NSG 6020 Week 6 Knowledge Check | NSG 6020 | South
University | 2026–2027 | Nursing Lecture Knowledge Check
Questions and Answers
Comprehensive Examination: Peripheral Vascular, Lymphatic, and
Cardiovascular Assessment
Academic Level: Graduate Nursing (Advanced Practice)
Difficulty: Advanced/Hard
Total Questions: 150 Multiple-Choice
Primary References: Bates' Guide to Physical Examination & History Taking, Bickley's Physical
Examination & Health Assessment, Current Nursing Practice Standards
Table of Contents
Section Topic Area Questions
I Cardiovascular Anatomy and Physiology 1–20
Cardiac Assessment Techniques (Inspection, Palpation,
II 21–40
Percussion, Auscultation)
III Heart Sounds and Murmurs 41–60
IV Peripheral Vascular System Assessment 61–80
V Arterial and Venous Disorders 81–100
VI Lymphatic System Assessment 101–120
VII Advanced Clinical Scenarios and Differential Diagnosis 121–140
VIII Integration and Comprehensive Application 141–150
Section I: Cardiovascular Anatomy and Physiology (Questions 1–
20)
• 1. Which blood vessels serve to pump blood from the heart and, due to their elastic fibers,
allow for stretching with recoil during the cardiac cycle?
A) Veins
B) Capillaries
C) Arteries
D) Venules
🔴🔴 C) Arteries — Arteries are thick-walled vessels with elastic fibers that enable them to
stretch during systole and recoil during diastole, maintaining continuous blood flow. Veins
are capacitance vessels, and capillaries are exchange vessels.
• 2. Which layer of the arterial wall is primarily responsible for vasoconstriction and
vasodilation?
, A) Tunica intima
B) Tunica media
C) Tunica adventitia
D) Endothelium
🔴🔴 B) Tunica media — The tunica media contains smooth muscle and elastic fibers; its
contraction and relaxation regulate vessel diameter and peripheral vascular resistance.
• 3. The point of maximal impulse (PMI) in a healthy adult is normally located at which
intercostal space and anatomical landmark?
A) 2nd intercostal space, left sternal border
B) 4th intercostal space, midclavicular line
C) 5th intercostal space, midclavicular line
D) 6th intercostal space, anterior axillary line
🔴🔴 C) 5th intercostal space, midclavicular line — The PMI, also known as the apical
impulse, is normally palpated at the 5th intercostal space in the left midclavicular line,
corresponding to the left ventricular apex.
• 4. Which heart valve separates the left ventricle from the aorta?
A) Mitral valve
B) Tricuspid valve
C) Pulmonic valve
D) Aortic valve
🔴🔴 D) Aortic valve — The aortic valve is a semilunar valve located between the left
ventricle and the aorta, preventing backflow of blood into the left ventricle during diastole.
• 5. During the cardiac cycle, the S1 heart sound ("lub") is produced primarily by:
A) Closure of the semilunar valves
B) Closure of the atrioventricular valves
C) Opening of the atrioventricular valves
D) Turbulent flow through the aorta
🔴🔴 B) Closure of the atrioventricular valves — S1 corresponds to the closure of the
mitral and tricuspid valves at the beginning of ventricular systole. It is loudest at the apex.
• 6. Which of the following correctly describes the pathway of blood flow through the heart?
A) Right atrium → tricuspid valve → right ventricle → pulmonic valve → lungs
B) Right atrium → mitral valve → right ventricle → aortic valve → lungs
C) Left atrium → tricuspid valve → left ventricle → pulmonic valve → body
D) Left atrium → aortic valve → left ventricle → mitral valve → body
🔴🔴 A) Right atrium → tricuspid valve → right ventricle → pulmonic valve → lungs —
Deoxygenated blood enters the right atrium, passes through the tricuspid valve to the right
ventricle, and exits through the pulmonic valve to the pulmonary arteries for oxygenation.
• 7. The coronary arteries receive blood during which phase of the cardiac cycle?
