NR 509 MIDTERM EXAM /NR 509 MIDTERM
EXAM PREP 2025 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|LATEST
UPDATE|GUARANTEED PASS
A 77-year-old man is experiencing progressive shortness of breath and dizziness. The patient
undergoes cardiac catheterization, and the systolic blood pressure measured in the left ventricle
is 180 mm Hg, while the systolic blood pressure measured in the aorta is 140 mm Hg. The
patient is most likely experiencing symptoms related to what valvular condition?
a. Aortic insufficiency
b. Mitral stenosis
c. Aortic stenosis
d. Mitral regurgitation
e. Pulmonic stenosis
c. Aortic stenosis
On routine physical examination, a 40-year-old teacher is found to have a single second heart
sound. The most likely explanation for this finding is what?
a. Auscultation occurred during inspiration.
b. The patient has pulmonic stenosis.
c. Auscultation occurred during expiration.
d. The patient has a right bundle branch block.
e. The patient has a left bundle branch block.
c. Auscultation occurred during expiration.
A first-year medical student is examining a standardized patient with a structurally normal heart.
The student is having difficulty auscultating the splitting of the second heart sound. At what
1|Page
,area on the patient's chest would the student have the best opportunity of hearing this sound?
a. Apex
b. Right second interspace
c. Left second and third interspace
d. Lower left sternal border
e. Midsternum
c. Left second and third interspace
A 20-year-old college student is experiencing dyspnea on exertion and palpitations. On cardiac
auscultation, the second heart sound is split and fixed on both inspiration and expiration. What
is the most likely cardiac condition associated with this finding?
a. Left bundle branch block
b. Pulmonic stenosis
c. Right bundle branch block
d. Atrial septal defect
e. Tricuspid stenosis
d. Atrial septal defect
A 70-year-old retired business executive presents to the Emergency Department with
progressive shortness of breath and two-pillow orthopnea. On physical examination, the blood
pressure is 145/90 mm Hg, there is jugular venous distension, lower extremity pitting edema to
the knee, and a blowing holosystolic murmur heard best at the lower left sternal border. No
other murmurs or thrills are auscultated on physical exam. Which of the following interventions
is to most likely to improve the patient's symptoms?
a. Removal of intravascular volume with diuresis
b. Replacement of the mitral valve
c. Replacement of the aortic valve
a. Removal of intravascular volume with diuresis
A 55-year-old actress sustains a heart attack, and the follow-up electrocardiogram demonstrates
a left bundle branch block. What would be the likely duration of the QRS complex?
a. 75 milliseconds
b. 90 milliseconds
c. 95 milliseconds
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,d. 100 milliseconds
e. 125 milliseconds
e. 125 milliseconds
A 55-year-old truck driver with obstructive sleep apnea has diastolic heart failure. An
echocardiogram demonstrates significant biatrial enlargement. What portion of his
electrocardiogram would likely be abnormal?
a. QRS complex
b. R wave
c. S wave
d. P wave
e. T wave
d. P wave
A 45-year-old physician is placed on a β-blocker for hypertension. Prior to medication
administration, the patient's heart rate is 75 beats per minute with a cardiac output of 5 liters
per minute. Following initiation of the medication, the heart rate decreases to 60 beats per
minute without a change in stroke volume. What would be the expected new cardiac output?
a. 3 liters per minute
b. 4 liters per minute
c. 5 liters per minute
d. 6 liters per minute e. 10 liters per minute
b. 4 liters per minute
A 68-year-old retired administrative assistant complains of a 3-month history of recurring pain
after ambulating that radiates from her back in the upper lumbar region into both buttocks,
bilateral thighs, and mid-calf regions. Her pain is typically improved by sitting or by leaning
forward. The origin of her pain is likely secondary to which of the following?
a. Peripheral arterial disease (PAD)
b. Venous stasis
c. Acute arterial occlusion
d. Neurogenic claudication
e. Abdominal aortic aneurysm
d. Neurogenic claudication
3|Page
, A patient that has a known history of cardiovascular disease including a myocardial infarction
and positive ankle- brachial index indicating peripheral arterial disease in his left leg is now
having some issues with erectile dysfunction (ED). The clinician suspects it may be due to
medications or further vascular disease. He does not complain of any other symptoms. If his
symptoms are related to vascular disease, where would the lesion likely be located?
a. Aortorenal
b. Iliac pudendal
c. Common femoral
d. Superficial femoral
e. Popliteal
b. Iliac pudendal
A 73-year-old retired salesman presents to the Emergency Department complaining of chest
pain that started about 2 hours ago. Electrocardiogram, cardiac enzymes, and chest x-ray are
normal. The nurse notes that his blood pressures in the right arm are significantly lower than of
blood pressures in his left arm. Based on history and physical examination, which of the
following will most likely explain his signs and symptoms?
a. Dissecting aortic aneurysm
b. Coarctation of the aorta
c. Myocardial infarction (MI)
d. Pulmonary embolism (PE)
e. Pericarditis
a. Dissecting aortic aneurysm
A 19-year-old carwash attendant sustained a laceration to the ulnar aspect of his mid-forearm
while at work last week. He did not have it evaluated at that time and is now noticing purulent
discharge and increasing pain from the wound along with fever and chills. Where would the
clinician expect to find the first signs of lymphadenopathy?
