GNRS 578 Review Questions - Test 1 M.H || with error-free
answers.
The first heart sound (S1) is produced by the:
1. closure of the semilunar valves.
2. opening of the semilunar valves.
3. opening of the AV valves.
4. closure of the AV valves. correct answers 4
Rationale:
S1 occurs with closure of the atrioventricular valves. The second heart sound (S2) occurs with
closure of the semilunar valves. Normally opening of the semilunar valves is silent, but in aortic
or pulmonic stenosis, an ejection click may be heard. An ejection click occurs early in systole at
the start of ejection because it results from opening of the semilunar valves. A third heart sound
(S3) can be heard when the ventricles are resistant to filling during the early rapid filling phase.
S3 is heard when the AV valves open and atrial blood first pours into the ventricles.
CH. 20
Which of the following guidelines may be used to identify which heart sound is S1?
1. S1 coincides with the carotid artery pulse.
2. S1 coincides with the A wave of the jugular venous pulse wave.
3. S1 coincides with the Q wave of the QRS electrocardiogram complex.
4. S1 is louder than S2 at the base of the heart. correct answers 1
Rationale:
,S1 coincides with the carotid artery pulse. S1 is loudest at the apex of the heart. S1 coincides
with the C wave of the jugular venous pulse wave. S1 coincides with the R wave (the upstroke of
the QRS complex).
CH. 20
Which of the following cardiac alterations occurs during pregnancy?
1. An increased heart rate and increased blood pressure
2. An increased stroke volume and decreased cardiac output
3. An increase in cardiac volume and a decrease in blood pressure
4. An increase in cardiac output and blood pressure correct answers 3
Rationale:
During pregnancy the blood volume increases by 30% to 40%; this creates an increase in stroke
volume and cardiac output and an increased pulse rate of 10 to 15 beats per minute. The arterial
blood pressure decreases in pregnancy as a result of peripheral vasodilation.
CH. 20
Which of the following is an appropriate position to have the patient assume when auscultating
for extra heart sounds or murmurs?
1. Roll toward the left side
2. Recumbent position
3. Trendelenburg position
4. Roll toward the right side correct answers 1
Rationale:
,After auscultation in the supine position, the nurse should have the patient roll onto the left side;
the examiner should listen at the apex with the bell for the presence of any diastolic filling
sounds (i.e., S3 or S4) or murmurs that may be heard only in this position. The examiner should
have the patient sit up and lean forward; the examiner should auscultate at the base with the
diaphragm for a soft, high-pitched, early diastolic murmur of aortic or pulmonic regurgitation.
CH. 20
The student nurse demonstrates correct technique in using the stethoscope to auscultate heart
sounds when he/she does which of the following?
1. Performs assessment while the patient is watching television.
2. Uses the bell to detect higher pitched sounds.
3. Auscultates in only 4 locations.
4. Makes sure earpieces fit snugly and are pointed to their nose. correct answers 4
Rationale:
When auscultating, the earpieces of the stethoscope should fit snugly in the examiner's ear canal
and they should be aimed forward (toward nose) to avoid air leak. The diaphragm of the
stethoscope is used for higher pitched sounds and the bell for lower pitched sounds. It's
important to minimize noise in order to be able to appropriately assess sounds with the
stethoscope. Heart sounds should be assessed for in 5 locations using a rough Z pattern from the
base of the hear across and down and over to the apex.
CH. 20
The ability of the heart to contract independently of any signals or stimulation is due to:
1. automaticity.
2. conduction.
, 3. depolarization.
4. repolarization. correct answers 1
Rationale:
The heart can contract by itself, independent of any signals or stimulation from the body; this
property is termed automaticity. Depolarization is the reversal of the resting potential in excitable
cardiac muscle cell membranes when stimulated. Conduction is the process by which an
electrical impulse is transmitted through the heart. Repolarization is the process by which the
membrane potential of a cardiac muscle cell is restored to the cell's resting potential.
CH. 20
When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a
continuous sound that mimics the sound of a machine. This finding most likely indicates:
1. a normal sound because of the thinner chest wall of the newborn.
2. the presence of congenital heart disease.
3. pathology only when accompanied by an increased heart rate.
4. an expected sound caused by nonclosure of the ductus arteriosus. correct answers 4
Rationale:
The murmur of a patent ductus arteriosus is a continuous machinery murmur, which disappears
by 2 to 3 days.