A) Ventricular systole
B) Ventricular diastole
C) Atrial systole
, D) Isovolumetric contraction
🔴🔴 B) Ventricular diastole — Coronary artery perfusion occurs primarily during
ventricular diastole when the myocardium relaxes and coronary vascular resistance is lowest,
allowing maximal blood flow to the heart muscle.
• 8. Which of the following is the correct formula for calculating cardiac output?
A) Heart rate × Stroke volume
B) Heart rate × Blood pressure
C) Stroke volume × Peripheral resistance
D) Cardiac index × Body surface area
🔴🔴 A) Heart rate × Stroke volume — Cardiac output (CO) is the volume of blood
pumped by the heart per minute, calculated as heart rate (beats/min) multiplied by stroke
volume (mL/beat).
• 9. The jugular venous pressure (JVP) is an indirect measure of:
A) Left ventricular function
B) Right atrial pressure
C) Aortic valve competence
D) Pulmonary artery pressure
🔴🔴 B) Right atrial pressure — The JVP reflects pressure in the right atrium and central
venous pressure. Elevated JVP suggests right-sided heart failure, fluid overload, or
constrictive pericarditis.
• 10. Which of the following ECG leads provides the best view of the inferior wall of the left
ventricle?
A) V1–V2
B) V3–V4
C) Leads II, III, and aVF
D) Leads I, aVL, V5–V6
🔴🔴 C) Leads II, III, and aVF — The inferior leads (II, III, aVF) view the inferior wall of the
left ventricle, which is supplied by the right coronary artery in most individuals.
• 11. The preload of the heart is best defined as:
A) The resistance the ventricle must overcome to eject blood
B) The volume of blood in the ventricle at end-diastole
C) The force of myocardial contraction
D) The pressure generated during ventricular systole
🔴🔴 B) The volume of blood in the ventricle at end-diastole — Preload represents the
degree of myocardial stretch before contraction, determined by venous return and end-
diastolic volume.
• 12. Afterload is primarily determined by:
A) Heart rate
B) Stroke volume
C) Systemic vascular resistance
D) Venous return
, 🔴🔴 C) Systemic vascular resistance — Afterload is the resistance the left ventricle must
overcome to eject blood, primarily determined by systemic vascular resistance and aortic
impedance.
• 13. Which of the following is a normal finding in the cardiovascular assessment of an older
adult?
A) Visible carotid artery pulsations
B) S4 heart sound
C) Bilateral pitting edema
D) Jugular venous distention at 45 degrees
🔴🔴 B) S4 heart sound — An S4 (atrial gallop) may be a normal finding in older adults
due to decreased ventricular compliance, though it can also indicate pathological conditions
such as hypertension or ischemic heart disease.
• 14. The dicrotic notch on an arterial pressure waveform corresponds to:
A) Opening of the aortic valve
B) Closure of the aortic valve
C) Opening of the mitral valve
D) Closure of the mitral valve
🔴🔴 B) Closure of the aortic valve — The dicrotic notch represents the brief increase in
aortic pressure upon closure of the aortic valve, marking the onset of diastole.
• 15. Which of the following statements about the cardiac conduction system is correct?
A) The SA node is located in the interventricular septum
B) The AV node serves as the primary pacemaker of the heart
C) The Bundle of His transmits impulses from the AV node to the ventricles
D) Purkinje fibers are located in the atria
🔴🔴 C) The Bundle of His transmits impulses from the AV node to the ventricles — The
Bundle of His is the only electrical connection between the atria and ventricles, transmitting
impulses from the AV node to the bundle branches and Purkinje fibers.
• 16. A patient presents with a blood pressure of 150/92 mmHg. The pulse pressure is:
A) 58 mmHg
B) 92 mmHg
C) 150 mmHg
D) 242 mmHg
🔴🔴 A) 58 mmHg — Pulse pressure is calculated as systolic pressure minus diastolic
pressure (150 − 92 = 58 mmHg). Normal pulse pressure is approximately 40 mmHg.
• 17. Which of the following arteries is most commonly used to assess pulse in an adult during
a routine physical examination?
A) Femoral artery
B) Popliteal artery
C) Radial artery
D) Dorsalis pedis artery
🔴🔴 C) Radial artery — The radial artery at the wrist is the most commonly used site for
assessing pulse rate and rhythm due to its superficial location and ease of access.
