NUR 505 Exam #2 questions with correct answers A+
Grade 2026\2027
tricuspid valve
- correct answer valve between the right atrium and the right ventricle (AV valve)
has 3 cusps
prevents blood from flowing back into atria during systole
4th ICS at lower left sternal border
mitral valve
- correct answer valve between the left atrium and the left ventricle (AV valve)
has 2 cusps
prevents blood from flowing back into atria during systole
5th ICS at MCL
Also PMI, location of apical pulse
best location to auscultate S1, S3, and S4
absence of PMI
- correct answer indicates extracardiac issue (pleural or pericardial fluid)
systolic click
- correct answer caused by floppy mitral valve
high-pitched
have patient lie supine and upright
opening snap
- correct answer caused by abrupt recoil of stenotic mitral or tricuspid valve
,high-pitched with sharp snap or click
patient in any position
pericardial friction rub
- correct answer intense, grating, machine-like that may occupy all of systole and diastole
S1
- correct answer the first heart sound, heard when the atrioventricular (mitral and tricuspid) valves close
low-pitched
heard at apex
S2
- correct answer the second heart sound, heard when the semilunar (aortic and pulmonic) valves close
higher pitch and shorter duration than S1
heard at aortic and pulmonic areas
S3
- correct answer caused by passive blood flow from atria
quiet, low-pitched and somewhat difficult to hear
have patient lie supine or left lateral recumbent position
gallop
- correct answer S3 and S4 fuse together caused by fast heart rates
low-pitched and intense
have patient supine or in left lateral recumbent position
S4
- correct answer caused by vibration of valves, papillae, and ventricular walls
quiet, low-pitched and resembles rhythm of "TEN-nessee"
have patient supine of left lateral recumbent position
most commonly heard in older adults with HTN
,loud S4 always suggests pathology
mitral stenosis
- correct answer auscultate with bell with patient in left lateral decubitus position
restricts forward flow
often occurs in mitral regurgitation
caused by rheumatic fever or cardiac infection
low frequency, DIASTOLIC rumble and DOES NOT RADIATE
followed by OPENING SNAP
PAPALPABLE THRILL AT APEX
mitral regurgitation
- correct answer loudest at apex and transmitted into left axilla
valve incompetence causes backflow from ventricle to atrium
caused by rheumatic fever, MI, myxoma, rupture of chordae
HOLOSYSTOLIC, PLATEUA-SHAPED, HARSH BLOWING quality
often quite LOUD
mitral valve prolapse
- correct answer valve incompetence early in systole but prolapse into atrium later in systole
listen with patient upright
typically LATE SYSTOLIC murmur preceded by MIDSYSTOLIC CLICKS but both murmur and clicks highly
variable in intensity and timing
common with PECTUS EXCAVATUM
aortic valve
- correct answer heart valve between the left ventricle and the aorta (semilunar valve)
has 3 cusps
open during systole for pulmonary circulation and closes during diastole to shut off backward flow into
ventricles
2nd ICS at right sternal border
, best location to auscultate S2
aortic stenosis
- correct answer calcification of valve cusps restricts forward flow
caused by congenital bicuspid valve, rheumatic heart disease, atherosclerosis
MID-SYSTOLIC murmur that is MEDIUM-PITCHED, COARSE, DIAMOND-SHAPED, CRESCENDO-
DECRESCENDO
RADIATES alone LEFT STERNAL BORDER and to CAROTID with palpable thrill
may be the CAUSE OF SUDDEN DEATH IN CHILDREN AND ADOLESCENTS with or without physical activity
aortic regurgitation
- correct answer heard with diaphragm patient sitting and leaning forward
incompetent valve allows backflow from aorta to ventricle
caused by rheumatic heart disease, Marfan syndrome, syphilis, ankylosing spondylitis, dissection, or
cardiac trauma
EARLY DIASTOLIC, HIGH-PITCHED, BLOWING often with diamond-shaped midsystolic murmur
AUSTIN-FLINT MURMUR common
WATER-HAMMER or CORRIGAN pulse common
Austin-Flint murmur
- correct answer caused by aortic regurgitation
heard with bell at apex
low-pitched
pulmonic valve
- correct answer right semilunar valve separating the right ventricle and pulmonary artery
has 3 cusps
helps pushes blood into pulmonary artery during systole, and closes during diastole to prevent backflow
of blood into ventricles
2nd ICS at left sternal border