CH. 20
A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:
1. increased viscosity of blood.
answers.
The first heart sound (S1) is produced by the:
1. closure of the semilunar valves.
2. opening of the semilunar valves.
3. opening of the AV valves.
4. closure of the AV valves. correct answers 4
Rationale:
S1 occurs with closure of the atrioventricular valves. The second heart sound (S2) occurs with
closure of the semilunar valves. Normally opening of the semilunar valves is silent, but in aortic
or pulmonic stenosis, an ejection click may be heard. An ejection click occurs early in systole at
the start of ejection because it results from opening of the semilunar valves. A third heart sound
(S3) can be heard when the ventricles are resistant to filling during the early rapid filling phase.
S3 is heard when the AV valves open and atrial blood first pours into the ventricles.
CH. 20
Which of the following guidelines may be used to identify which heart sound is S1?
1. S1 coincides with the carotid artery pulse.
2. S1 coincides with the A wave of the jugular venous pulse wave.
3. S1 coincides with the Q wave of the QRS electrocardiogram complex.
4. S1 is louder than S2 at the base of the heart. correct answers 1
Rationale:
,S1 coincides with the carotid artery pulse. S1 is loudest at the apex of the heart. S1 coincides
with the C wave of the jugular venous pulse wave. S1 coincides with the R wave (the upstroke of
the QRS complex).
CH. 20
Which of the following cardiac alterations occurs during pregnancy?
1. An increased heart rate and increased blood pressure
2. An increased stroke volume and decreased cardiac output
3. An increase in cardiac volume and a decrease in blood pressure
4. An increase in cardiac output and blood pressure correct answers 3
Rationale:
During pregnancy the blood volume increases by 30% to 40%; this creates an increase in stroke
volume and cardiac output and an increased pulse rate of 10 to 15 beats per minute. The arterial
blood pressure decreases in pregnancy as a result of peripheral vasodilation.
CH. 20
Which of the following is an appropriate position to have the patient assume when auscultating
for extra heart sounds or murmurs?
1. Roll toward the left side
2. Recumbent position
3. Trendelenburg position
4. Roll toward the right side correct answers 1
Rationale:
,After auscultation in the supine position, the nurse should have the patient roll onto the left side;
the examiner should listen at the apex with the bell for the presence of any diastolic filling
sounds (i.e., S3 or S4) or murmurs that may be heard only in this position. The examiner should
have the patient sit up and lean forward; the examiner should auscultate at the base with the
diaphragm for a soft, high-pitched, early diastolic murmur of aortic or pulmonic regurgitation.
CH. 20
The student nurse demonstrates correct technique in using the stethoscope to auscultate heart
sounds when he/she does which of the following?
1. Performs assessment while the patient is watching television.
2. Uses the bell to detect higher pitched sounds.
3. Auscultates in only 4 locations.
4. Makes sure earpieces fit snugly and are pointed to their nose. correct answers 4
Rationale:
When auscultating, the earpieces of the stethoscope should fit snugly in the examiner's ear canal
and they should be aimed forward (toward nose) to avoid air leak. The diaphragm of the
stethoscope is used for higher pitched sounds and the bell for lower pitched sounds. It's
important to minimize noise in order to be able to appropriately assess sounds with the
stethoscope. Heart sounds should be assessed for in 5 locations using a rough Z pattern from the
base of the hear across and down and over to the apex.
CH. 20
The ability of the heart to contract independently of any signals or stimulation is due to:
1. automaticity.
2. conduction.
, 3. depolarization.
4. repolarization. correct answers 1
Rationale:
The heart can contract by itself, independent of any signals or stimulation from the body; this
property is termed automaticity. Depolarization is the reversal of the resting potential in excitable
cardiac muscle cell membranes when stimulated. Conduction is the process by which an
electrical impulse is transmitted through the heart. Repolarization is the process by which the
membrane potential of a cardiac muscle cell is restored to the cell's resting potential.
CH. 20
When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a
continuous sound that mimics the sound of a machine. This finding most likely indicates:
1. a normal sound because of the thinner chest wall of the newborn.
2. the presence of congenital heart disease.
3. pathology only when accompanied by an increased heart rate.
4. an expected sound caused by nonclosure of the ductus arteriosus. correct answers 4
Rationale:
The murmur of a patent ductus arteriosus is a continuous machinery murmur, which disappears
by 2 to 3 days.
CH. 20
A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:
1. increased viscosity of blood.