University | 2026–2027 | Nursing Lecture Knowledge Check
Questions and Answers
Comprehensive Examination: Peripheral Vascular, Lymphatic, and
Cardiovascular Assessment
Academic Level: Graduate Nursing (Advanced Practice)
Difficulty: Advanced/Hard
Total Questions: 150 Multiple-Choice
Primary References: Bates' Guide to Physical Examination & History Taking, Bickley's Physical
Examination & Health Assessment, Current Nursing Practice Standards
Table of Contents
Section Topic Area Questions
I Cardiovascular Anatomy and Physiology 1–20
Cardiac Assessment Techniques (Inspection, Palpation,
II 21–40
Percussion, Auscultation)
III Heart Sounds and Murmurs 41–60
IV Peripheral Vascular System Assessment 61–80
V Arterial and Venous Disorders 81–100
VI Lymphatic System Assessment 101–120
VII Advanced Clinical Scenarios and Differential Diagnosis 121–140
VIII Integration and Comprehensive Application 141–150
Section I: Cardiovascular Anatomy and Physiology (Questions 1–
20)
• 1. Which blood vessels serve to pump blood from the heart and, due to their elastic fibers,
allow for stretching with recoil during the cardiac cycle?
A) Veins
B) Capillaries
C) Arteries
D) Venules
🔴🔴 C) Arteries — Arteries are thick-walled vessels with elastic fibers that enable them to
stretch during systole and recoil during diastole, maintaining continuous blood flow. Veins
are capacitance vessels, and capillaries are exchange vessels.
• 2. Which layer of the arterial wall is primarily responsible for vasoconstriction and
vasodilation?
, A) Tunica intima
B) Tunica media
C) Tunica adventitia
D) Endothelium
🔴🔴 B) Tunica media — The tunica media contains smooth muscle and elastic fibers; its
contraction and relaxation regulate vessel diameter and peripheral vascular resistance.
• 3. The point of maximal impulse (PMI) in a healthy adult is normally located at which
intercostal space and anatomical landmark?
A) 2nd intercostal space, left sternal border
B) 4th intercostal space, midclavicular line
C) 5th intercostal space, midclavicular line
D) 6th intercostal space, anterior axillary line
🔴🔴 C) 5th intercostal space, midclavicular line — The PMI, also known as the apical
impulse, is normally palpated at the 5th intercostal space in the left midclavicular line,
corresponding to the left ventricular apex.
• 4. Which heart valve separates the left ventricle from the aorta?
A) Mitral valve
B) Tricuspid valve
C) Pulmonic valve
D) Aortic valve
🔴🔴 D) Aortic valve — The aortic valve is a semilunar valve located between the left
ventricle and the aorta, preventing backflow of blood into the left ventricle during diastole.
• 5. During the cardiac cycle, the S1 heart sound ("lub") is produced primarily by:
A) Closure of the semilunar valves
B) Closure of the atrioventricular valves
C) Opening of the atrioventricular valves
D) Turbulent flow through the aorta
🔴🔴 B) Closure of the atrioventricular valves — S1 corresponds to the closure of the
mitral and tricuspid valves at the beginning of ventricular systole. It is loudest at the apex.
• 6. Which of the following correctly describes the pathway of blood flow through the heart?
A) Right atrium → tricuspid valve → right ventricle → pulmonic valve → lungs
B) Right atrium → mitral valve → right ventricle → aortic valve → lungs
C) Left atrium → tricuspid valve → left ventricle → pulmonic valve → body
D) Left atrium → aortic valve → left ventricle → mitral valve → body
🔴🔴 A) Right atrium → tricuspid valve → right ventricle → pulmonic valve → lungs —
Deoxygenated blood enters the right atrium, passes through the tricuspid valve to the right
ventricle, and exits through the pulmonic valve to the pulmonary arteries for oxygenation.
• 7. The coronary arteries receive blood during which phase of the cardiac cycle?
A) Ventricular systole
B) Ventricular diastole
C) Atrial systole
, D) Isovolumetric contraction
🔴🔴 B) Ventricular diastole — Coronary artery perfusion occurs primarily during
ventricular diastole when the myocardium relaxes and coronary vascular resistance is lowest,
allowing maximal blood flow to the heart muscle.
