NU 518 Exam 2 Practice Questions & Answers:
Core Physical Systems (Verified Update)
This comprehensive study guide covers the core domains tested on NU 518 Exam
2: Core Physical Systems at the University of South Alabama. It includes original
practice questions with detailed rationales, organized by topic: Cardiac
Examination (JVP, Heart Sounds, Murmurs), Blood Pressure Classification,
Peripheral Vascular Assessment, and Systemic Evaluations.
The exam concentrates on cardiac examinations (JVP measurement, heart
murmur identification and grading, heart sounds), blood pressure classifications
per the 2025 ACC/AHA guidelines, and basic systemic evaluations of the major
body systems.
Section 1: Cardiac Examination — Jugular Venous Pressure
Q1. A nurse practitioner is measuring jugular venous pressure
(JVP) on a patient with suspected heart failure. At what angle
should the patient be positioned?
A. Supine at 0 degrees
B. Reclined at approximately 45 degrees
C. Sitting upright at 90 degrees
D. Prone position
Answer: B
Rationale: The patient should be reclined at approximately 45
degrees of elevation for proper JVP measurement. This angle
,allows the pulsation of the internal jugular vein to be visible in
the neck while avoiding engorgement from a fully supine
position or disappearance when sitting upright. The right
internal jugular vein is best examined with the patient seated at
a 45-degree angle.
Q2. What is the normal mean jugular venous pressure,
determined as the vertical distance above the midpoint of the
right atrium?
A. 2 to 4 cm H₂O
B. 6 to 8 cm H₂O
C. 10 to 12 cm H₂O
D. 14 to 16 cm H₂O
Answer: B
Rationale: The normal mean jugular venous pressure is 6 to 8
cm H₂O above the midpoint of the right atrium. Deviations from
this normal range reflect either hypovolemia (mean venous
pressure less than 5 cm H₂O) or impaired cardiac filling (mean
venous pressure greater than 9 cm H₂O).
Q3. A JVP measurement of 12 cm H₂O would most likely
indicate which of the following?
A. Hypovolemia
B. Normal venous pressure
C. Elevated right atrial pressure
D. Dehydration
,Answer: C
Rationale: An elevated JVP (≥10 cm H₂O) is the most useful
finding for assessing ventricular filling pressures. When present,
it is indicative of volume overload or impaired cardiac filling,
reflecting high right atrial pressure.
Q4. What are the three positive waves of the normal jugular
venous pulse?
A. a, c, and v waves
B. x, y, and z waves
C. s, d, and t waves
D. p, q, and r waves
Answer: A
Rationale: The normal jugular venous pulse contains three
positive waves labeled "a," "c," and "v." The a wave is generated
by atrial contraction, the c wave is caused by transmission of
the carotid arterial impulse or bulging of the tricuspid valve into
the right atrium in early systole, and the v wave reflects the
passive increase in pressure and volume of the right atrium as it
fills in late systole and early diastole.
Q5. The "a" wave of the jugular venous pulse is generated by:
A. Ventricular contraction
B. Atrial contraction
C. Closure of the aortic valve
D. Opening of the mitral valve
, Answer: B
Rationale: The a wave is generated by atrial contraction, which
actively fills the right ventricle in end-diastole. It occurs just
after the P wave of the ECG and before the carotid upstroke.
Q6. Which of the following is TRUE regarding JVP
measurement?
A. It is best heard over the pulmonic area with the bell of the
stethoscope
B. It is measured with the patient at a 45-degree angle
C. It is best heard over the apex
D. It does not vary with respiration
Answer: B
Rationale: JVP is measured with the patient reclined at
approximately 45 degrees. It is assessed by observing the right
side of the patient's neck, not by auscultation. The JVP does
vary with respiration (normally decreasing with inspiration).
