitral and pulmonic.
i. c. Aortic and pulmonic.
In assessing a 70-year-old man, the nurse finds the following: blood pressure 140/100 mm
Hg; heart rate 104 beats per minute and slightly irregular; and the split S2 heart sound.
Which of these findings can be explained by expected hemodynamic changes related to
age?
2|P age
,a. Increase in resting heart rate
b. Increase in systolic blood pressure
c. Decrease in diastolic blood pressure
d... Increase in diastolic blood pressure
b. Increase in systolic blood pressure
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?"
c. "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 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
d. 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.
b. 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 the bell of the stethoscope over the left carotid
artery. This finding would indicate:
a. Valvular disorder.
b. Blood flow turbulence.
c. Fluid volume overload.
d. Ventricular hypertrophy.
b. Blood flow turbulence.
During an inspection of the precordium of an adult patient, the nurse notices the chest
moving in a forceful manner along the sternal border. This finding most likely suggests
3|P age
, a(n):
a. Normal heart.
b. Systolic murmur.
c... Enlargement of the left ventricle.
d. Enlargement of the right ventricle.
d. Enlargement of the right ventricle.
During an assessment of a healthy adult, where would the nurse expect to palpate the
apical impulse?
a. Third left intercostal space at the midclavicular line
b. Fourth left intercostal space at the sternal border
c. Fourth left intercostal space at the anterior axillary line
d. Fifth left intercostal space at the midclavicular line
d. 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.
c. 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 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
b. 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 normally.
d. Refer the patient to a cardiologist for further testing.
c. 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 the carotid artery pulse.
During the cardiac auscultation, the nurse hears a sound immediately occurring after the
S2 at the second left intercostal space. To further assess this sound, what should the nurse
do?
4|P age
