Question 1

Purkinje fibers are located in the:

Accepted Answer

A)  sinoatrial node. 
B)  atrioventricular node. 
C)  myocardium. 
D)  aortic arch. 
A)  sinoatrial node. 
B)  atrioventricular node. 
C)  myocardium. 
D)  aortic arch.

Question 2

During the auscultation of heart tones, you are uncertain whether the sound you hear is an S2 split. You should ask the patient to inhale deeply while listening at the ______ area.

Accepted Answer

Splitting of S₂ is

Question 3

In the fetus, the right ventricle pumps blood through the:

Accepted Answer

A)  left atrium. 
B)  ductus arteriosus. 
C)  lungs. 
D)  foramen ovale. 
A)  left atrium. 
B)  ductus arteriosus. 
C)  lungs. 
D)  foramen ovale.

Question 4

The apex of a 2-month-old baby's heart typically lies closest to the:

Accepted Answer

A)  fourth left intercostal space. 
B)  midsternal area. 
C)  midthoracic spinal area. 
D)  sixth left intercostal space. 
A)  fourth left intercostal space. 
B)  midsternal area. 
C)  midthoracic spinal area. 
D)  sixth left intercostal space.

Question 5

The major heart sounds are normally created by:

Accepted Answer

A)  valves opening. 
B)  valves closing. 
C)  the rapid movement of blood. 
D)  rubbing together of the cardiac walls. 
A)  valves opening. 
B)  valves closing. 
C)  the rapid movement of blood. 
D)  rubbing together of the cardiac walls.

Question 6

An increase in heart rate during inspiration, with a decrease in this rate during expiration, is an expected finding in:

Accepted Answer

A)  adults under stress. 
B)  4-year-old children. 
C)  pregnant women. 
D)  premature infants. 
A)  adults under stress. 
B)  4-year-old children. 
C)  pregnant women. 
D)  premature infants.

Question 7

To estimate heart size by percussion, you should begin tapping at the:

Accepted Answer

A)  anterior axillary line. 
B)  left sternal border. 
C)  midclavicular line. 
D)  midsternal line. 
A)  anterior axillary line. 
B)  left sternal border. 
C)  midclavicular line. 
D)  midsternal line.

Question 8

Which two structures together form the primary muscle mass of the heart?

Accepted Answer

A)  Right and left ventricles 
B)  Left ventricle and the aorta 
C)  Right and left atria 
D)  Left atrium and the pulmonary vein 
A)  Right and left ventricles 
B)  Left ventricle and the aorta 
C)  Right and left atria 
D)  Left atrium and the pulmonary vein

Question 9

Pleural pain differs from chest discomfort caused by other conditions in that it is:

Accepted Answer

A)  precipitated by coughing. 
B)  eased with deep breathing. 
C)  usually described as dull in nature. 
D)  related to time of day. 
A)  precipitated by coughing. 
B)  eased with deep breathing. 
C)  usually described as dull in nature. 
D)  related to time of day.

Question 10

A lift along the left sternal border is most likely the result of:

Accepted Answer

A)  aortic stenosis. 
B)  atrial septal defect. 
C)  pulmonary hypertension. 
D)  right ventricular hypertrophy. 
A)  aortic stenosis. 
B)  atrial septal defect. 
C)  pulmonary hypertension. 
D)  right ventricular hypertrophy.

Question 11

In the adult, the apical impulse should be most visible when the patient is in what position?

Accepted Answer

A)  Supine 
B)  Upright 
C)  Lithotomy 
D)  Right lateral recumbent 
A)  Supine 
B)  Upright 
C)  Lithotomy 
D)  Right lateral recumbent

Question 12

A condition that is likely to present with dizziness and syncope is:

Accepted Answer

A)  bacterial endocarditis. 
B)  hypertension. 
C)  sick sinus syndrome. 
D)  pericarditis. 
A)  bacterial endocarditis. 
B)  hypertension. 
C)  sick sinus syndrome. 
D)  pericarditis.

Question 13

The auscultation of a triphasic friction rub in a patient with acute chest pain should lead you to suspect:

Accepted Answer

A)  congestive heart failure. 
B)  pericarditis. 
C)  endocarditis. 
D)  cardiac tamponade. 
A)  congestive heart failure. 
B)  pericarditis. 
C)  endocarditis. 
D)  cardiac tamponade.

