Systems – Health Assessment in Nursing (Weber, 7th Edition)
Cardiovascular system
1.Which of the following is the primary pacemaker of the heart?
a. Atrioventricular (AV) node
b. Sinoatrial (SA) node
c. Bundle of His
d. Purkinje fibers
Answer: b. Sinoatrial (SA) node
Rationale: The SA node initiates electrical impulses that set the heart’s rhythm.
2. A patient presents with chest pain radiating to the left arm. What is the most likely
cause?
a. Gastroesophageal reflux
b. Myocardial infarction
c. Pneumonia
d. Anxiety
Answer: b. Myocardial infarction
Rationale: Chest pain radiating to the left arm is a classic sign of a heart attack.
3. Which heart sound is associated with the closing of the atrioventricular valves?
a. S1
b. S2
c. S3
d. S4
Answer: a. S1
Rationale: S1 is produced by the closure of the mitral and tricuspid valves at the start of
systole.
,4. Which of the following indicates left-sided heart failure?
a. Peripheral edema
b. Jugular vein distension
c. Pulmonary congestion
d. Hepatomegaly
Answer: c. Pulmonary congestion
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary symptoms.
5. The nurse is auscultating a patient’s heart and hears a whooshing sound between S1
and S2. This is likely a:
a. Murmur
b. Gallop
c. Rub
d. Click
Answer: a. Murmur
Rationale: Murmurs are turbulent blood flow sounds occurring between heart sounds.
6. Which vessel carries oxygenated blood from the lungs to the heart?
a. Pulmonary artery
b. Pulmonary vein
c. Aorta
d. Superior vena cava
Answer: b. Pulmonary vein
Rationale: Pulmonary veins transport oxygen-rich blood from the lungs to the left atrium.
7. The nurse observes jugular vein distension in a patient. This is a sign of:
a. Left-sided heart failure
,b. Right-sided heart failure
c. Myocardial infarction
d. Aortic stenosis
Answer: b. Right-sided heart failure
Rationale: Right-sided heart failure causes systemic venous congestion, reflected as
JVD.
8. What is the normal range for adult resting heart rate?
a. 40–60 bpm
b. 60–100 bpm
c. 100–120 bpm
d. 120–140 bpm
Answer: b. 60–100 bpm
Rationale: A normal adult heart rate at rest ranges from 60–100 beats per minute.
9. Which of the following is a modifiable risk factor for cardiovascular disease?
a. Age
b. Family history
c. Smoking
d. Gender
Answer: c. Smoking
Rationale: Smoking is a lifestyle factor that can be changed to reduce cardiovascular
risk.
10. A patient has an irregularly irregular pulse. This is most likely due to:
a. Sinus rhythm
b. Atrial fibrillation
c. Ventricular tachycardia
, d. First-degree heart block
Answer: b. Atrial fibrillation
Rationale: Atrial fibrillation produces an irregularly irregular heartbeat due to chaotic
atrial activity.
11. The S1 heart sound is caused by:
a. Closure of the aortic and pulmonic valves
b. Closure of the mitral and tricuspid valves
c. Opening of the semilunar valves
d. Opening of the AV valves
Answer: b. Closure of the mitral and tricuspid valves
Rationale: S1 (“lub”) corresponds to AV valve closure at the beginning of systole.
12. Which heart valve is located between the left atrium and left ventricle?
a. Tricuspid
b. Pulmonary
c. Mitral
d. Aortic
Answer: c. Mitral
Rationale: The mitral valve (bicuspid) separates the left atrium and left ventricle.
13. Which of the following is a non-modifiable risk factor for heart disease?
a. Hypertension
b. Age
c. Diet
d. Smoking
Answer: b. Age
Rationale: Age cannot be changed and increases the risk of cardiovascular disease.