best location to auscultate S2
Grade 2026\2027
tricuspid valve
- correct answer valve between the right atrium and the right ventricle (AV valve)
has 3 cusps
prevents blood from flowing back into atria during systole
4th ICS at lower left sternal border
mitral valve
- correct answer valve between the left atrium and the left ventricle (AV valve)
has 2 cusps
prevents blood from flowing back into atria during systole
5th ICS at MCL
Also PMI, location of apical pulse
best location to auscultate S1, S3, and S4
absence of PMI
- correct answer indicates extracardiac issue (pleural or pericardial fluid)
systolic click
- correct answer caused by floppy mitral valve
high-pitched
have patient lie supine and upright
opening snap
- correct answer caused by abrupt recoil of stenotic mitral or tricuspid valve
,high-pitched with sharp snap or click
patient in any position
pericardial friction rub
- correct answer intense, grating, machine-like that may occupy all of systole and diastole
S1
- correct answer the first heart sound, heard when the atrioventricular (mitral and tricuspid) valves close
low-pitched
heard at apex
S2
- correct answer the second heart sound, heard when the semilunar (aortic and pulmonic) valves close
higher pitch and shorter duration than S1
heard at aortic and pulmonic areas
S3
- correct answer caused by passive blood flow from atria
quiet, low-pitched and somewhat difficult to hear
have patient lie supine or left lateral recumbent position
gallop
- correct answer S3 and S4 fuse together caused by fast heart rates
low-pitched and intense
have patient supine or in left lateral recumbent position
S4
- correct answer caused by vibration of valves, papillae, and ventricular walls
quiet, low-pitched and resembles rhythm of "TEN-nessee"
have patient supine of left lateral recumbent position
most commonly heard in older adults with HTN
,loud S4 always suggests pathology
mitral stenosis
- correct answer auscultate with bell with patient in left lateral decubitus position
restricts forward flow
often occurs in mitral regurgitation
caused by rheumatic fever or cardiac infection
low frequency, DIASTOLIC rumble and DOES NOT RADIATE
followed by OPENING SNAP
PAPALPABLE THRILL AT APEX
mitral regurgitation
- correct answer loudest at apex and transmitted into left axilla
valve incompetence causes backflow from ventricle to atrium
caused by rheumatic fever, MI, myxoma, rupture of chordae
HOLOSYSTOLIC, PLATEUA-SHAPED, HARSH BLOWING quality
often quite LOUD
mitral valve prolapse
- correct answer valve incompetence early in systole but prolapse into atrium later in systole
listen with patient upright
typically LATE SYSTOLIC murmur preceded by MIDSYSTOLIC CLICKS but both murmur and clicks highly
variable in intensity and timing
common with PECTUS EXCAVATUM
aortic valve
- correct answer heart valve between the left ventricle and the aorta (semilunar valve)
has 3 cusps
open during systole for pulmonary circulation and closes during diastole to shut off backward flow into
ventricles
2nd ICS at right sternal border
, best location to auscultate S2
aortic stenosis
- correct answer calcification of valve cusps restricts forward flow
caused by congenital bicuspid valve, rheumatic heart disease, atherosclerosis
MID-SYSTOLIC murmur that is MEDIUM-PITCHED, COARSE, DIAMOND-SHAPED, CRESCENDO-
DECRESCENDO
RADIATES alone LEFT STERNAL BORDER and to CAROTID with palpable thrill
may be the CAUSE OF SUDDEN DEATH IN CHILDREN AND ADOLESCENTS with or without physical activity
aortic regurgitation
- correct answer heard with diaphragm patient sitting and leaning forward
incompetent valve allows backflow from aorta to ventricle
caused by rheumatic heart disease, Marfan syndrome, syphilis, ankylosing spondylitis, dissection, or
cardiac trauma
EARLY DIASTOLIC, HIGH-PITCHED, BLOWING often with diamond-shaped midsystolic murmur
AUSTIN-FLINT MURMUR common
WATER-HAMMER or CORRIGAN pulse common
Austin-Flint murmur
- correct answer caused by aortic regurgitation
heard with bell at apex
low-pitched
pulmonic valve
- correct answer right semilunar valve separating the right ventricle and pulmonary artery
has 3 cusps
helps pushes blood into pulmonary artery during systole, and closes during diastole to prevent backflow
of blood into ventricles
2nd ICS at left sternal border
best location to auscultate S2
