NSG 3160 Exam 3 2026 | 200 Practice Questions
with Answers & Detailed Explanations | Health
Assessment – Cardiovascular, Respiratory, Neuro,
Abdominal & MSK | Galen College | Latest Update
📚 Section 1: Cardiovascular Assessment (Questions 1–50)
1. A nurse is assessing the carotid arteries of an older patient. Which of the following
actions should the nurse AVOID?
A) Palpate gently to avoid excessive pressure
B) Palpate only one carotid artery at a time
C) Palpate both carotid arteries simultaneously to measure if pulses are equal
D) Auscultate for bruits before palpation
Answer: C
Explanation: Palpating both carotid arteries simultaneously is never done. This maneuver
can compromise blood flow to the brain (cerebral circulation) and induce bradycardia or
syncope. Carotid pulses must be palpated one side at a time. Auscultation for bruits should
be performed before palpation to avoid falsely detecting a bruit caused by compression .
, 2. A nurse is assessing a patient's capillary refill time. Which finding is considered
normal?
A) Less than 2 seconds
B) 3–4 seconds
C) 5–6 seconds
D) Greater than 6 seconds
Answer: A
Explanation: Normal capillary refill time is less than 2 seconds (1–2 seconds). Prolonged
capillary refill (>2 seconds) may indicate poor peripheral perfusion. Conditions that can
skew capillary refill findings include cold temperature, cigarette smoking, peripheral edema,
and anemia .
3. The nurse is assessing the apical impulse on an adult patient. Where would the
nurse expect to palpate this impulse?
A) Second left intercostal space at the sternal border
B) Fifth left intercostal space at the midclavicular line
C) Fourth left intercostal space at the midclavicular line
D) Third left intercostal space at the sternal border
Answer: B
Explanation: The apical impulse (point of maximal impulse or PMI) is normally located in the
fifth left intercostal space at the midclavicular line. This corresponds to the apex of the heart.
Displacement of the PMI may indicate cardiac enlargement or other pathology .
, 4. Some older adults experience a sudden drop in blood pressure when rising to sit
or stand. This is called:
A) Aortic impulse
B) Orthostatic hypotension
C) Cardiac thrill
D) Bradypnea
Answer: B
Explanation: Orthostatic hypotension is defined as a drop in systolic blood pressure of 20
mm Hg or more, or a drop in diastolic blood pressure of 10 mm Hg or more, within 3
minutes of standing. This is a common finding in older adults and requires careful
assessment and fall prevention interventions .
5. During a cardiac assessment, the nurse hears a high-pitched, blowing diastolic
murmur at the left sternal border. This finding is most consistent with:
A) Aortic stenosis
B) Mitral regurgitation
C) Aortic regurgitation
D) Tricuspid stenosis
Answer: C
Explanation: Aortic regurgitation produces a high-pitched, blowing diastolic murmur best
heard at the left sternal border (often with the patient leaning forward, expiration). Aortic
, stenosis is a systolic ejection murmur, mitral regurgitation is a holosystolic murmur at the
apex, and tricuspid stenosis is a diastolic murmur that increases with inspiration .
6. In assessing a patient's major risk factors for heart disease, the nurse should
include which of the following?
A) Family history, hypertension, stress, age
B) Personality type, high cholesterol, diabetes, smoking
C) Smoking, hypertension, obesity, diabetes, high cholesterol
D) Alcohol consumption, obesity, diabetes, stress, high cholesterol
Answer: C
Explanation: Major risk factors for coronary artery disease include elevated serum
cholesterol, elevated blood pressure, smoking, obesity, diabetes, and a sedentary lifestyle.
Family history and age are also important but are non-modifiable risk factors .
