,NSG3160/NSG 3160 Exam 3 | Health
Assessment | Galen College | Q & A |
2026/2027 Edition (PDF)
1. A nurse auscultates a patient's heart and hears a split S2 that widens on inspiration and narrows on
expiration. This finding is:
A) Paradoxical splitting
B) Fixed splitting
C) Physiologic (normal) splitting
D) Reverse splitting
Correct Answer: Physiologic (normal) splitting
Rationale: Normal splitting of S2 occurs because inspiration increases venous return to the right
ventricle, delaying pulmonic valve closure, causing the split to widen on inspiration and narrow on
expiration. Fixed splitting does not vary with respiration and is seen in atrial septal defects. Paradoxical
splitting narrows on inspiration.
2. A patient with heart failure has an S3 gallop. The nurse knows that S3 is best heard with the:
A) Bell of the stethoscope at the apex, with the patient lying on the left side
B) Diaphragm at the base, with the patient sitting forward
C) Bell at the left sternal border
D) Diaphragm at the right second intercostal space
Correct Answer: Bell of the stethoscope at the apex, with the patient lying on the left side
Rationale: S3 is a low-frequency sound best heard with the bell of the stethoscope at the apex in the left
lateral decubitus position. S3 occurs during rapid ventricular filling and is often associated with heart
failure or volume overload.
,3. What causes the S1 heart sound ("Lub")?
A) Closure of the semilunar valves
B) Closure of the atrioventricular (AV) valves
C) Opening of the AV valves
D) Closure of the aortic valve
Correct Answer: Closure of the atrioventricular (AV) valves
Rationale: S1 is caused by the closure of the AV valves (mitral and tricuspid) at the start of systole. It
serves as a reference point for timing all cardiac sounds.
4. What causes the S2 heart sound ("Dub")?
A) Closure of the AV valves
B) Opening of the semilunar valves
C) Closure of the semilunar valves (aortic and pulmonic)
D) Closure of the mitral valve
Correct Answer: Closure of the semilunar valves (aortic and pulmonic)
Rationale: S2 is caused by the closure of the semilunar valves (aortic and pulmonic) at the end of systole.
It is best heard at the base of the heart.
5. The nurse auscultates a high-pitched, blowing sound immediately after S2 at the left sternal border.
This is most likely:
A) Mitral stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) Pulmonic stenosis
Correct Answer: Aortic regurgitation
, Rationale: Aortic regurgitation causes an early diastolic decrescendo murmur best heard at the left
sternal border (Erb's point). Mitral stenosis causes a diastolic murmur at the apex, and mitral
regurgitation causes a systolic murmur.
6. A patient with mitral stenosis would most likely have a murmur that is:
A) Systolic, heard at the apex
B) Diastolic, heard at the apex
C) Systolic, heard at the right upper sternal border
D) Diastolic, heard at the left lower sternal border
Correct Answer: Diastolic, heard at the apex
Rationale: Mitral stenosis causes a diastolic rumbling murmur best heard at the apex with the bell of the
stethoscope. The murmur is low-pitched and occurs in diastole.
7. A patient with mitral regurgitation would most likely have a murmur that is:
A) Systolic, heard at the apex, radiating to the axilla
B) Diastolic, heard at the apex
C) Systolic, heard at the right upper sternal border
D) Diastolic, heard at the left lower sternal border
Correct Answer: Systolic, heard at the apex, radiating to the axilla
Rationale: Mitral regurgitation causes a holosystolic, high-pitched blowing murmur best heard at the
apex, with radiation to the left axilla. It is a systolic murmur.
8. During a cardiovascular assessment, the nurse palpates the chest wall and feels a vibration over the
aortic area during systole. This finding is documented as:
A) Heave
Assessment | Galen College | Q & A |
2026/2027 Edition (PDF)
1. A nurse auscultates a patient's heart and hears a split S2 that widens on inspiration and narrows on
expiration. This finding is:
A) Paradoxical splitting
B) Fixed splitting
C) Physiologic (normal) splitting
D) Reverse splitting
Correct Answer: Physiologic (normal) splitting
Rationale: Normal splitting of S2 occurs because inspiration increases venous return to the right
ventricle, delaying pulmonic valve closure, causing the split to widen on inspiration and narrow on
expiration. Fixed splitting does not vary with respiration and is seen in atrial septal defects. Paradoxical
splitting narrows on inspiration.
2. A patient with heart failure has an S3 gallop. The nurse knows that S3 is best heard with the:
A) Bell of the stethoscope at the apex, with the patient lying on the left side
B) Diaphragm at the base, with the patient sitting forward
C) Bell at the left sternal border
D) Diaphragm at the right second intercostal space
Correct Answer: Bell of the stethoscope at the apex, with the patient lying on the left side
Rationale: S3 is a low-frequency sound best heard with the bell of the stethoscope at the apex in the left
lateral decubitus position. S3 occurs during rapid ventricular filling and is often associated with heart
failure or volume overload.
,3. What causes the S1 heart sound ("Lub")?
A) Closure of the semilunar valves
B) Closure of the atrioventricular (AV) valves
C) Opening of the AV valves
D) Closure of the aortic valve
Correct Answer: Closure of the atrioventricular (AV) valves
Rationale: S1 is caused by the closure of the AV valves (mitral and tricuspid) at the start of systole. It
serves as a reference point for timing all cardiac sounds.
4. What causes the S2 heart sound ("Dub")?
A) Closure of the AV valves
B) Opening of the semilunar valves
C) Closure of the semilunar valves (aortic and pulmonic)
D) Closure of the mitral valve
Correct Answer: Closure of the semilunar valves (aortic and pulmonic)
Rationale: S2 is caused by the closure of the semilunar valves (aortic and pulmonic) at the end of systole.
It is best heard at the base of the heart.
5. The nurse auscultates a high-pitched, blowing sound immediately after S2 at the left sternal border.
This is most likely:
A) Mitral stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) Pulmonic stenosis
Correct Answer: Aortic regurgitation
, Rationale: Aortic regurgitation causes an early diastolic decrescendo murmur best heard at the left
sternal border (Erb's point). Mitral stenosis causes a diastolic murmur at the apex, and mitral
regurgitation causes a systolic murmur.
6. A patient with mitral stenosis would most likely have a murmur that is:
A) Systolic, heard at the apex
B) Diastolic, heard at the apex
C) Systolic, heard at the right upper sternal border
D) Diastolic, heard at the left lower sternal border
Correct Answer: Diastolic, heard at the apex
Rationale: Mitral stenosis causes a diastolic rumbling murmur best heard at the apex with the bell of the
stethoscope. The murmur is low-pitched and occurs in diastole.
7. A patient with mitral regurgitation would most likely have a murmur that is:
A) Systolic, heard at the apex, radiating to the axilla
B) Diastolic, heard at the apex
C) Systolic, heard at the right upper sternal border
D) Diastolic, heard at the left lower sternal border
Correct Answer: Systolic, heard at the apex, radiating to the axilla
Rationale: Mitral regurgitation causes a holosystolic, high-pitched blowing murmur best heard at the
apex, with radiation to the left axilla. It is a systolic murmur.
8. During a cardiovascular assessment, the nurse palpates the chest wall and feels a vibration over the
aortic area during systole. This finding is documented as:
A) Heave
