NUR631 Midterm Exam Prep Test Bank Latest
/ NUR 631 Advanced Health Assessment
Newest Midterm Exam Prep Test Bank with
300+ Questions and Correct Answers
When listening to heart sounds, the nurse knows that the valve closures that can be heard for
S2 is:
A) pulmonic
B) aortic
C) tricuspid
D) mitral –
Correct Answer :B) aortic
A+ TEST BANK 1
, NUR631 Midterm Exam Prep Test
The second heart sound (S2) occurs with the closure of the aortic valve and signals the end of
systole. Although it is heard over all the precordium, S2 is loudest at the base of the heart.
(Bates, p347)
A 45-year-old man is in the clinic for a routine physical. During history the patient states he has
been having difficulty sleeping. "I'll be sleeping great and then I wake up and feel like I can't
catch my breath." His symptoms indicates sleep related symptoms of a certain type of
disease, so which question would the NP want to ask?
A) Have you had a recent sinus infection or URI?
B) Do you have any history of problems with your heart?
C) Do you think it is because it's been so hot at night?
D) When was your last electroencephalogram? –
Correct Answer :B) Do you have any history of problems with your heart?
Paroxysmal nocturnal dyspnea occurs with heart failure. Lying down increases volume of
intrathoracic blood, and the weakened heart cannot accommodate the increased load.
Classically, the person awakens after 2 hours of sleep, arises, and flings open a window with
the perception of needing fresh air. (Bates, p357)
In assessing a patient's major risk factors for heart disease, which would the nurse want to
include when taking a history?
A) Personality type, high cholesterol, diabetes, smoking
B) Family history, hypertension, stress, age
C) Alcohol consumption, obesity, diabetes, stress, high cholesterol
D) Smoking, hypertension, obesity, diabetes, and high cholesterol, activity level, family history
- Correct Answer :D) Smoking, hypertension, obesity, diabetes, and high cholesterol, activity
level, family history
A+ TEST BANK 2
, NUR631 Midterm Exam Prep Test
For major risk factors for coronary artery disease, collect data regarding elevated serum
cholesterol, elevated blood pressure, blood glucose levels above 130 mg/dL or known
diabetes mellitus, obesity, cigarette smoking, low activity level (Bates, p358)
In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse
would:
A) palpate the artery in the upper one third of the neck.
B) listen with the bell of the stethoscope to assess for bruits.
C) palpate both arteries simultaneously to compare amplitude.
D) instruct the patient to take slow deep breaths during inspiration. –
Correct Answer :B) listen with the bell of the stethoscope to assess for bruits.
If cardiovascular disease is suspected, the nurse should auscultate each carotid artery for the
presence of a bruit. The NP should avoid compressing the artery because this could create an
artificial bruit, and it could compromise circulation if the carotid artery is already narrowed by
atherosclerosis. Avoid excessive pressure on the carotid sinus area higher in the neck;
excessive vagal stimulation here could slow down the heart rate, especially in older adults.
Palpate only one carotid artery at a time to avoid compromising arterial blood to the brain.
The bell of the stethoscope is best for picking up bruits. The diaphragm is more attuned to
relatively high-pitched sounds; the bell is more sensitive to low-pitched sounds like bruits.
(Bates, 381)
All of the following are true about assessing the jugular venous pressure EXCEPT:
A) The jugular venous pressure is affected by changes in the right atrial filling.
B) The pulsation from the internal jugular vein reflects the left ventricle pressure.
C) The jugular venous pressure is determined by the highest point of oscillation in the internal
jugular vein.
A+ TEST BANK 3
, NUR631 Midterm Exam Prep Test
D) The jugular venous pressure is considered abnormal if it is greater than 4 cm above the
sternal angle or greater than 9 cm above the right atrium. –
Correct Answer :B) The pulsation from the internal jugular vein reflects the left ventricle
pressure.
The jugular venous pressure is affected by changes in R atrial filling. The JVP is abnormal at a
height greater than 4 cm and is determined by the highest point of oscillation. The pulsation
from the internal jugular vein is not palpable. (Bates, p354-355)
During an assessment of a healthy adult, where would the nurse expect to palpate the apical
impulse?
A) fourth left intercostal space at the anterior axillary line
B) fifth left intercostal space at the midclavicular line
C) third left intercostal space at the midclavicular line
D) fourth left intercostal space at the sternal border –
Correct Answer :B) fifth left intercostal space at the midclavicular line
The apical pulse should occupy only one intercostal space, the fourth or fifth, and it should be
at or medial to the midclavicular line (Bates, p385-387).
The nurse is preparing to auscultate for heart sounds. Which technique is correct?
A) Listen in the 6 auscultation areas.
B) Listen for only murmurs and low pitched sounds.
C) Listen to the sounds at the aortic, tricuspid, pulmonic, and mitral areas.
D) Listen to the sounds only at the site where the apical pulse is felt to be the strongest. -
Correct Answer :A) Listen in the 6 auscultation areas.
A+ TEST BANK 4