ADVANCED HEALTH ASSESSMENT
QUESTIONS AND ANSWERS GRADED A+
The most anterior surface of the heart is formed by the right ventricle. The heart is turned ventrally on
its axis, putting its right side more forward. The left atrium is above the left ventricle, forming the most
posterior aspect of the heart.
Which two structures together form the primary muscle mass of the heart?
A. Right and left ventricles
B. Left ventricle and the aorta
C. Right and left atria
D. Left atrium and the pulmonary vein – Answer: A
Normal cardiac changes that occur during pregnancy include:
A. decreased cardiac output.
B. increased thickness and mass of the left ventricle.
C. decreased heart rate.
D. dilation of the ventricles. - Answers: B
Mr. Jones and his wife have brought in their infant daughter for a routine visit. A holosystolic murmur in
an infant that is best heard along the left sternal border, is in the third to fifth intercostal spaces, and
does not radiate to the neck is indicative of:
A. ventricular septal defect.
B. patent ductus arteriosus.
C. pulmonary stenosis.
D. dextrocardia. - Answer: A
Regurgitation through the ventricular septal defect results in a holosystolic murmur that is best heard
along the left sternal border, is in the third to fifth intercostal spaces, and does not radiate to the neck.
Mr. O., age 50, comes for his yearly 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. - Answer: B
When Mr. O. says 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.
Ms. Sharpe is a 22-year-old secretary. She presents with fatigue, malaise, and a rash. On auscultation of
her heart, you note murmurs of mitral regurgitation and aortic stenosis. She reports a recent severe sore
throat. You suspect:
A. angina.
B. acute rheumatic fever.
C. cardiac amyloidosis.
D. aortic sclerosis. - Answer: B
Acute rheumatic fever is a systemic connective tissue disease that occurs after a streptococcal
pharyngitis or skin infection. It may result in serious cardiac valvular involvement of the mitral or aortic
valve. Often the valve becomes stenotic and regurgitant. Prevention is adequate treatment of
streptococcal pharyngitis or skin infections.
The atria are small, thin-walled structures that act primarily as reservoirs for the blood returning to the
heart from the venous system. The pericardium is a double-walled membranous fibro serous sac
enclosing the heart and the bases of the great vessels. A sinus is a dilated channel for venous blood. The
ventricles are large, thick-walled chambers that pump blood to the lungs and throughout the body. The
ventricles are the primary muscle mass of the heart.
To estimate heart size by percussion, you should begin tapping at the:
A. anterior axillary line.
B. left sternal border.
C. midclavicular line.
D. midsternal line. - Answer: A
Estimating the size of the heart can be done by percussion. Begin tapping at the anterior axillary line,
moving medially along the intercostal spaces toward the sternal border. The change from a resonant to a
dull note marks the cardiac border.
To hear diastolic heart sounds, you should ask patients to:
A. lie on their back.
QUESTIONS AND ANSWERS GRADED A+
The most anterior surface of the heart is formed by the right ventricle. The heart is turned ventrally on
its axis, putting its right side more forward. The left atrium is above the left ventricle, forming the most
posterior aspect of the heart.
Which two structures together form the primary muscle mass of the heart?
A. Right and left ventricles
B. Left ventricle and the aorta
C. Right and left atria
D. Left atrium and the pulmonary vein – Answer: A
Normal cardiac changes that occur during pregnancy include:
A. decreased cardiac output.
B. increased thickness and mass of the left ventricle.
C. decreased heart rate.
D. dilation of the ventricles. - Answers: B
Mr. Jones and his wife have brought in their infant daughter for a routine visit. A holosystolic murmur in
an infant that is best heard along the left sternal border, is in the third to fifth intercostal spaces, and
does not radiate to the neck is indicative of:
A. ventricular septal defect.
B. patent ductus arteriosus.
C. pulmonary stenosis.
D. dextrocardia. - Answer: A
Regurgitation through the ventricular septal defect results in a holosystolic murmur that is best heard
along the left sternal border, is in the third to fifth intercostal spaces, and does not radiate to the neck.
Mr. O., age 50, comes for his yearly 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. - Answer: B
When Mr. O. says 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.
Ms. Sharpe is a 22-year-old secretary. She presents with fatigue, malaise, and a rash. On auscultation of
her heart, you note murmurs of mitral regurgitation and aortic stenosis. She reports a recent severe sore
throat. You suspect:
A. angina.
B. acute rheumatic fever.
C. cardiac amyloidosis.
D. aortic sclerosis. - Answer: B
Acute rheumatic fever is a systemic connective tissue disease that occurs after a streptococcal
pharyngitis or skin infection. It may result in serious cardiac valvular involvement of the mitral or aortic
valve. Often the valve becomes stenotic and regurgitant. Prevention is adequate treatment of
streptococcal pharyngitis or skin infections.
The atria are small, thin-walled structures that act primarily as reservoirs for the blood returning to the
heart from the venous system. The pericardium is a double-walled membranous fibro serous sac
enclosing the heart and the bases of the great vessels. A sinus is a dilated channel for venous blood. The
ventricles are large, thick-walled chambers that pump blood to the lungs and throughout the body. The
ventricles are the primary muscle mass of the heart.
To estimate heart size by percussion, you should begin tapping at the:
A. anterior axillary line.
B. left sternal border.
C. midclavicular line.
D. midsternal line. - Answer: A
Estimating the size of the heart can be done by percussion. Begin tapping at the anterior axillary line,
moving medially along the intercostal spaces toward the sternal border. The change from a resonant to a
dull note marks the cardiac border.
To hear diastolic heart sounds, you should ask patients to:
A. lie on their back.
