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NR509 WEEK 4 FINAL EXAM 2026 COMPLETE (105)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
NR509
Prepare for the NR509 Week 4 Final Exam with this comprehensive practice resource
designed to support your exam success. It features exam-style questions covering
advanced health assessment, comprehensive physical examination, diagnostic
reasoning, documentation, patient interviewing, and clinical decision-making. Use it
to reinforce essential concepts, assess your knowledge, and build confidence before
your final exam. An excellent study aid for nursing students preparing for the NR509
Week 4 Final Exam.
MULTIPLE CHOICE.
Question 1: The sac that surrounds and protects the heart is called the:
A. Myocardium
B. Endocardium
C. Pericardium
D. Pleural space
Correct answer: C. Pericardium
Rationale: The pericardium is the fibrous sac that surrounds and protects
the heart. The myocardium is the muscular layer, and the endocardium is
the inner lining of the heart chambers .
Question 2: The direction of blood flow through the heart is best described by
which of these?
A. Vena cava → right atrium → right ventricle → lungs → pulmonary artery → left
atrium → left ventricle
B. Right atrium → right ventricle → pulmonary artery → lungs → pulmonary vein →
left atrium → left ventricle
C. Aorta → right atrium → right ventricle → lungs → pulmonary vein → left atrium
→ left ventricle → vena cava
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D. Right atrium → right ventricle → pulmonary vein → lungs → pulmonary artery →
left atrium → left ventricle
Correct answer: B. Right atrium → right ventricle → pulmonary artery →
lungs → pulmonary vein → left atrium → left ventricle
Rationale: Deoxygenated blood returns to the right atrium via the vena
cava, flows to the right ventricle, then is pumped through the pulmonary
artery to the lungs. Oxygenated blood returns via the pulmonary veins to
the left atrium and then to the left ventricle .
Question 3: The nurse is reviewing the anatomy and physiologic functioning
of the heart. Which statement best describes what is meant by atrial kick?
A. The atria contract during systole and attempt to push against closed valves.
B. Contraction of the atria at the beginning of diastole can be felt as a
palpitation.
C. Atrial kick is the pressure exerted against the atria as the ventricles contract
during systole.
D. The atria contract toward the end of diastole and push the remaining blood
into the ventricles.
Correct answer: D. The atria contract toward the end of diastole and push
the remaining blood into the ventricles.
Rationale: Atrial kick refers to the atrial contraction that occurs at the end
of diastole, delivering the final 20-30% of ventricular filling. This is
sometimes called the "atrial systole" phase .
Question 4: When listening to heart sounds, the nurse knows the valve
closures that can be heard best at the base of the heart are:
A. Mitral and tricuspid
B. Tricuspid and aortic
C. Aortic and pulmonic
D. Mitral and pulmonic
Correct answer: C. Aortic and pulmonic
Rationale: The aortic and pulmonic valves (semilunar valves) are heard
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best at the base of the heart (2nd intercostal spaces). The mitral and
tricuspid valves (AV valves) are heard best at the apex .
Question 5: During an assessment of a 68-year-old man with a recent onset
of right-sided weakness, the nurse hears a blowing, swishing sound with the
bell of the stethoscope over the left carotid artery. This finding would indicate:
A. Valvular disorder
B. Blood flow turbulence
C. Fluid volume overload
D. Ventricular hypertrophy
Correct answer: B. Blood flow turbulence
Rationale: A blowing, swishing sound (bruit) over the carotid artery
indicates turbulent blood flow, often due to stenosis or atherosclerotic
plaque. This finding is concerning for possible cerebrovascular disease .
Question 6: During an inspection of the precordium of an adult patient, the
nurse notices the chest moving in a forceful manner along the sternal border.
This finding most likely suggests a(n):
A. Normal heart
B. Systolic murmur
C. Enlargement of the left ventricle
D. Enlargement of the right ventricle
Correct answer: D. Enlargement of the right ventricle
Rationale: A forceful pulsation along the left sternal border suggests right
ventricular hypertrophy or enlargement. Left ventricular enlargement is
typically seen at the apex .
Question 7: During an assessment of a healthy adult, where would the nurse
expect to palpate the apical impulse?
A. Third left intercostal space at the midclavicular line
B. Fourth left intercostal space at the sternal border
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C. Fourth left intercostal space at the anterior axillary line
D. Fifth left intercostal space at the midclavicular line
Correct answer: D. Fifth left intercostal space at the midclavicular line
Rationale: The apical impulse (point of maximal impulse or PMI) is
normally located at the 5th intercostal space at the midclavicular line in
adults. Displacement may indicate cardiac enlargement .
Question 8: A patient reports sudden loss of vision in one eye described as a
"curtain coming down." The most concerning diagnosis is:
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Cataract
D. Chronic open-angle glaucoma
Correct answer: B. Retinal detachment
Rationale: A "curtain" coming down over vision is a classic warning sign of
retinal detachment, which is an ophthalmologic emergency requiring
urgent evaluation and intervention .
Question 9: During fundoscopic exam, arteriovenous nicking is most
associated with:
A. Diabetes mellitus
B. Chronic hypertension
C. Increased intracranial pressure
D. Macular degeneration
Correct answer: B. Chronic hypertension
Rationale: Arteriovenous (AV) nicking occurs when thickened arterioles
compress adjacent venules at crossing points. This is a hallmark finding
of chronic hypertension on fundoscopic examination .
