1
NU
NU650 FINAL TEST EXAM QUESTIONS
AND ANSWERS UPDATED (2024/2025)
(VERIFIED ANSWERS)
Displacement of the PMI lateral to the midclavicular line or greater than
10cm lateral to the midsternal line suggests: - ANS ✓Left ventricular
hypertension Ventricular dilation from MI or heart failure
atrioventricular valves - ANS ✓mitral and tricuspid
semilunar valves - ANS ✓pulmonary and aortic
S1 heart sound - ANS ✓closure of AV valves (mitral and tricuspid), systole
Systolic blood pressure - ANS ✓Normally corresponds with maximal left
ventricular pressure
S2 heart sound - ANS ✓closure of aortic and pulmonic valves during diastole;
best heard at left 2nd/3rd ICS
NU650
, 2
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Mitral stenosis murmur - ANS ✓disastolic rumble at apex and/or opening snap
S3 heart sound - ANS ✓In children and YA may arise from rapid deceleration of
column of blood against the ventricular wall In older adults usually indicates a
pathologic change in ventricular compliance
S4 heart sound - ANS ✓Not often heard in normal adults Marks atrial
contraction
Right sided cardiac events usually occur - ANS ✓slightly later than left sided
Aortic valve sound location - ANS ✓2nd intercostal space, right sternal border
Pulmonic valve sound location - ANS ✓2nd intercostal space, left sternal
border
Tricuspid valve sound location - ANS ✓4th intercostal space, left sternal
border
Mitral valve sound location - ANS ✓5th intercostal space, midclavicular line
P wave - ANS ✓atrial depolarization
NU650
, 3
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QRS compels - ANS ✓ventricular depolarization
Q wave - ANS ✓downward deflection from septal depolarization
R wave - ANS ✓upward deflection from ventricular depolarization
S wave
Downward deflection after R wave
S wave - ANS ✓Downward deflection after R wave
T wave - ANS ✓ventricular repolarization
acute aortic dissection - ANS ✓may appear to be abdominal pain due to lower
back pain; presents as a "tearing" pain
Where is JVP best assessed - ANS ✓-pulsations in the right internal jugular vein
which is directly in line with the superior vena cava and right atrium
Abnormal JVP Measurement - ANS ✓>3 cm above sternal angle>8 cm above
right atrium
Elevated JVP - ANS ✓-Acute and chronic heart failure
-Tricuspid stenosis
NU650
, 4
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-Chronic pulmonary stenosis
-Superior vena cava obstruction
-Cardiac tamponade
-Constrictive pericarditis
Pediatric PMI - ANS ✓Usually at the fourth intercostal space lateral to the
midclavicular line, so closer to the sternum until about age four Four to six years
old, it is at the fourth intercostal space, midclavicular line until the child grows a
little bit and moves into the fifth intercostal space
Murmur Grades - ANS ✓Grade 1 murmur is barely audible,
Grade 2 murmur is louder
Grade 3 murmur is loud but not accompanied by a thrill
Grade 4 murmur is loud and associated with a palpable thrill
Grade 5 murmur is associated with a thrill, and the murmur can be heard with
the stethoscope partially off the chest.
Harsh sounding murmur - ANS ✓Usually related to aortic stenosis
Pitch of murmur - ANS ✓high (sharp/blowing), medium, low (dull/humming)
Position to assess mitral stenosis - ANS ✓left lateral decubitus
NU650
NU
NU650 FINAL TEST EXAM QUESTIONS
AND ANSWERS UPDATED (2024/2025)
(VERIFIED ANSWERS)
Displacement of the PMI lateral to the midclavicular line or greater than
10cm lateral to the midsternal line suggests: - ANS ✓Left ventricular
hypertension Ventricular dilation from MI or heart failure
atrioventricular valves - ANS ✓mitral and tricuspid
semilunar valves - ANS ✓pulmonary and aortic
S1 heart sound - ANS ✓closure of AV valves (mitral and tricuspid), systole
Systolic blood pressure - ANS ✓Normally corresponds with maximal left
ventricular pressure
S2 heart sound - ANS ✓closure of aortic and pulmonic valves during diastole;
best heard at left 2nd/3rd ICS
NU650
, 2
NU
Mitral stenosis murmur - ANS ✓disastolic rumble at apex and/or opening snap
S3 heart sound - ANS ✓In children and YA may arise from rapid deceleration of
column of blood against the ventricular wall In older adults usually indicates a
pathologic change in ventricular compliance
S4 heart sound - ANS ✓Not often heard in normal adults Marks atrial
contraction
Right sided cardiac events usually occur - ANS ✓slightly later than left sided
Aortic valve sound location - ANS ✓2nd intercostal space, right sternal border
Pulmonic valve sound location - ANS ✓2nd intercostal space, left sternal
border
Tricuspid valve sound location - ANS ✓4th intercostal space, left sternal
border
Mitral valve sound location - ANS ✓5th intercostal space, midclavicular line
P wave - ANS ✓atrial depolarization
NU650
, 3
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QRS compels - ANS ✓ventricular depolarization
Q wave - ANS ✓downward deflection from septal depolarization
R wave - ANS ✓upward deflection from ventricular depolarization
S wave
Downward deflection after R wave
S wave - ANS ✓Downward deflection after R wave
T wave - ANS ✓ventricular repolarization
acute aortic dissection - ANS ✓may appear to be abdominal pain due to lower
back pain; presents as a "tearing" pain
Where is JVP best assessed - ANS ✓-pulsations in the right internal jugular vein
which is directly in line with the superior vena cava and right atrium
Abnormal JVP Measurement - ANS ✓>3 cm above sternal angle>8 cm above
right atrium
Elevated JVP - ANS ✓-Acute and chronic heart failure
-Tricuspid stenosis
NU650
, 4
NU
-Chronic pulmonary stenosis
-Superior vena cava obstruction
-Cardiac tamponade
-Constrictive pericarditis
Pediatric PMI - ANS ✓Usually at the fourth intercostal space lateral to the
midclavicular line, so closer to the sternum until about age four Four to six years
old, it is at the fourth intercostal space, midclavicular line until the child grows a
little bit and moves into the fifth intercostal space
Murmur Grades - ANS ✓Grade 1 murmur is barely audible,
Grade 2 murmur is louder
Grade 3 murmur is loud but not accompanied by a thrill
Grade 4 murmur is loud and associated with a palpable thrill
Grade 5 murmur is associated with a thrill, and the murmur can be heard with
the stethoscope partially off the chest.
Harsh sounding murmur - ANS ✓Usually related to aortic stenosis
Pitch of murmur - ANS ✓high (sharp/blowing), medium, low (dull/humming)
Position to assess mitral stenosis - ANS ✓left lateral decubitus
NU650
