NR 667 CARDIAC AND RESPIRATORY
ASSESSMENTS | PRACTICE QUESTIONS
AND ANSWERS WITH RATIONALES |
2026/2027 UPDATED | CHAMBERLAIN
COLLEGE OF NURSING
Introduction
Cardiac and respiratory assessments are essential skills for advanced nursing practice.
Nurses must be able to obtain focused health histories, perform systematic physical
examinations, interpret abnormal findings, recognize clinical deterioration, and
determine appropriate next steps in patient care. This practice question bank is
designed to reinforce those competencies through original, scenario-based multiple-
choice questions.
The questions cover cardiovascular and pulmonary anatomy and physiology,
symptom assessment, inspection, palpation, percussion, auscultation, vital-sign
interpretation, diagnostic testing, clinical reasoning, documentation, and patient safety.
Scenarios emphasize findings such as chest pain, dyspnea, abnormal heart sounds,
murmurs, edema, adventitious breath sounds, hypoxemia, and changes in respiratory
effort.
Use each question to practice distinguishing expected findings from clinically
significant abnormalities. Review the rationale for every answer, including why
alternative options are less appropriate. In clinical practice, findings must always be
interpreted in context, and urgent symptoms require prompt assessment and escalation
according to institutional protocols.
Study note: This is an original educational practice set, not a verified copy of
Chamberlain’s examination or a guarantee of exam results. Apply your course
materials and current clinical guidelines when preparing for assessment.
Core Domains Covered
1.
Cardiovascular history and symptom analysis
2.
3.
Cardiac inspection, palpation, and auscultation
, 4.
5.
Heart sounds, murmurs, and peripheral vascular findings
6.
7.
Respiratory history and focused examination
8.
9.
Lung sounds, oxygenation, and respiratory distress
10.
11.
Cardiopulmonary diagnostic tests and interpretation
12.
13.
Differential diagnosis and clinical reasoning
14.
15.
Documentation, prioritization, and patient safety
16.
17.
Integrated cardiac and respiratory scenarios
18.
19.
Patient education and follow-up planning
20.
Questions 1–100: Cardiac and Respiratory
Assessment
Question 1
,A 58-year-old patient reports substernal chest pressure that began 20 minutes ago
while walking upstairs. The discomfort radiates to the left arm and is accompanied by
diaphoresis and nausea. What is the nurse practitioner’s priority action?
A. Obtain a detailed dietary history.
B. Initiate emergency evaluation, assess vital signs, and obtain a 12-lead ECG
promptly.
C. Schedule an outpatient exercise stress test.
D. Recommend rest and reassessment in one hour.
Rationale: B is correct because acute chest pressure with radiation, diaphoresis, and
nausea suggests possible acute coronary syndrome. Immediate assessment, emergency
escalation, and prompt ECG acquisition are essential. A provides information but
must not delay urgent care. C is inappropriate during a potentially acute coronary
event. D risks dangerous delays in diagnosing myocardial ischemia or infarction.
Question 2
During cardiac auscultation, the examiner identifies the point of maximal impulse
(PMI). Where is the PMI normally located in a healthy adult?
A. Second right intercostal space at the sternal border.
B. Fourth left intercostal space at the sternal border.
C. Fifth left intercostal space near the midclavicular line.
D. Second left intercostal space at the sternal border.
Rationale: C is correct because the normal adult PMI is typically located at the fifth
left intercostal space near the midclavicular line. A and D are locations used to assess
the aortic and pulmonic areas. B is not the usual location of the adult PMI. An
enlarged or displaced PMI may indicate ventricular enlargement or other cardiac
abnormalities.
Question 3
A patient presents with progressive exertional dyspnea, bilateral ankle edema, and
difficulty breathing when lying flat. Which condition should be considered most
strongly?
A. Allergic rhinitis.
B. Uncomplicated viral bronchitis.
C. Heart failure.
, D. Acute otitis media.
Rationale: C is correct because orthopnea, peripheral edema, and exertional dyspnea
are common findings in heart failure. A and D do not adequately explain the
combination of systemic fluid retention and breathing difficulty. B can cause cough
and respiratory symptoms but is less consistent with the overall presentation. Further
assessment should include lung auscultation, jugular venous pressure, oxygen
saturation, and appropriate diagnostic testing.
Question 4
A patient’s respiratory rate is 30 breaths/minute, oxygen saturation is 86% on room
air, and accessory muscle use is visible. What is the most appropriate initial response?
A. Complete the routine medical history before intervening.
B. Encourage the patient to walk to improve ventilation.
C. Reassess the patient in 30 minutes.
D. Initiate urgent respiratory assessment, provide appropriate oxygen support, and
activate emergency assistance as indicated.
Rationale: D is correct because hypoxemia, tachypnea, and accessory muscle use
indicate potentially severe respiratory compromise. Immediate airway and breathing
assessment, oxygen support appropriate to the clinical situation, and urgent escalation
are necessary. A delays stabilization. B increases oxygen demand and may worsen
distress. C is unsafe because the patient may deteriorate rapidly.
Question 5
Which assessment technique is most appropriate for detecting a palpable vibration
associated with turbulent blood flow across a heart valve?
A. Inspection.
B. Palpation.
C. Percussion.
D. Measurement of respiratory rate.
Rationale: B is correct because a palpable vibration, called a thrill, may accompany a
significant cardiac murmur and is detected by palpation. A may reveal visible
pulsations but cannot reliably identify a thrill. C is not routinely useful for identifying
cardiac thrills. D assesses respiratory function rather than turbulent cardiac blood flow.
