Health Assessment Exam 3 test bank questions
with answers
While auscultating the heart at the third intercostal space, left sternal border, the nurse note
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
s a high-
cx cx
pitched, scratchy sound that increases with exhalation with the client leaning forward. The
cx cx cx cx cx cx cx cx cx cx cx cx cx
nurse would document which of the following?
cx cx cx cx cx cx
A) Pericardial friction rub
cx cx cx
B) Midsystolic click
cx cx
C) Summation gallop
cx cx
D) Aortic ejection click - ans-A) Pericardial friction rub
cx cx cx cx cxcx cx cx cx
During chest auscultation, the nurse hears a quiet murmur immediately upon placing the st
cx cx cx cx cx cx cx cx cx cx cx cx cx
ethoscope on the client's chest. The nurse interprets this as which grade?
cx cx cx cx cx cx cx cx cx cx cx
A) I cx
B) II cx
C) III cx
D) IV - ans-B) II
cx cx cxcx cx
After teaching a group of students about blood flow through the heart, the instructor determi
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
nes that the teaching was successful when the students state that after being received by th
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
e atria, the blood goes to which of the following?
cx cx cx cx cx cx cx cx cx
A) Chordae tendineae
cx cx
B) Ventricles
cx
C) Semilunar valves
cx cx
D) Precordium - ans-B) Ventricles
cx cx cxcx cx
A group of students is reviewing the structures of the heart, noting that the thickest layer of t
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
he heart is made up of contractile muscle cells. The students are correct in identifying it as w
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
hich of the following? cx cx cx
A) Myocardium
cx
B) Epicardium
cx
C) Endocardium
cx
D) Pericardium - ans-A) Myocardium
cx cx cxcx cx
A nursing student is reviewing the electrical conduction of the heart. The student is correct i
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
n identifying the sinoatrial node of the heart as which of the following?
cx cx cx cx cx cx cx cx cx cx cx cx
A) Bundle of His
cx cx cx
B) Purkinje fibers
cx cx
C) Pacemaker
cx
D) Conduction system - ans-C) Pacemaker
cx cx cx cxcx cx
,The nurse is assessing a client's first heart sound. The nurse interprets this finding as indica
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ting which heart action?
cx cx cx
A) Isometric contraction
cx cx
B) Closure of the semilunar valves
cx cx cx cx cx
C) Beginning of diastole
cx cx cx
D) Closure of the atrioventricular valves - ans-d
cx cx cx cx cx cx cxcx
A nurse assesses a client's jugular venous pulse to gather information about which of the fo
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
llowing?
A) Left arterial pressure.
cx cx cx
B) Left ventricular diastolic filling.
cx cx cx cx
C) Right ventricular pressure.
cx cx cx
D) Hemodynamics of the right side of the heart. - ans-d
cx cx cx cx cx cx cx cx cx cxcx
On examination, the nurse would expect what finding if a client is in right-sided failure?
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
A) Increased jugular venous pressure
cx cx cx cx
B) Decreased right-sided volume
cx cx cx
C) Decreased central venous pressure
cx cx cx cx
D) Decreased stroke volume - ans-a
cx cx cx cx cxcx
A client presents with chest pain described as a pressure and squeezing sensation that is st
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
eady and severe. The nurse would suspect which system as the most likely source?
cx cx cx cx cx cx cx cx cx cx cx cx cx
A) Cardiac
cx
B) Gastrointestinal
cx
C) Musculoskeletal
cx
D) Pulmonary - ans-a
cx cx cxcx
A client complains of palpitations and a feeling of anxiety. Which of the following would be m
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ost appropriate for the nurse to keep in mind?
cx cx cx cx cx cx cx cx
A) This is a normal response by the heart's conduction system.
cx cx cx cx cx cx cx cx cx cx
B) This is the body's response to an increase in cardiac output.
cx cx cx cx cx cx cx cx cx cx cx
C) The heart is attempting to increase cardiac output.
cx cx cx cx cx cx cx cx
D) The heart is responding to increased renal perfusion. - ans-c
cx cx cx cx cx cx cx cx cx cxcx
Which of the following would the nurse suspect when a client with a cardiac condition compl
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ains of not sleeping well and having to get up frequently at night to urinate?
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
A) This indicates the heart is working efficiently.
cx cx cx cx cx cx cx
B) Increased urination at rest may indicate heart failure.
cx cx cx cx cx cx cx cx
C) The client has decreased performance levels of activities of daily living.
cx cx cx cx cx cx cx cx cx cx cx
D) The client most likely sleeps without a pillow at night. - ans-b
cx cx cx cx cx cx cx cx cx cx cx cxcx
When auscultating the left carotid artery, the nurse notes a swishing sound. The nurse inter
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
prets this finding as suggesting which of the following?
cx cx cx cx cx cx cx cx
A) Decreased cardiac output
cx cx cx
B) Increased central venous pressure
cx cx cx cx
, C) A narrowed vessel
cx cx cx
D) Right ventricular failure - ans-b
cx cx cx cx cxcx
Which technique would be most appropriate to use when examining the jugular venous pul
cx cx cx cx cx cx cx cx cx cx cx cx cx
se?
A) Perform the exam with the client in a supine position.
cx cx cx cx cx cx cx cx cx cx
B) Have the client look straight ahead with chin slightly lifted.
cx cx cx cx cx cx cx cx cx cx
C) Have the client sit up at a 90-degree angle.
cx cx cx cx cx cx cx cx cx
D) Inspect the suprasternal notch or around the clavicles. - ans-d
cx cx cx cx cx cx cx cx cx cxcx
The nurse is preparing to assess a client's apical impulse. The nurse would palpate at whic
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
h location?
cx
A) Second intercostal space, left sternal border
cx cx cx cx cx cx
B) Third intercostal space, left axillary line
cx cx cx cx cx cx
C) Fourth intercostal space, left sternal border
cx cx cx cx cx cx
D) Fifth intercostal space, left midclavicular line - ans-d
cx cx cx cx cx cx cx cxcx
A nurse is preparing a presentation for a local community group about coronary artery dise
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ase and culture. Which information would the nurse include?
cx cx cx cx cx cx cx cx
A) Caucasians take higher lifestyle risks than African Americans.
cx cx cx cx cx cx cx cx
B) Hypertension is more prevalent in African Americans.
cx cx cx cx cx cx cx
C) Hypertension is seen more in white women than in African-American women.
cx cx cx cx cx cx cx cx cx cx cx
D) Hispanic Americans have a higher rate of coronary artery disease than white Americans
cx cx cx cx cx cx cx cx cx cx cx cx cx
. - ans-b
cx cxcx
A nurse auscultates a client's heart sounds and notes an accentuated first heart sound. The
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
nurse would suspect which of the following?
cx cx cx cx cx cx cx
A) Hypothyroidismcx
B) Fever cx
C) Mitral stenosiscx cx
D) Heart murmur - ans-c
cx cx cx cxcx
Which characteristic of the first heart sound would the nurse expect to hear in a client with m
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
itral insufficiency? cx
A) Split cx
B) Diminished cx
C) Accentuated cx
D) Varying - ans-bcx cx cxcx
A nurse suspects that a client may have a pericardial friction rub. To ensure that the nurse h
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ears this, the nurse would place the client in which position?
cx cx cx cx cx cx cx cx cx cx
A) Supine with head of bed elevated 30 degrees
cx cx cx cx cx cx cx cx
B) Leaning forward while in a sitting position
cx cx cx cx cx cx cx
C) Flat, left lateral
cx cx cx
D) Sitting upright in a straight back chair - ans-b
cx cx cx cx cx cx cx cx cxcx
with answers
While auscultating the heart at the third intercostal space, left sternal border, the nurse note
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
s a high-
cx cx
pitched, scratchy sound that increases with exhalation with the client leaning forward. The
cx cx cx cx cx cx cx cx cx cx cx cx cx
nurse would document which of the following?
cx cx cx cx cx cx
A) Pericardial friction rub
cx cx cx
B) Midsystolic click
cx cx
C) Summation gallop
cx cx
D) Aortic ejection click - ans-A) Pericardial friction rub
cx cx cx cx cxcx cx cx cx
During chest auscultation, the nurse hears a quiet murmur immediately upon placing the st
cx cx cx cx cx cx cx cx cx cx cx cx cx
ethoscope on the client's chest. The nurse interprets this as which grade?
cx cx cx cx cx cx cx cx cx cx cx
A) I cx
B) II cx
C) III cx
D) IV - ans-B) II
cx cx cxcx cx
After teaching a group of students about blood flow through the heart, the instructor determi
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
nes that the teaching was successful when the students state that after being received by th
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
e atria, the blood goes to which of the following?
cx cx cx cx cx cx cx cx cx
A) Chordae tendineae
cx cx
B) Ventricles
cx
C) Semilunar valves
cx cx
D) Precordium - ans-B) Ventricles
cx cx cxcx cx
A group of students is reviewing the structures of the heart, noting that the thickest layer of t
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
he heart is made up of contractile muscle cells. The students are correct in identifying it as w
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
hich of the following? cx cx cx
A) Myocardium
cx
B) Epicardium
cx
C) Endocardium
cx
D) Pericardium - ans-A) Myocardium
cx cx cxcx cx
A nursing student is reviewing the electrical conduction of the heart. The student is correct i
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
n identifying the sinoatrial node of the heart as which of the following?
cx cx cx cx cx cx cx cx cx cx cx cx
A) Bundle of His
cx cx cx
B) Purkinje fibers
cx cx
C) Pacemaker
cx
D) Conduction system - ans-C) Pacemaker
cx cx cx cxcx cx
,The nurse is assessing a client's first heart sound. The nurse interprets this finding as indica
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ting which heart action?
cx cx cx
A) Isometric contraction
cx cx
B) Closure of the semilunar valves
cx cx cx cx cx
C) Beginning of diastole
cx cx cx
D) Closure of the atrioventricular valves - ans-d
cx cx cx cx cx cx cxcx
A nurse assesses a client's jugular venous pulse to gather information about which of the fo
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
llowing?
A) Left arterial pressure.
cx cx cx
B) Left ventricular diastolic filling.
cx cx cx cx
C) Right ventricular pressure.
cx cx cx
D) Hemodynamics of the right side of the heart. - ans-d
cx cx cx cx cx cx cx cx cx cxcx
On examination, the nurse would expect what finding if a client is in right-sided failure?
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
A) Increased jugular venous pressure
cx cx cx cx
B) Decreased right-sided volume
cx cx cx
C) Decreased central venous pressure
cx cx cx cx
D) Decreased stroke volume - ans-a
cx cx cx cx cxcx
A client presents with chest pain described as a pressure and squeezing sensation that is st
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
eady and severe. The nurse would suspect which system as the most likely source?
cx cx cx cx cx cx cx cx cx cx cx cx cx
A) Cardiac
cx
B) Gastrointestinal
cx
C) Musculoskeletal
cx
D) Pulmonary - ans-a
cx cx cxcx
A client complains of palpitations and a feeling of anxiety. Which of the following would be m
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ost appropriate for the nurse to keep in mind?
cx cx cx cx cx cx cx cx
A) This is a normal response by the heart's conduction system.
cx cx cx cx cx cx cx cx cx cx
B) This is the body's response to an increase in cardiac output.
cx cx cx cx cx cx cx cx cx cx cx
C) The heart is attempting to increase cardiac output.
cx cx cx cx cx cx cx cx
D) The heart is responding to increased renal perfusion. - ans-c
cx cx cx cx cx cx cx cx cx cxcx
Which of the following would the nurse suspect when a client with a cardiac condition compl
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ains of not sleeping well and having to get up frequently at night to urinate?
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
A) This indicates the heart is working efficiently.
cx cx cx cx cx cx cx
B) Increased urination at rest may indicate heart failure.
cx cx cx cx cx cx cx cx
C) The client has decreased performance levels of activities of daily living.
cx cx cx cx cx cx cx cx cx cx cx
D) The client most likely sleeps without a pillow at night. - ans-b
cx cx cx cx cx cx cx cx cx cx cx cxcx
When auscultating the left carotid artery, the nurse notes a swishing sound. The nurse inter
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
prets this finding as suggesting which of the following?
cx cx cx cx cx cx cx cx
A) Decreased cardiac output
cx cx cx
B) Increased central venous pressure
cx cx cx cx
, C) A narrowed vessel
cx cx cx
D) Right ventricular failure - ans-b
cx cx cx cx cxcx
Which technique would be most appropriate to use when examining the jugular venous pul
cx cx cx cx cx cx cx cx cx cx cx cx cx
se?
A) Perform the exam with the client in a supine position.
cx cx cx cx cx cx cx cx cx cx
B) Have the client look straight ahead with chin slightly lifted.
cx cx cx cx cx cx cx cx cx cx
C) Have the client sit up at a 90-degree angle.
cx cx cx cx cx cx cx cx cx
D) Inspect the suprasternal notch or around the clavicles. - ans-d
cx cx cx cx cx cx cx cx cx cxcx
The nurse is preparing to assess a client's apical impulse. The nurse would palpate at whic
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
h location?
cx
A) Second intercostal space, left sternal border
cx cx cx cx cx cx
B) Third intercostal space, left axillary line
cx cx cx cx cx cx
C) Fourth intercostal space, left sternal border
cx cx cx cx cx cx
D) Fifth intercostal space, left midclavicular line - ans-d
cx cx cx cx cx cx cx cxcx
A nurse is preparing a presentation for a local community group about coronary artery dise
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ase and culture. Which information would the nurse include?
cx cx cx cx cx cx cx cx
A) Caucasians take higher lifestyle risks than African Americans.
cx cx cx cx cx cx cx cx
B) Hypertension is more prevalent in African Americans.
cx cx cx cx cx cx cx
C) Hypertension is seen more in white women than in African-American women.
cx cx cx cx cx cx cx cx cx cx cx
D) Hispanic Americans have a higher rate of coronary artery disease than white Americans
cx cx cx cx cx cx cx cx cx cx cx cx cx
. - ans-b
cx cxcx
A nurse auscultates a client's heart sounds and notes an accentuated first heart sound. The
cx cx cx cx cx cx cx cx cx cx cx cx cx cx
nurse would suspect which of the following?
cx cx cx cx cx cx cx
A) Hypothyroidismcx
B) Fever cx
C) Mitral stenosiscx cx
D) Heart murmur - ans-c
cx cx cx cxcx
Which characteristic of the first heart sound would the nurse expect to hear in a client with m
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
itral insufficiency? cx
A) Split cx
B) Diminished cx
C) Accentuated cx
D) Varying - ans-bcx cx cxcx
A nurse suspects that a client may have a pericardial friction rub. To ensure that the nurse h
cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx cx
ears this, the nurse would place the client in which position?
cx cx cx cx cx cx cx cx cx cx
A) Supine with head of bed elevated 30 degrees
cx cx cx cx cx cx cx cx
B) Leaning forward while in a sitting position
cx cx cx cx cx cx cx
C) Flat, left lateral
cx cx cx
D) Sitting upright in a straight back chair - ans-b
cx cx cx cx cx cx cx cx cxcx