Question 10: A positive Weber test lateralizing to the left with diminished air
conduction greater than bone conduction on the right suggests:
NR509 WEEK 4 FINAL EXAM 2026 COMPLETE (105)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
NR509
Prepare for the NR509 Week 4 Final Exam with this comprehensive practice resource
designed to support your exam success. It features exam-style questions covering
advanced health assessment, comprehensive physical examination, diagnostic
reasoning, documentation, patient interviewing, and clinical decision-making. Use it
to reinforce essential concepts, assess your knowledge, and build confidence before
your final exam. An excellent study aid for nursing students preparing for the NR509
Week 4 Final Exam.
MULTIPLE CHOICE.
Question 1: The sac that surrounds and protects the heart is called the:
A. Myocardium
B. Endocardium
C. Pericardium
D. Pleural space
Correct answer: C. Pericardium
Rationale: The pericardium is the fibrous sac that surrounds and protects
the heart. The myocardium is the muscular layer, and the endocardium is
the inner lining of the heart chambers .
Question 2: The direction of blood flow through the heart is best described by
which of these?
A. Vena cava → right atrium → right ventricle → lungs → pulmonary artery → left
atrium → left ventricle
B. Right atrium → right ventricle → pulmonary artery → lungs → pulmonary vein →
left atrium → left ventricle
C. Aorta → right atrium → right ventricle → lungs → pulmonary vein → left atrium
→ left ventricle → vena cava
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D. Right atrium → right ventricle → pulmonary vein → lungs → pulmonary artery →
left atrium → left ventricle
Correct answer: B. Right atrium → right ventricle → pulmonary artery →
lungs → pulmonary vein → left atrium → left ventricle
Rationale: Deoxygenated blood returns to the right atrium via the vena
cava, flows to the right ventricle, then is pumped through the pulmonary
artery to the lungs. Oxygenated blood returns via the pulmonary veins to
the left atrium and then to the left ventricle .
Question 3: The nurse is reviewing the anatomy and physiologic functioning
of the heart. Which statement best describes what is meant by atrial kick?
A. The atria contract during systole and attempt to push against closed valves.
B. Contraction of the atria at the beginning of diastole can be felt as a
palpitation.
C. Atrial kick is the pressure exerted against the atria as the ventricles contract
during systole.
D. The atria contract toward the end of diastole and push the remaining blood
into the ventricles.
Correct answer: D. The atria contract toward the end of diastole and push
the remaining blood into the ventricles.
Rationale: Atrial kick refers to the atrial contraction that occurs at the end
of diastole, delivering the final 20-30% of ventricular filling. This is
sometimes called the "atrial systole" phase .
Question 4: When listening to heart sounds, the nurse knows the valve
closures that can be heard best at the base of the heart are:
A. Mitral and tricuspid
B. Tricuspid and aortic
C. Aortic and pulmonic
D. Mitral and pulmonic
Correct answer: C. Aortic and pulmonic
Rationale: The aortic and pulmonic valves (semilunar valves) are heard
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best at the base of the heart (2nd intercostal spaces). The mitral and
tricuspid valves (AV valves) are heard best at the apex .
Question 5: During an assessment of a 68-year-old man with a recent onset
of right-sided weakness, the nurse hears a blowing, swishing sound with the
bell of the stethoscope over the left carotid artery. This finding would indicate:
A. Valvular disorder
B. Blood flow turbulence
C. Fluid volume overload
D. Ventricular hypertrophy
Correct answer: B. Blood flow turbulence
Rationale: A blowing, swishing sound (bruit) over the carotid artery
indicates turbulent blood flow, often due to stenosis or atherosclerotic
plaque. This finding is concerning for possible cerebrovascular disease .
Question 6: During an inspection of the precordium of an adult patient, the
nurse notices the chest moving in a forceful manner along the sternal border.
This finding most likely suggests a(n):
A. Normal heart
B. Systolic murmur
C. Enlargement of the left ventricle
D. Enlargement of the right ventricle
Correct answer: D. Enlargement of the right ventricle
Rationale: A forceful pulsation along the left sternal border suggests right
ventricular hypertrophy or enlargement. Left ventricular enlargement is
typically seen at the apex .
Question 7: During an assessment of a healthy adult, where would the nurse
expect to palpate the apical impulse?
A. Third left intercostal space at the midclavicular line
B. Fourth left intercostal space at the sternal border
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C. Fourth left intercostal space at the anterior axillary line
D. Fifth left intercostal space at the midclavicular line
Correct answer: D. Fifth left intercostal space at the midclavicular line
Rationale: The apical impulse (point of maximal impulse or PMI) is
normally located at the 5th intercostal space at the midclavicular line in
adults. Displacement may indicate cardiac enlargement .
Question 8: A patient reports sudden loss of vision in one eye described as a
"curtain coming down." The most concerning diagnosis is:
A. Acute angle-closure glaucoma
B. Retinal detachment
C. Cataract
D. Chronic open-angle glaucoma
Correct answer: B. Retinal detachment
Rationale: A "curtain" coming down over vision is a classic warning sign of
retinal detachment, which is an ophthalmologic emergency requiring
urgent evaluation and intervention .
Question 9: During fundoscopic exam, arteriovenous nicking is most
associated with:
A. Diabetes mellitus
B. Chronic hypertension
C. Increased intracranial pressure
D. Macular degeneration
Correct answer: B. Chronic hypertension
Rationale: Arteriovenous (AV) nicking occurs when thickened arterioles
compress adjacent venules at crossing points. This is a hallmark finding
of chronic hypertension on fundoscopic examination .
Question 10: A positive Weber test lateralizing to the left with diminished air
conduction greater than bone conduction on the right suggests:
