NUR 3065 COMPLETE PREP U
CHAPTER 14 BASED QUESTIONS AND
ANSWERS
While auscultating the heart at the third intercostal space, left sternal border, the nurse notes a high-
pitched, scratchy sound that increases with exhalation with the client leaning forward. The nurse would
document which of the following?
Aortic ejection click
Midsystolic click
Summation gallop
Pericardial friction rub - ANS-✅Pericardial friction rub
Explanation:
A pericardial friction rub is best heard in the third intercostal space at the left sternal border and is
associated with a high-pitched, scratchy sound caused by inflammation of the pericardial sac. A
midsystolic click is heard in middle or late systole over the mitral or apical area. A summation gallop is
the simultaneous occurrence of S3 and S4 sounds. An aortic ejection click is heard during early systole at
the second right intercostal space and apex.
A nursing student is reviewing the electrical conduction of the heart. The student is correct in identifying
the sinoatrial node of the heart as which of the following?
Purkinje fibers
Bundle of His
Pacemaker
Conduction system - ANS-✅Pacemaker
Explanation:
The sinoatrial node is often called the pacemaker of the heart because it generates impulses that are
conducted through the heart. The impulse is conduced across the atria to the AV node, which then relays
the impulse to the AV bundle or bundle of His. From here the impulse travels down the right and left
bundle branches and the Purkinje fibers in the myocardium of both ventricles. All these structures make
up the conduction system of the heart.
A nurse is having difficulty determining a client's heart sounds, specifically S1 and S2. Which of the
following would be appropriate for the nurse to do?
Use the bell of the stethoscope to help distinguish the sounds
Palpate the carotid pulse while auscultating the heart
Determine the pulse deficit
Palpate the apical impulse - ANS-✅Palpate the carotid pulse while auscultating the heart
Explanation:
If a nurse is having difficulty differentiating S1 from S2, the nurse should palpate the carotid pulse while
auscultating the heart. The harsh sound that occurs with the carotid pulse is the S1 sound. The nurse
should use the diaphragm of the stethoscope to auscultate S1 and S2 heart sounds. A pulse deficit is
, determined if the heart rhythm is found to be irregular. Palpating the apical impulse wouldn't provide
any help in differentiating S1 and S2 sounds.
The nurse hears high-pitched swooshing sounds over the carotid artery on the right side. What is this
sound indicative of?
Murmurs
Normal findings
Gallops
Bruits - ANS-✅Bruits
Explanation:
Distinguishing a murmur from a bruit can be challenging. Murmurs originate in the heart or great vessels
and are usually louder over the upper precordium and quieter near the neck. Bruits are higher pitched,
more superficial, and heard only over the arteries. A gallop is a generic term for an additional heart
sounds heard besides the normal S1 and S2 sound.
The nurse is caring for a client who has an elevated cholesterol level. To reduce the mean total blood
cholesterol and low-density lipoprotein (LDL) cholesterol levels, what diet should the nurse discuss with
the client?
Low-fat, low-cholesterol meals
High-protein, low-carbohydrate meals
Low-cholesterol, low-carbohydrate meals
High-protein, low-fat meals - ANS-✅Low-fat, low-cholesterol meals
Explanation:
This client should follow a low-fat, low-cholesterol diet. It would be inappropriate to teach the client to
eat high-protein or low-carbohydrate meals since they are not the focus of the management of elevated
cholesterol levels.
A student states that a client has palpable rushing vibration in the area of the pulmonic valve. What
should the instructor explain that the student is feeling?
A thrill
A thrust
A normal finding
A heave - ANS-✅A thrill
Explanation:
Thrills are vibrations detected on palpation. A palpable, rushing vibration (thrill) is caused from turbulent
blood flow with incompetent valves, pulmonary hypertension, or septal defects. This vibration is usually
in the location of the valve in which it is associated. A thrust or a heave is a forceful thrusting on the
chest, which is not a normal finding.
In order to palpate an apical pulse when performing a cardiac assessment, where should the nurse place
the fingers?
left midclavicular line at the fifth intercostal space
right of the midclavicular line at the third intercostal space
left midclavicular line at the third intercostal space
CHAPTER 14 BASED QUESTIONS AND
ANSWERS
While auscultating the heart at the third intercostal space, left sternal border, the nurse notes a high-
pitched, scratchy sound that increases with exhalation with the client leaning forward. The nurse would
document which of the following?
Aortic ejection click
Midsystolic click
Summation gallop
Pericardial friction rub - ANS-✅Pericardial friction rub
Explanation:
A pericardial friction rub is best heard in the third intercostal space at the left sternal border and is
associated with a high-pitched, scratchy sound caused by inflammation of the pericardial sac. A
midsystolic click is heard in middle or late systole over the mitral or apical area. A summation gallop is
the simultaneous occurrence of S3 and S4 sounds. An aortic ejection click is heard during early systole at
the second right intercostal space and apex.
A nursing student is reviewing the electrical conduction of the heart. The student is correct in identifying
the sinoatrial node of the heart as which of the following?
Purkinje fibers
Bundle of His
Pacemaker
Conduction system - ANS-✅Pacemaker
Explanation:
The sinoatrial node is often called the pacemaker of the heart because it generates impulses that are
conducted through the heart. The impulse is conduced across the atria to the AV node, which then relays
the impulse to the AV bundle or bundle of His. From here the impulse travels down the right and left
bundle branches and the Purkinje fibers in the myocardium of both ventricles. All these structures make
up the conduction system of the heart.
A nurse is having difficulty determining a client's heart sounds, specifically S1 and S2. Which of the
following would be appropriate for the nurse to do?
Use the bell of the stethoscope to help distinguish the sounds
Palpate the carotid pulse while auscultating the heart
Determine the pulse deficit
Palpate the apical impulse - ANS-✅Palpate the carotid pulse while auscultating the heart
Explanation:
If a nurse is having difficulty differentiating S1 from S2, the nurse should palpate the carotid pulse while
auscultating the heart. The harsh sound that occurs with the carotid pulse is the S1 sound. The nurse
should use the diaphragm of the stethoscope to auscultate S1 and S2 heart sounds. A pulse deficit is
, determined if the heart rhythm is found to be irregular. Palpating the apical impulse wouldn't provide
any help in differentiating S1 and S2 sounds.
The nurse hears high-pitched swooshing sounds over the carotid artery on the right side. What is this
sound indicative of?
Murmurs
Normal findings
Gallops
Bruits - ANS-✅Bruits
Explanation:
Distinguishing a murmur from a bruit can be challenging. Murmurs originate in the heart or great vessels
and are usually louder over the upper precordium and quieter near the neck. Bruits are higher pitched,
more superficial, and heard only over the arteries. A gallop is a generic term for an additional heart
sounds heard besides the normal S1 and S2 sound.
The nurse is caring for a client who has an elevated cholesterol level. To reduce the mean total blood
cholesterol and low-density lipoprotein (LDL) cholesterol levels, what diet should the nurse discuss with
the client?
Low-fat, low-cholesterol meals
High-protein, low-carbohydrate meals
Low-cholesterol, low-carbohydrate meals
High-protein, low-fat meals - ANS-✅Low-fat, low-cholesterol meals
Explanation:
This client should follow a low-fat, low-cholesterol diet. It would be inappropriate to teach the client to
eat high-protein or low-carbohydrate meals since they are not the focus of the management of elevated
cholesterol levels.
A student states that a client has palpable rushing vibration in the area of the pulmonic valve. What
should the instructor explain that the student is feeling?
A thrill
A thrust
A normal finding
A heave - ANS-✅A thrill
Explanation:
Thrills are vibrations detected on palpation. A palpable, rushing vibration (thrill) is caused from turbulent
blood flow with incompetent valves, pulmonary hypertension, or septal defects. This vibration is usually
in the location of the valve in which it is associated. A thrust or a heave is a forceful thrusting on the
chest, which is not a normal finding.
In order to palpate an apical pulse when performing a cardiac assessment, where should the nurse place
the fingers?
left midclavicular line at the fifth intercostal space
right of the midclavicular line at the third intercostal space
left midclavicular line at the third intercostal space
