CHAPTER 31: ASSESSMENT:
CARDIOVASCULAR SYSTEM HARDING:
LEWIS'S MEDICAL-SURGICAL
NURSING. EXAM 2025 QUESTIONS AND
ANSWERS
1. An older adult patient who has just arrived in the emergency department has a pulse deficit
of 46 beats. The nurse should expect that the patient may require:
a. cardiac catheterization.
b. emergent cardioversion.
c. hourly blood pressure checks.
d. electrocardiographic monitoring. - ANS ANS: D
Pulse deficit is a difference between simultaneously obtained apical and radial pulses. It
indicates that there may be a cardiac dysrhythmia that would best be detected with ECG
monitoring. Frequent BP monitoring, cardiac catheterization, and emergent cardioversion are
used for diagnosis and/or treatment of cardiovascular disorders but would not be as helpful in
determining the immediate reason for the pulse deficit.
1 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
, 2. The nurse is reviewing the 12-lead electrocardiograph (ECG) for a healthy older adult patient
who is having an annual physical examination. What finding should be of most concern to the
nurse?
a. A right bundle branch block.
b. The PR interval is 0.21 seconds.
c. The QRS duration is 0.13 seconds.
d. The heart rate (HR) is 41 beats/min. - ANS ANS: D
The resting HR does not change with aging, so the decrease in HR needs further investigation.
Bundle branch block and slight increases in PR interval or QRS duration are common in older
individuals because of increases in conduction time through the AV node, bundle of His, and
bundle branches
3. During a physical examination of an older patient, the nurse palpates the point of maximal
impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. What would be
the most focused follow-up action for the nurse to take?
a. Ask about risk factors for atherosclerosis.
b. Determine family history of heart disease.
c. Assess for symptoms of left ventricular hypertrophy.
2 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
CARDIOVASCULAR SYSTEM HARDING:
LEWIS'S MEDICAL-SURGICAL
NURSING. EXAM 2025 QUESTIONS AND
ANSWERS
1. An older adult patient who has just arrived in the emergency department has a pulse deficit
of 46 beats. The nurse should expect that the patient may require:
a. cardiac catheterization.
b. emergent cardioversion.
c. hourly blood pressure checks.
d. electrocardiographic monitoring. - ANS ANS: D
Pulse deficit is a difference between simultaneously obtained apical and radial pulses. It
indicates that there may be a cardiac dysrhythmia that would best be detected with ECG
monitoring. Frequent BP monitoring, cardiac catheterization, and emergent cardioversion are
used for diagnosis and/or treatment of cardiovascular disorders but would not be as helpful in
determining the immediate reason for the pulse deficit.
1 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
, 2. The nurse is reviewing the 12-lead electrocardiograph (ECG) for a healthy older adult patient
who is having an annual physical examination. What finding should be of most concern to the
nurse?
a. A right bundle branch block.
b. The PR interval is 0.21 seconds.
c. The QRS duration is 0.13 seconds.
d. The heart rate (HR) is 41 beats/min. - ANS ANS: D
The resting HR does not change with aging, so the decrease in HR needs further investigation.
Bundle branch block and slight increases in PR interval or QRS duration are common in older
individuals because of increases in conduction time through the AV node, bundle of His, and
bundle branches
3. During a physical examination of an older patient, the nurse palpates the point of maximal
impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. What would be
the most focused follow-up action for the nurse to take?
a. Ask about risk factors for atherosclerosis.
b. Determine family history of heart disease.
c. Assess for symptoms of left ventricular hypertrophy.
2 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