a. Epitrochlear nodes
b. Lateral axillary nodes
c. Central axillary nodes
d. Infraclavicular nodes
e. Cervical chain nodes
a. Epitrochlear nodes
4|Page
EXAM PREP 2025 WITH ACTUAL CORRECT
QUESTIONS AND VERIFIED DETAILED
ANSWERS |FREQUENTLY TESTED
QUESTIONS AND SOLUTIONS|ALREADY
GRADED A+|NEWEST|LATEST
UPDATE|GUARANTEED PASS
A 77-year-old man is experiencing progressive shortness of breath and dizziness. The patient
undergoes cardiac catheterization, and the systolic blood pressure measured in the left ventricle
is 180 mm Hg, while the systolic blood pressure measured in the aorta is 140 mm Hg. The
patient is most likely experiencing symptoms related to what valvular condition?
a. Aortic insufficiency
b. Mitral stenosis
c. Aortic stenosis
d. Mitral regurgitation
e. Pulmonic stenosis
c. Aortic stenosis
On routine physical examination, a 40-year-old teacher is found to have a single second heart
sound. The most likely explanation for this finding is what?
a. Auscultation occurred during inspiration.
b. The patient has pulmonic stenosis.
c. Auscultation occurred during expiration.
d. The patient has a right bundle branch block.
e. The patient has a left bundle branch block.
c. Auscultation occurred during expiration.
A first-year medical student is examining a standardized patient with a structurally normal heart.
The student is having difficulty auscultating the splitting of the second heart sound. At what
1|Page
,area on the patient's chest would the student have the best opportunity of hearing this sound?
a. Apex
b. Right second interspace
c. Left second and third interspace
d. Lower left sternal border
e. Midsternum
c. Left second and third interspace
A 20-year-old college student is experiencing dyspnea on exertion and palpitations. On cardiac
auscultation, the second heart sound is split and fixed on both inspiration and expiration. What
is the most likely cardiac condition associated with this finding?
a. Left bundle branch block
b. Pulmonic stenosis
c. Right bundle branch block
d. Atrial septal defect
e. Tricuspid stenosis
d. Atrial septal defect
A 70-year-old retired business executive presents to the Emergency Department with
progressive shortness of breath and two-pillow orthopnea. On physical examination, the blood
pressure is 145/90 mm Hg, there is jugular venous distension, lower extremity pitting edema to
the knee, and a blowing holosystolic murmur heard best at the lower left sternal border. No
other murmurs or thrills are auscultated on physical exam. Which of the following interventions
is to most likely to improve the patient's symptoms?
a. Removal of intravascular volume with diuresis
b. Replacement of the mitral valve
c. Replacement of the aortic valve
a. Removal of intravascular volume with diuresis
A 55-year-old actress sustains a heart attack, and the follow-up electrocardiogram demonstrates
a left bundle branch block. What would be the likely duration of the QRS complex?
a. 75 milliseconds
b. 90 milliseconds
c. 95 milliseconds
2|Page
,d. 100 milliseconds
e. 125 milliseconds
e. 125 milliseconds
A 55-year-old truck driver with obstructive sleep apnea has diastolic heart failure. An
echocardiogram demonstrates significant biatrial enlargement. What portion of his
electrocardiogram would likely be abnormal?
a. QRS complex
b. R wave
c. S wave
d. P wave
e. T wave
d. P wave
A 45-year-old physician is placed on a β-blocker for hypertension. Prior to medication
administration, the patient's heart rate is 75 beats per minute with a cardiac output of 5 liters
per minute. Following initiation of the medication, the heart rate decreases to 60 beats per
minute without a change in stroke volume. What would be the expected new cardiac output?
a. 3 liters per minute
b. 4 liters per minute
c. 5 liters per minute
d. 6 liters per minute e. 10 liters per minute
b. 4 liters per minute
A 68-year-old retired administrative assistant complains of a 3-month history of recurring pain
after ambulating that radiates from her back in the upper lumbar region into both buttocks,
bilateral thighs, and mid-calf regions. Her pain is typically improved by sitting or by leaning
forward. The origin of her pain is likely secondary to which of the following?
a. Peripheral arterial disease (PAD)
b. Venous stasis
c. Acute arterial occlusion
d. Neurogenic claudication
e. Abdominal aortic aneurysm
d. Neurogenic claudication
3|Page
, A patient that has a known history of cardiovascular disease including a myocardial infarction
and positive ankle- brachial index indicating peripheral arterial disease in his left leg is now
having some issues with erectile dysfunction (ED). The clinician suspects it may be due to
medications or further vascular disease. He does not complain of any other symptoms. If his
symptoms are related to vascular disease, where would the lesion likely be located?
a. Aortorenal
b. Iliac pudendal
c. Common femoral
d. Superficial femoral
e. Popliteal
b. Iliac pudendal
A 73-year-old retired salesman presents to the Emergency Department complaining of chest
pain that started about 2 hours ago. Electrocardiogram, cardiac enzymes, and chest x-ray are
normal. The nurse notes that his blood pressures in the right arm are significantly lower than of
blood pressures in his left arm. Based on history and physical examination, which of the
following will most likely explain his signs and symptoms?
a. Dissecting aortic aneurysm
b. Coarctation of the aorta
c. Myocardial infarction (MI)
d. Pulmonary embolism (PE)
e. Pericarditis
a. Dissecting aortic aneurysm
A 19-year-old carwash attendant sustained a laceration to the ulnar aspect of his mid-forearm
while at work last week. He did not have it evaluated at that time and is now noticing purulent
discharge and increasing pain from the wound along with fever and chills. Where would the
clinician expect to find the first signs of lymphadenopathy?
a. Epitrochlear nodes
b. Lateral axillary nodes
c. Central axillary nodes
d. Infraclavicular nodes
e. Cervical chain nodes
a. Epitrochlear nodes
4|Page
