NR 509 FINAL EXAM - 300 MULTIPLE CHOICE QUESTIONS
WITH DETAILED VERIFIED ANSWERS (100% CORRECT)
/ALREADY GRADED A+
SECTION 1: CARDIOVASCULAR ASSESSMENT (Questions 1-40)
1. A patient with a history of intravenous drug use presents with fever, heart
murmur, and Janeway lesions. The most likely diagnosis is:
A. Acute pericarditis
B. Infective endocarditis
C. Rheumatic heart disease
D. Myocarditis
Correct Answer: B. Infective endocarditis
Rationale: Janeway lesions are non-tender, erythematous macules on the palms
and soles that are pathognomonic for infective endocarditis. Risk factors include
IV drug use, prosthetic valves, and structural heart disease.
---
2. The point of maximal impulse (PMI) is normally located at:
,A. The 2nd intercostal space at the left sternal border
B. The 5th intercostal space at the midclavicular line
C. The 3rd intercostal space at the right sternal border
D. The 4th intercostal space at the anterior axillary line
Correct Answer: B. The 5th intercostal space at the midclavicular line
Rationale: The PMI is normally located in the 5th intercostal space at the
midclavicular line, corresponding to the apex of the left ventricle. Displacement
may indicate cardiomegaly.
---
3. The jugular venous pressure (JVP) is best assessed by examining which vessel?
A. External jugular vein
B. Internal jugular vein
C. Carotid artery
D. Subclavian vein
Correct Answer: B. Internal jugular vein
,Rationale: The internal jugular vein provides the most accurate assessment of JVP.
The patient should be positioned at 45 degrees, and the vertical height of the
pulsation above the sternal angle is measured (normal < 3 cm).
---
4. A patient presents with shortness of breath, orthopnea, and bilateral peripheral
edema. These findings are MOST consistent with:
A. Heart failure
B. Asthma
C. Pneumonia
D. Pulmonary embolism
Correct Answer: A. Heart failure
Rationale: Shortness of breath, orthopnea (difficulty breathing when lying flat),
and bilateral peripheral edema are classic signs of heart failure. Fluid
accumulation in the lungs and periphery indicates decreased cardiac output.
---
5. Which of the following is a sign of right-sided heart failure?
A. Crackles in the lungs
, B. Jugular venous distension (JVD)
C. Pulmonary edema
D. Orthopnea
Correct Answer: B. Jugular venous distension (JVD)
Rationale: Right-sided heart failure leads to systemic venous congestion, resulting
in JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary congestion
(crackles, pulmonary edema, orthopnea) is characteristic of left-sided heart
failure.
---
6. A patient presents with sudden onset of sharp chest pain, shortness of breath,
and hemoptysis. What is the MOST likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pneumothorax
Correct Answer: B. Pulmonary embolism
WITH DETAILED VERIFIED ANSWERS (100% CORRECT)
/ALREADY GRADED A+
SECTION 1: CARDIOVASCULAR ASSESSMENT (Questions 1-40)
1. A patient with a history of intravenous drug use presents with fever, heart
murmur, and Janeway lesions. The most likely diagnosis is:
A. Acute pericarditis
B. Infective endocarditis
C. Rheumatic heart disease
D. Myocarditis
Correct Answer: B. Infective endocarditis
Rationale: Janeway lesions are non-tender, erythematous macules on the palms
and soles that are pathognomonic for infective endocarditis. Risk factors include
IV drug use, prosthetic valves, and structural heart disease.
---
2. The point of maximal impulse (PMI) is normally located at:
,A. The 2nd intercostal space at the left sternal border
B. The 5th intercostal space at the midclavicular line
C. The 3rd intercostal space at the right sternal border
D. The 4th intercostal space at the anterior axillary line
Correct Answer: B. The 5th intercostal space at the midclavicular line
Rationale: The PMI is normally located in the 5th intercostal space at the
midclavicular line, corresponding to the apex of the left ventricle. Displacement
may indicate cardiomegaly.
---
3. The jugular venous pressure (JVP) is best assessed by examining which vessel?
A. External jugular vein
B. Internal jugular vein
C. Carotid artery
D. Subclavian vein
Correct Answer: B. Internal jugular vein
,Rationale: The internal jugular vein provides the most accurate assessment of JVP.
The patient should be positioned at 45 degrees, and the vertical height of the
pulsation above the sternal angle is measured (normal < 3 cm).
---
4. A patient presents with shortness of breath, orthopnea, and bilateral peripheral
edema. These findings are MOST consistent with:
A. Heart failure
B. Asthma
C. Pneumonia
D. Pulmonary embolism
Correct Answer: A. Heart failure
Rationale: Shortness of breath, orthopnea (difficulty breathing when lying flat),
and bilateral peripheral edema are classic signs of heart failure. Fluid
accumulation in the lungs and periphery indicates decreased cardiac output.
---
5. Which of the following is a sign of right-sided heart failure?
A. Crackles in the lungs
, B. Jugular venous distension (JVD)
C. Pulmonary edema
D. Orthopnea
Correct Answer: B. Jugular venous distension (JVD)
Rationale: Right-sided heart failure leads to systemic venous congestion, resulting
in JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary congestion
(crackles, pulmonary edema, orthopnea) is characteristic of left-sided heart
failure.
---
6. A patient presents with sudden onset of sharp chest pain, shortness of breath,
and hemoptysis. What is the MOST likely diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pneumothorax
Correct Answer: B. Pulmonary embolism
