Chapter 15: Heart
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mr. O, age 50 years, comes for his annual health assessment, which is provided by his
employer. During your initial history-taking
interview, Mr. O mentions that he routinely engages in light exercise. At this time, you should:
a. ask if he makes his own bed daily.
b. have the patient describe his exercise.
c. make a note that he walks each day.
d. record “light exercise” in the history.
ANS: B
When Mr. O says that he engages in light exercise, have him describe his exercise. To qualify his
use of the term light, ask him the type, length of time, frequency, and intensity of his activities.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Which of the following information belongs in the past medical history section related to heart
and blood vessel assessment?
a. Adolescent inguinal hernia
b. Childhood mumps
c. History of bee stings
d. Previous unexplained fever
ANS: D
Previous unexplained fever should be included in the past medical history of a heart and blood
vessel assessment. This incidence may be related to acute rheumatic fever, with potential heart
valve damage.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. A patient you are seeing in the emergency department for chest pain is believed to be having a
myocardial infarction. During the
health history interview of his family history, he relates that his father had died of “heart
trouble.” The most important follow-up
question you should pose is which of the following?
a. “Did your father have coronary bypass surgery?”
b. “Did your father’s father have heart trouble also?”
c. “What were your father’s usual dietary habits?”
d. “What age was your father at the time of his death?”
ANS: D
A family history of sudden death, particularly in young and middle-aged relatives, significantly
increases one’s chance of a similar occurrence.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Which one of the following is a common symptom of cardiovascular disorders in the older
adult?
a. Fatigue
b. Joint pain
c. Poor night vision
d. Weight gain
ANS: A
Common symptoms of cardiovascular disorders in older adults include confusion, dizziness,
blackouts, syncope, palpitations, coughs and wheezes, hemoptysis, shortness of breath, chest
pains or tightness, impotence, fatigue, and leg edema.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. In the adult, the apical impulse should be most visible when the patient is in what position?
a. Supine
b. Upright
c. Lithotomy
d. Right lateral recumbent
ANS: B
In most adults, the apical impulse should be visible at about the midclavicular line in the fifth left
intercostal space, but it is easily obscured by obesity, large breasts, or muscularity. The apical
impulse may become visible only when the patient sits upright and the heart is brought closer to
the anterior wall. A visible and palpable impulse when the patient is supine suggests an intensity
that may be the result of a problem. In most adults, the apical impulse will not be visible in the
upright, lithotomy, or right lateral recumbent positions.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. If the apical impulse is more vigorous than expected, it is called a:
a. lift.
b. thrill.
c. bruit.
d. murmur.
ANS: A
If the apical impulse is more vigorous than expected, it is referred to as a lift or heave. A thrill is
a palpable murmur. A bruit is an auscultated arterial murmur. A murmur is an auscultated sound
caused by turbulent blood flow into, through, or out of the heart.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A palpable rushing vibration over the base of the heart at the second intercostal space is called
a:
a. heave.
b. lift.
c. thrill.
d. thrust.
ANS: C
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mr. O, age 50 years, comes for his annual health assessment, which is provided by his
employer. During your initial history-taking
interview, Mr. O mentions that he routinely engages in light exercise. At this time, you should:
a. ask if he makes his own bed daily.
b. have the patient describe his exercise.
c. make a note that he walks each day.
d. record “light exercise” in the history.
ANS: B
When Mr. O says that he engages in light exercise, have him describe his exercise. To qualify his
use of the term light, ask him the type, length of time, frequency, and intensity of his activities.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Which of the following information belongs in the past medical history section related to heart
and blood vessel assessment?
a. Adolescent inguinal hernia
b. Childhood mumps
c. History of bee stings
d. Previous unexplained fever
ANS: D
Previous unexplained fever should be included in the past medical history of a heart and blood
vessel assessment. This incidence may be related to acute rheumatic fever, with potential heart
valve damage.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. A patient you are seeing in the emergency department for chest pain is believed to be having a
myocardial infarction. During the
health history interview of his family history, he relates that his father had died of “heart
trouble.” The most important follow-up
question you should pose is which of the following?
a. “Did your father have coronary bypass surgery?”
b. “Did your father’s father have heart trouble also?”
c. “What were your father’s usual dietary habits?”
d. “What age was your father at the time of his death?”
ANS: D
A family history of sudden death, particularly in young and middle-aged relatives, significantly
increases one’s chance of a similar occurrence.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
, 4. Which one of the following is a common symptom of cardiovascular disorders in the older
adult?
a. Fatigue
b. Joint pain
c. Poor night vision
d. Weight gain
ANS: A
Common symptoms of cardiovascular disorders in older adults include confusion, dizziness,
blackouts, syncope, palpitations, coughs and wheezes, hemoptysis, shortness of breath, chest
pains or tightness, impotence, fatigue, and leg edema.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. In the adult, the apical impulse should be most visible when the patient is in what position?
a. Supine
b. Upright
c. Lithotomy
d. Right lateral recumbent
ANS: B
In most adults, the apical impulse should be visible at about the midclavicular line in the fifth left
intercostal space, but it is easily obscured by obesity, large breasts, or muscularity. The apical
impulse may become visible only when the patient sits upright and the heart is brought closer to
the anterior wall. A visible and palpable impulse when the patient is supine suggests an intensity
that may be the result of a problem. In most adults, the apical impulse will not be visible in the
upright, lithotomy, or right lateral recumbent positions.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. If the apical impulse is more vigorous than expected, it is called a:
a. lift.
b. thrill.
c. bruit.
d. murmur.
ANS: A
If the apical impulse is more vigorous than expected, it is referred to as a lift or heave. A thrill is
a palpable murmur. A bruit is an auscultated arterial murmur. A murmur is an auscultated sound
caused by turbulent blood flow into, through, or out of the heart.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A palpable rushing vibration over the base of the heart at the second intercostal space is called
a:
a. heave.
b. lift.
c. thrill.
d. thrust.
ANS: C