Q7. The "y" descent in the jugular venous pulse represents:
A. Atrial relaxation
B. Tricuspid valve opening and right ventricular filling
C. Aortic valve closure
D. Pulmonic valve opening
Answer: B
Rationale: The y descent represents the abrupt termination of
Core Physical Systems (Verified Update)
This comprehensive study guide covers the core domains tested on NU 518 Exam
2: Core Physical Systems at the University of South Alabama. It includes original
practice questions with detailed rationales, organized by topic: Cardiac
Examination (JVP, Heart Sounds, Murmurs), Blood Pressure Classification,
Peripheral Vascular Assessment, and Systemic Evaluations.
The exam concentrates on cardiac examinations (JVP measurement, heart
murmur identification and grading, heart sounds), blood pressure classifications
per the 2025 ACC/AHA guidelines, and basic systemic evaluations of the major
body systems.
Section 1: Cardiac Examination — Jugular Venous Pressure
Q1. A nurse practitioner is measuring jugular venous pressure
(JVP) on a patient with suspected heart failure. At what angle
should the patient be positioned?
A. Supine at 0 degrees
B. Reclined at approximately 45 degrees
C. Sitting upright at 90 degrees
D. Prone position
Answer: B
Rationale: The patient should be reclined at approximately 45
degrees of elevation for proper JVP measurement. This angle
,allows the pulsation of the internal jugular vein to be visible in
the neck while avoiding engorgement from a fully supine
position or disappearance when sitting upright. The right
internal jugular vein is best examined with the patient seated at
a 45-degree angle.
Q2. What is the normal mean jugular venous pressure,
determined as the vertical distance above the midpoint of the
right atrium?
A. 2 to 4 cm H₂O
B. 6 to 8 cm H₂O
C. 10 to 12 cm H₂O
D. 14 to 16 cm H₂O
Answer: B
Rationale: The normal mean jugular venous pressure is 6 to 8
cm H₂O above the midpoint of the right atrium. Deviations from
this normal range reflect either hypovolemia (mean venous
pressure less than 5 cm H₂O) or impaired cardiac filling (mean
venous pressure greater than 9 cm H₂O).
Q3. A JVP measurement of 12 cm H₂O would most likely
indicate which of the following?
A. Hypovolemia
B. Normal venous pressure
C. Elevated right atrial pressure
D. Dehydration
,Answer: C
Rationale: An elevated JVP (≥10 cm H₂O) is the most useful
finding for assessing ventricular filling pressures. When present,
it is indicative of volume overload or impaired cardiac filling,
reflecting high right atrial pressure.
Q4. What are the three positive waves of the normal jugular
venous pulse?
A. a, c, and v waves
B. x, y, and z waves
C. s, d, and t waves
D. p, q, and r waves
Answer: A
Rationale: The normal jugular venous pulse contains three
positive waves labeled "a," "c," and "v." The a wave is generated
by atrial contraction, the c wave is caused by transmission of
the carotid arterial impulse or bulging of the tricuspid valve into
the right atrium in early systole, and the v wave reflects the
passive increase in pressure and volume of the right atrium as it
fills in late systole and early diastole.
Q5. The "a" wave of the jugular venous pulse is generated by:
A. Ventricular contraction
B. Atrial contraction
C. Closure of the aortic valve
D. Opening of the mitral valve
, Answer: B
Rationale: The a wave is generated by atrial contraction, which
actively fills the right ventricle in end-diastole. It occurs just
after the P wave of the ECG and before the carotid upstroke.
Q6. Which of the following is TRUE regarding JVP
measurement?
A. It is best heard over the pulmonic area with the bell of the
stethoscope
B. It is measured with the patient at a 45-degree angle
C. It is best heard over the apex
D. It does not vary with respiration
Answer: B
Rationale: JVP is measured with the patient reclined at
approximately 45 degrees. It is assessed by observing the right
side of the patient's neck, not by auscultation. The JVP does
vary with respiration (normally decreasing with inspiration).
Q7. The "y" descent in the jugular venous pulse represents:
A. Atrial relaxation
B. Tricuspid valve opening and right ventricular filling
C. Aortic valve closure
D. Pulmonic valve opening
Answer: B
Rationale: The y descent represents the abrupt termination of