Question 14

Normal heart sounds are best heard:

Accepted Answer

A)  directly over the semilunar and bicuspid heart valves. 
B)  over areas where blood flows after it passes through a valve. 
C)  near the carotid vessels. 
D)  over the central sternum. 
A)  directly over the semilunar and bicuspid heart valves. 
B)  over areas where blood flows after it passes through a valve. 
C)  near the carotid vessels. 
D)  over the central sternum.

Question 15

A third heart sound is created by:

Accepted Answer

A)  atrial contraction. 
B)  ventricular contraction. 
C)  diastolic filling. 
D)  regurgitation between the right and left ventricles. 
A)  atrial contraction. 
B)  ventricular contraction. 
C)  diastolic filling. 
D)  regurgitation between the right and left ventricles.

Question 16

Chest pain with an organic cause in a child is most likely the result of:

Accepted Answer

A)  cardiac disease. 
B)  asthma. 
C)  esophageal reflux. 
D)  arthritis. 
A)  cardiac disease. 
B)  asthma. 
C)  esophageal reflux. 
D)  arthritis.

Question 17

You are listening to a patient's heart sounds in the aortic and pulmonic areas. The sound becomes asynchronous during inspiration. The prevalent heart sound in this area is most likely:

Accepted Answer

A)  S1. 
B)  S2. 
C)  S3. 
D)  S4. 
A)  S1. 
B)  S2. 
C)  S3. 
D)  S4.

Question 18

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:

Accepted Answer

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. 
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.

Question 19

Normal cardiac changes that occur during pregnancy include:

Accepted Answer

A)  decreased cardiac output. 
B)  increased thickness and mass of the left ventricle. 
C)  decreased heart rate. 
D)  dilation of the ventricles. 
A)  decreased cardiac output. 
B)  increased thickness and mass of the left ventricle. 
C)  decreased heart rate. 
D)  dilation of the ventricles.

Question 20

A grade IV mitral regurgitation murmur would:

Accepted Answer

A)  be described as a diastolic murmur. 
B)  not be expected to have a thrill. 
C)  radiate to the axilla. 
D)  be heard best at the base. 
A)  be described as a diastolic murmur. 
B)  not be expected to have a thrill. 
C)  radiate to the axilla. 
D)  be heard best at the base.

Exam 14: Heart

Purkinje fibers are located in the:

During the auscultation of heart tones, you are uncertain whether the sound you hear is an S2 split. You should ask the patient to inhale deeply while listening at the ______ area.

In the fetus, the right ventricle pumps blood through the:

The apex of a 2-month-old baby's heart typically lies closest to the:

The major heart sounds are normally created by:

An increase in heart rate during inspiration, with a decrease in this rate during expiration, is an expected finding in:

To estimate heart size by percussion, you should begin tapping at the:

Which two structures together form the primary muscle mass of the heart?

Pleural pain differs from chest discomfort caused by other conditions in that it is:

A lift along the left sternal border is most likely the result of:

In the adult, the apical impulse should be most visible when the patient is in what position?

A condition that is likely to present with dizziness and syncope is:

The auscultation of a triphasic friction rub in a patient with acute chest pain should lead you to suspect:

Normal heart sounds are best heard:

A third heart sound is created by:

Chest pain with an organic cause in a child is most likely the result of:

You are listening to a patient's heart sounds in the aortic and pulmonic areas. The sound becomes asynchronous during inspiration. The prevalent heart sound in this area is most likely:

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:

Normal cardiac changes that occur during pregnancy include:

A grade IV mitral regurgitation murmur would:

The History and Interviewing Process

Cultural Competency

Examination Techniques and Equipment

Vital Signs and Pain Assessment

Mental Status

Growth and Measurement

Nutrition

Skin, Hair, and Nails

Lymphatic System

Head and Neck

Eyes

Ears, Nose, and Throat

Chest and Lungs

Blood Vessels

Breasts and Axillae

Abdomen

Female Genitalia

Male Genitalia

Anus, Rectum, and Prostate

Musculoskeletal System

Neurologic System

Sports Participation Evaluation

Putting It All Together

Taking the Next Steps: Critical Thinking

Recording Information

Emergency or Life-Threatening Situations

Filters

During the auscultation of heart tones, you are uncertain whether the sound you hear is an S₂ split. You should ask the patient to inhale deeply while listening at the ______ area.