• 8. Which of the following is the correct formula for calculating cardiac output?
A) Heart rate × Stroke volume
B) Heart rate × Blood pressure
C) Stroke volume × Peripheral resistance
D) Cardiac index × Body surface area
🔴🔴 A) Heart rate × Stroke volume — Cardiac output (CO) is the volume of blood
pumped by the heart per minute, calculated as heart rate (beats/min) multiplied by stroke
volume (mL/beat).
• 9. The jugular venous pressure (JVP) is an indirect measure of:
A) Left ventricular function
B) Right atrial pressure
C) Aortic valve competence
D) Pulmonary artery pressure
🔴🔴 B) Right atrial pressure — The JVP reflects pressure in the right atrium and central
venous pressure. Elevated JVP suggests right-sided heart failure, fluid overload, or
constrictive pericarditis.
• 10. Which of the following ECG leads provides the best view of the inferior wall of the left
ventricle?
A) V1–V2
B) V3–V4
C) Leads II, III, and aVF
D) Leads I, aVL, V5–V6
🔴🔴 C) Leads II, III, and aVF — The inferior leads (II, III, aVF) view the inferior wall of the
left ventricle, which is supplied by the right coronary artery in most individuals.
• 11. The preload of the heart is best defined as:
A) The resistance the ventricle must overcome to eject blood
B) The volume of blood in the ventricle at end-diastole
C) The force of myocardial contraction
D) The pressure generated during ventricular systole
🔴🔴 B) The volume of blood in the ventricle at end-diastole — Preload represents the
degree of myocardial stretch before contraction, determined by venous return and end-
diastolic volume.
• 12. Afterload is primarily determined by:
A) Heart rate
B) Stroke volume
C) Systemic vascular resistance
D) Venous return
, 🔴🔴 C) Systemic vascular resistance — Afterload is the resistance the left ventricle must
overcome to eject blood, primarily determined by systemic vascular resistance and aortic
impedance.
• 13. Which of the following is a normal finding in the cardiovascular assessment of an older
adult?
A) Visible carotid artery pulsations
B) S4 heart sound
C) Bilateral pitting edema
D) Jugular venous distention at 45 degrees
🔴🔴 B) S4 heart sound — An S4 (atrial gallop) may be a normal finding in older adults
due to decreased ventricular compliance, though it can also indicate pathological conditions
such as hypertension or ischemic heart disease.
• 14. The dicrotic notch on an arterial pressure waveform corresponds to:
A) Opening of the aortic valve
B) Closure of the aortic valve
C) Opening of the mitral valve
D) Closure of the mitral valve
🔴🔴 B) Closure of the aortic valve — The dicrotic notch represents the brief increase in
aortic pressure upon closure of the aortic valve, marking the onset of diastole.
• 15. Which of the following statements about the cardiac conduction system is correct?
A) The SA node is located in the interventricular septum
B) The AV node serves as the primary pacemaker of the heart
C) The Bundle of His transmits impulses from the AV node to the ventricles
D) Purkinje fibers are located in the atria
🔴🔴 C) The Bundle of His transmits impulses from the AV node to the ventricles — The
Bundle of His is the only electrical connection between the atria and ventricles, transmitting
impulses from the AV node to the bundle branches and Purkinje fibers.
• 16. A patient presents with a blood pressure of 150/92 mmHg. The pulse pressure is:
A) 58 mmHg
B) 92 mmHg
C) 150 mmHg
D) 242 mmHg
🔴🔴 A) 58 mmHg — Pulse pressure is calculated as systolic pressure minus diastolic
pressure (150 − 92 = 58 mmHg). Normal pulse pressure is approximately 40 mmHg.
• 17. Which of the following arteries is most commonly used to assess pulse in an adult during
a routine physical examination?
A) Femoral artery
B) Popliteal artery
C) Radial artery
D) Dorsalis pedis artery
🔴🔴 C) Radial artery — The radial artery at the wrist is the most commonly used site for
assessing pulse rate and rhythm due to its superficial location and ease of access.