Question 6
ASSESSMENTS | PRACTICE QUESTIONS
AND ANSWERS WITH RATIONALES |
2026/2027 UPDATED | CHAMBERLAIN
COLLEGE OF NURSING
Introduction
Cardiac and respiratory assessments are essential skills for advanced nursing practice.
Nurses must be able to obtain focused health histories, perform systematic physical
examinations, interpret abnormal findings, recognize clinical deterioration, and
determine appropriate next steps in patient care. This practice question bank is
designed to reinforce those competencies through original, scenario-based multiple-
choice questions.
The questions cover cardiovascular and pulmonary anatomy and physiology,
symptom assessment, inspection, palpation, percussion, auscultation, vital-sign
interpretation, diagnostic testing, clinical reasoning, documentation, and patient safety.
Scenarios emphasize findings such as chest pain, dyspnea, abnormal heart sounds,
murmurs, edema, adventitious breath sounds, hypoxemia, and changes in respiratory
effort.
Use each question to practice distinguishing expected findings from clinically
significant abnormalities. Review the rationale for every answer, including why
alternative options are less appropriate. In clinical practice, findings must always be
interpreted in context, and urgent symptoms require prompt assessment and escalation
according to institutional protocols.
Study note: This is an original educational practice set, not a verified copy of
Chamberlain’s examination or a guarantee of exam results. Apply your course
materials and current clinical guidelines when preparing for assessment.
Core Domains Covered
1.
Cardiovascular history and symptom analysis
2.
3.
Cardiac inspection, palpation, and auscultation
, 4.
5.
Heart sounds, murmurs, and peripheral vascular findings
6.
7.
Respiratory history and focused examination
8.
9.
Lung sounds, oxygenation, and respiratory distress
10.
11.
Cardiopulmonary diagnostic tests and interpretation
12.
13.
Differential diagnosis and clinical reasoning
14.
15.
Documentation, prioritization, and patient safety
16.
17.
Integrated cardiac and respiratory scenarios
18.
19.
Patient education and follow-up planning
20.
Questions 1–100: Cardiac and Respiratory
Assessment
Question 1
,A 58-year-old patient reports substernal chest pressure that began 20 minutes ago
while walking upstairs. The discomfort radiates to the left arm and is accompanied by
diaphoresis and nausea. What is the nurse practitioner’s priority action?
A. Obtain a detailed dietary history.
B. Initiate emergency evaluation, assess vital signs, and obtain a 12-lead ECG
promptly.
C. Schedule an outpatient exercise stress test.
D. Recommend rest and reassessment in one hour.
Rationale: B is correct because acute chest pressure with radiation, diaphoresis, and
nausea suggests possible acute coronary syndrome. Immediate assessment, emergency
escalation, and prompt ECG acquisition are essential. A provides information but
must not delay urgent care. C is inappropriate during a potentially acute coronary
event. D risks dangerous delays in diagnosing myocardial ischemia or infarction.
Question 2
During cardiac auscultation, the examiner identifies the point of maximal impulse
(PMI). Where is the PMI normally located in a healthy adult?
A. Second right intercostal space at the sternal border.
B. Fourth left intercostal space at the sternal border.
C. Fifth left intercostal space near the midclavicular line.
D. Second left intercostal space at the sternal border.
Rationale: C is correct because the normal adult PMI is typically located at the fifth
left intercostal space near the midclavicular line. A and D are locations used to assess
the aortic and pulmonic areas. B is not the usual location of the adult PMI. An
enlarged or displaced PMI may indicate ventricular enlargement or other cardiac
abnormalities.
Question 3
A patient presents with progressive exertional dyspnea, bilateral ankle edema, and
difficulty breathing when lying flat. Which condition should be considered most
strongly?
A. Allergic rhinitis.
B. Uncomplicated viral bronchitis.
C. Heart failure.
, D. Acute otitis media.
Rationale: C is correct because orthopnea, peripheral edema, and exertional dyspnea
are common findings in heart failure. A and D do not adequately explain the
combination of systemic fluid retention and breathing difficulty. B can cause cough
and respiratory symptoms but is less consistent with the overall presentation. Further
assessment should include lung auscultation, jugular venous pressure, oxygen
saturation, and appropriate diagnostic testing.
Question 4
A patient’s respiratory rate is 30 breaths/minute, oxygen saturation is 86% on room
air, and accessory muscle use is visible. What is the most appropriate initial response?
A. Complete the routine medical history before intervening.
B. Encourage the patient to walk to improve ventilation.
C. Reassess the patient in 30 minutes.
D. Initiate urgent respiratory assessment, provide appropriate oxygen support, and
activate emergency assistance as indicated.
Rationale: D is correct because hypoxemia, tachypnea, and accessory muscle use
indicate potentially severe respiratory compromise. Immediate airway and breathing
assessment, oxygen support appropriate to the clinical situation, and urgent escalation
are necessary. A delays stabilization. B increases oxygen demand and may worsen
distress. C is unsafe because the patient may deteriorate rapidly.
Question 5
Which assessment technique is most appropriate for detecting a palpable vibration
associated with turbulent blood flow across a heart valve?
A. Inspection.
B. Palpation.
C. Percussion.
D. Measurement of respiratory rate.
Rationale: B is correct because a palpable vibration, called a thrill, may accompany a
significant cardiac murmur and is detected by palpation. A may reveal visible
pulsations but cannot reliably identify a thrill. C is not routinely useful for identifying
cardiac thrills. D assesses respiratory function rather than turbulent cardiac blood flow.
Question 6