7. During an assessment of a 68-year-old man with a recent onset of right-sided
weakness, the nurse hears a blowing, swishing sound with the bell of the
stethoscope over the left carotid artery. This finding would indicate:
A) Normal blood flow
B) Blood flow turbulence
C) Venous hum
D) Arterial occlusion
with Answers & Detailed Explanations | Health
Assessment – Cardiovascular, Respiratory, Neuro,
Abdominal & MSK | Galen College | Latest Update
📚 Section 1: Cardiovascular Assessment (Questions 1–50)
1. A nurse is assessing the carotid arteries of an older patient. Which of the following
actions should the nurse AVOID?
A) Palpate gently to avoid excessive pressure
B) Palpate only one carotid artery at a time
C) Palpate both carotid arteries simultaneously to measure if pulses are equal
D) Auscultate for bruits before palpation
Answer: C
Explanation: Palpating both carotid arteries simultaneously is never done. This maneuver
can compromise blood flow to the brain (cerebral circulation) and induce bradycardia or
syncope. Carotid pulses must be palpated one side at a time. Auscultation for bruits should
be performed before palpation to avoid falsely detecting a bruit caused by compression .
, 2. A nurse is assessing a patient's capillary refill time. Which finding is considered
normal?
A) Less than 2 seconds
B) 3–4 seconds
C) 5–6 seconds
D) Greater than 6 seconds
Answer: A
Explanation: Normal capillary refill time is less than 2 seconds (1–2 seconds). Prolonged
capillary refill (>2 seconds) may indicate poor peripheral perfusion. Conditions that can
skew capillary refill findings include cold temperature, cigarette smoking, peripheral edema,
and anemia .
3. The nurse is assessing the apical impulse on an adult patient. Where would the
nurse expect to palpate this impulse?
A) Second left intercostal space at the sternal border
B) Fifth left intercostal space at the midclavicular line
C) Fourth left intercostal space at the midclavicular line
D) Third left intercostal space at the sternal border
Answer: B
Explanation: The apical impulse (point of maximal impulse or PMI) is normally located in the
fifth left intercostal space at the midclavicular line. This corresponds to the apex of the heart.
Displacement of the PMI may indicate cardiac enlargement or other pathology .
, 4. Some older adults experience a sudden drop in blood pressure when rising to sit
or stand. This is called:
A) Aortic impulse
B) Orthostatic hypotension
C) Cardiac thrill
D) Bradypnea
Answer: B
Explanation: Orthostatic hypotension is defined as a drop in systolic blood pressure of 20
mm Hg or more, or a drop in diastolic blood pressure of 10 mm Hg or more, within 3
minutes of standing. This is a common finding in older adults and requires careful
assessment and fall prevention interventions .
5. During a cardiac assessment, the nurse hears a high-pitched, blowing diastolic
murmur at the left sternal border. This finding is most consistent with:
A) Aortic stenosis
B) Mitral regurgitation
C) Aortic regurgitation
D) Tricuspid stenosis
Answer: C
Explanation: Aortic regurgitation produces a high-pitched, blowing diastolic murmur best
heard at the left sternal border (often with the patient leaning forward, expiration). Aortic
, stenosis is a systolic ejection murmur, mitral regurgitation is a holosystolic murmur at the
apex, and tricuspid stenosis is a diastolic murmur that increases with inspiration .
6. In assessing a patient's major risk factors for heart disease, the nurse should
include which of the following?
A) Family history, hypertension, stress, age
B) Personality type, high cholesterol, diabetes, smoking
C) Smoking, hypertension, obesity, diabetes, high cholesterol
D) Alcohol consumption, obesity, diabetes, stress, high cholesterol
Answer: C
Explanation: Major risk factors for coronary artery disease include elevated serum
cholesterol, elevated blood pressure, smoking, obesity, diabetes, and a sedentary lifestyle.
Family history and age are also important but are non-modifiable risk factors .
7. During an assessment of a 68-year-old man with a recent onset of right-sided
weakness, the nurse hears a blowing, swishing sound with the bell of the
stethoscope over the left carotid artery. This finding would indicate:
A) Normal blood flow
B) Blood flow turbulence
C) Venous hum
D) Arterial occlusion
