NSG-316 EXAM 3 QUESTIONS AND
ANSWERS GRADED A+ 2025/2026
Myocardium
heart muscle that surrounds ventricles and atrium
Atria are thinner as they need to pump less strong
pericardium
external layer that protects heart from injury/infection
endocardium
3 layered membrane that lines heart chambers
blockage of coronary arteries can lead to
heart attack or stroke
heart failure
increased pressure of cardiac overload
-pulm congestion
-inc amount of blood in pulm capillaries
Left sided heart failure
dyspnea/SOB, pulmonary edema
right sided heart failure
blood back up in the periphery and will present with edema
cardiomegaly
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,abnormal enlargement of the heart due to over working to compensate for decreased function
frequency
high pitched or low pitched
what should you use the diaphragm of a stethoscope for
high pitched, normal sounds
what should you use the bell of a stethoscope for
low pitched, abnormal heart sounds, murmurs
intensity/loudness
loud or soft
duration
short heart sounds, or silent periods
timing
systole or diastole
carotid artery/pulse
found in the neck. feel one at a time. S1 is felt
what is the most diminished pulse in the aging adult
pedal pulse
normal heart sounds
S1 and S2
S1 heart sound
-occurs with closure of mitral and tricuspid valves (AV valve)
-"lub" sound
-loudest at apex (5th intercostal space at midclavicular line)
S2 heart sound
-occurs with closure of aortic and pulmonic valves (semilunar valves)
-"dub" sound
-loudest at base of heart (2nd intercostal space)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, abnormal heart sounds
S3 and S4 sounds, murmurs, and bruits
S3 heart sounds
-not usually heard
-gallop sound
-indication of HF
-occurs with ventricular resistance of filling
S4 heart sounds
-create vibrations
-can be heard right before S1 sound
-occurs at end of diastole when ventricles resist filling
murmurs
-from turbulent blood flow
-heard directly over heart
-gentle blowing/swooshing sound
What is the murmur loudness scale for a level 1-3 murmur?
No thrill
What does a level 4 murmur indicate?
Feel thrill
What does a level 5 murmur indicate?
Feel and hear thrill
Can you hear a level 5 murmur through a stethoscope?
Yes
What does a level 6 murmur indicate?
Can hear thrill without stethoscope
timing of murmur
early, middle, late, systole/diastole (S1/S2)
murmur pitch
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS GRADED A+ 2025/2026
Myocardium
heart muscle that surrounds ventricles and atrium
Atria are thinner as they need to pump less strong
pericardium
external layer that protects heart from injury/infection
endocardium
3 layered membrane that lines heart chambers
blockage of coronary arteries can lead to
heart attack or stroke
heart failure
increased pressure of cardiac overload
-pulm congestion
-inc amount of blood in pulm capillaries
Left sided heart failure
dyspnea/SOB, pulmonary edema
right sided heart failure
blood back up in the periphery and will present with edema
cardiomegaly
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,abnormal enlargement of the heart due to over working to compensate for decreased function
frequency
high pitched or low pitched
what should you use the diaphragm of a stethoscope for
high pitched, normal sounds
what should you use the bell of a stethoscope for
low pitched, abnormal heart sounds, murmurs
intensity/loudness
loud or soft
duration
short heart sounds, or silent periods
timing
systole or diastole
carotid artery/pulse
found in the neck. feel one at a time. S1 is felt
what is the most diminished pulse in the aging adult
pedal pulse
normal heart sounds
S1 and S2
S1 heart sound
-occurs with closure of mitral and tricuspid valves (AV valve)
-"lub" sound
-loudest at apex (5th intercostal space at midclavicular line)
S2 heart sound
-occurs with closure of aortic and pulmonic valves (semilunar valves)
-"dub" sound
-loudest at base of heart (2nd intercostal space)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, abnormal heart sounds
S3 and S4 sounds, murmurs, and bruits
S3 heart sounds
-not usually heard
-gallop sound
-indication of HF
-occurs with ventricular resistance of filling
S4 heart sounds
-create vibrations
-can be heard right before S1 sound
-occurs at end of diastole when ventricles resist filling
murmurs
-from turbulent blood flow
-heard directly over heart
-gentle blowing/swooshing sound
What is the murmur loudness scale for a level 1-3 murmur?
No thrill
What does a level 4 murmur indicate?
Feel thrill
What does a level 5 murmur indicate?
Feel and hear thrill
Can you hear a level 5 murmur through a stethoscope?
Yes
What does a level 6 murmur indicate?
Can hear thrill without stethoscope
timing of murmur
early, middle, late, systole/diastole (S1/S2)
murmur pitch
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
