NU 650 STUDY GUIDE EXAM 2026/2027 QUESTIONS
AND SOLUTIONS RATED A+
✔✔You are concerned that a patient has an aortic regurgitation murmur. Which is the
best position to accentuate the murmur?
A) Upright
B) Upright, but leaning forward
C) Supine
D) Left lateral decubitus - ✔✔B
✔✔A 68-year-old retired waiter comes to your clinic for evaluation of fatigue. You
perform a cardiac examination and find his pulse rate is less than 60. Which of the
following conditions could be responsible for this heart rate?
A) Second-degree A-V block
B) Atrial flutter
C) Sinus arrhythmia
D) Atrial fibrillation - ✔✔A
✔✔Where is the point of maximal impulse (PMI) normally located?
A) In the left 5th intercostal space, 7 to 9 cm lateral to the sternum
B) In the left 5th intercostal space, 10 to 12 cm lateral to the sternum
C) In the left 5th intercostal space, in the anterior axillary line
D) In the left 5th intercostal space, in the midaxillary line - ✔✔A
✔✔Which of the following events occurs at the start of diastole?
A) Closure of the tricuspid valve
B) Opening of the pulmonic valve
C) Closure of the aortic valve
D) Production of the first heart sound (S1) - ✔✔C
✔✔Which is true of a third heart sound (S3)?
A) It marks atrial contraction.
B) It reflects normal compliance of the left ventricle.
C) It is caused by rapid deceleration of blood against the ventricular wall.
D) It is not heard in atrial fibrillation. - ✔✔C
✔✔Which is true of splitting of the second heart sound?
A) It is best heard over the pulmonic area with the bell of the stethoscope.
B) It normally increases with exhalation.
C) It is best heard over the apex.
D) It does not vary with respiration. - ✔✔A
✔✔Which of the following is true of jugular venous pressure (JVP) measurement?
A) It is measured with the patient at a 45-degree angle.
, B) The vertical height of the blood column in centimeters, plus 5 cm, is the JVP.
C) A JVP below 9 cm is abnormal.
D) It is measured above the sternal notch. - ✔✔B
✔✔Which of the following regarding jugular venous pulsations is a systolic
phenomenon?
A) The "y" descent
B) The "x" descent
C) The upstroke of the "a" wave
D) The downstroke of the "v" wave - ✔✔B
✔✔How much does cardiovascular risk increase for each increment of 20 mm Hg
systolic and 10 mm Hg diastolic in blood pressure?
A) 25%
B) 50%
C) 75%
D) 100% - ✔✔D
✔✔In healthy adults over 20, how often should blood pressure, body mass index, waist
circumference, and pulse be assessed, according to American Heart Association
guidelines?
A) Every 6 months
B) Every year
C) Every 2 years
D) Every 5 years - ✔✔C
✔✔Which of the following is a clinical identifier of metabolic syndrome?
A) Waist circumference of 38 inches for a male
B) Waist circumference of 34 inches for a female
C) BP of 134/88 for a male
D) BP of 128/84 for a female - ✔✔C
✔✔Mrs. Adams would like to begin an exercise program and was told to exercise as
intensely as necessary to obtain a heart rate 60% or greater of her maximum heart rate.
She is 52. What heart rate should she achieve?
A) 80
B) 100
C) 120
D) 140 - ✔✔B
✔✔In measuring the jugular venous pressure (JVP), which of the following is important?
A) Keep the patient's torso at a 45-degree angle.
B) Measure the highest visible pressure, usually at end expiration.
C) Add the vertical height over the sternal notch to a 5-cm constant.
AND SOLUTIONS RATED A+
✔✔You are concerned that a patient has an aortic regurgitation murmur. Which is the
best position to accentuate the murmur?
A) Upright
B) Upright, but leaning forward
C) Supine
D) Left lateral decubitus - ✔✔B
✔✔A 68-year-old retired waiter comes to your clinic for evaluation of fatigue. You
perform a cardiac examination and find his pulse rate is less than 60. Which of the
following conditions could be responsible for this heart rate?
A) Second-degree A-V block
B) Atrial flutter
C) Sinus arrhythmia
D) Atrial fibrillation - ✔✔A
✔✔Where is the point of maximal impulse (PMI) normally located?
A) In the left 5th intercostal space, 7 to 9 cm lateral to the sternum
B) In the left 5th intercostal space, 10 to 12 cm lateral to the sternum
C) In the left 5th intercostal space, in the anterior axillary line
D) In the left 5th intercostal space, in the midaxillary line - ✔✔A
✔✔Which of the following events occurs at the start of diastole?
A) Closure of the tricuspid valve
B) Opening of the pulmonic valve
C) Closure of the aortic valve
D) Production of the first heart sound (S1) - ✔✔C
✔✔Which is true of a third heart sound (S3)?
A) It marks atrial contraction.
B) It reflects normal compliance of the left ventricle.
C) It is caused by rapid deceleration of blood against the ventricular wall.
D) It is not heard in atrial fibrillation. - ✔✔C
✔✔Which is true of splitting of the second heart sound?
A) It is best heard over the pulmonic area with the bell of the stethoscope.
B) It normally increases with exhalation.
C) It is best heard over the apex.
D) It does not vary with respiration. - ✔✔A
✔✔Which of the following is true of jugular venous pressure (JVP) measurement?
A) It is measured with the patient at a 45-degree angle.
, B) The vertical height of the blood column in centimeters, plus 5 cm, is the JVP.
C) A JVP below 9 cm is abnormal.
D) It is measured above the sternal notch. - ✔✔B
✔✔Which of the following regarding jugular venous pulsations is a systolic
phenomenon?
A) The "y" descent
B) The "x" descent
C) The upstroke of the "a" wave
D) The downstroke of the "v" wave - ✔✔B
✔✔How much does cardiovascular risk increase for each increment of 20 mm Hg
systolic and 10 mm Hg diastolic in blood pressure?
A) 25%
B) 50%
C) 75%
D) 100% - ✔✔D
✔✔In healthy adults over 20, how often should blood pressure, body mass index, waist
circumference, and pulse be assessed, according to American Heart Association
guidelines?
A) Every 6 months
B) Every year
C) Every 2 years
D) Every 5 years - ✔✔C
✔✔Which of the following is a clinical identifier of metabolic syndrome?
A) Waist circumference of 38 inches for a male
B) Waist circumference of 34 inches for a female
C) BP of 134/88 for a male
D) BP of 128/84 for a female - ✔✔C
✔✔Mrs. Adams would like to begin an exercise program and was told to exercise as
intensely as necessary to obtain a heart rate 60% or greater of her maximum heart rate.
She is 52. What heart rate should she achieve?
A) 80
B) 100
C) 120
D) 140 - ✔✔B
✔✔In measuring the jugular venous pressure (JVP), which of the following is important?
A) Keep the patient's torso at a 45-degree angle.
B) Measure the highest visible pressure, usually at end expiration.
C) Add the vertical height over the sternal notch to a 5-cm constant.
