Chapter 21: Heart and Neck Vessels

Question 1

The anterior chest area that overlies the heart and great vessels is called the

a. endocardium.
b. epicardium.
c. myocardium.
d. precordium.

Answer 1

d. precordium.

Question 2

The bicuspid, or mitral, valve is located

a. between the left atrium and the left ventricle.
b. between the right atrium and the right ventricle.
c. at the beginning of the ascending aorta.
d. at the exit of each ventricle near the great vessels.

Answer 2

a. between the left atrium and the left ventricle.

Question 3

The semilunar valves are located

a. between the left atrium and the left ventricle.
b. between the right atrium and the right ventricle.
c. at the exit of each ventricle at the beginning of the great vessels.
d. at the beginning of the ascending aorta.

Answer 3

c. at the exit of each ventricle at the beginning of the great vessels.

Question 4

The sinoatrial node of the heart is located on the

a. anterior wall of the left atrium.
b. anterior wall of the right atrium.
c. upper intraventricular system.
d. posterior wall of the right atrium.

Answer 4

d. posterior wall of the right atrium.

Question 5

The P-wave phase of an electrocardiogram (ECG) represents

a. conduction of the impulse throughout the ventricles.
b. conduction of the impulse throughout the atria.
c. ventricular repolarization.
d. ventricular polarization.

Answer 5

b. conduction of the impulse throughout the atria.

Question 6

Assessment technique most often associated
with evaluation of the cardiovascular system

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 6

d. Auscultation

Question 7

Event of the heart when contraction of the ventricles forces blood into major vessels

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 7

h. Systole

Question 8

Palpable murmur described as feeling like the throat of a purring cat

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 8

g. Thrill

Question 9

Audible variation between closure of two valves

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 9

i. Splitting

Question 10

Area of auscultation located at second ICS at left sternal border

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 10

a. Pulmonic

Question 11

Localized area of tissue necrosis caused by prolonged anoxia

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 11

c. Infarct

Question 12

Area of auscultation located at the apex and assessing the left ventricle; fourth to fifth ICS at left midclavicular line (MCL)

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 12

f. Mitral

Question 13

Area of auscultation at second ICS and right sternal border

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 13

j. Aortic

Question 14

Part of stethoscope used to auscultate normal heart sounds

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 14

b. Diaphragm

Question 15

The portion of the stethoscope used to assess
for murmurs

a. Pulmonic
b. Diaphragm
c. Infarct
d. Auscultation
e. Bell
f. Mitral
g. Thrill
h. Systole
i. Splitting
j. Aortic

Answer 15

e. Bell

Question 16

During a cardiac examination, the nurse can best hear the S1 heart sound by placing the stethoscope at the client’s

a. base of the heart.
b. pulmonic valve area.
c. apex of the heart.
d. second left interspace.

Answer 16

c. apex of the heart.

Question 17

The S4 heart sound

a. can be heard during systole.
b. is often termed ventricular gallop.
c. is usually due to a heart murmur.
d. can be heard during diastole.

Answer 17

d. can be heard during diastole.

Question 18

An adult client visits the clinic and tells the nurse that she feels chest pain and pain down her left arm. The nurse should refer the client to a physician for possible

a. congestive heart failure.
b. angina.
c. palpitations.
d. acute anxiety reaction.

Answer 18

b. angina.

Question 19

An adult client tells the nurse that his father died of a massive coronary attack at the age of 65. The nurse should explain to the client that one of the risk factors for coronary heart disease is

a. high serum level of low-density lipoproteins.
b. low-carbohydrate diets.
c. high serum level of high-density lipoproteins.
d. diets that are high in antioxidant vitamins.

Answer 19

a. high serum level of low-density lipoproteins.

Question 20

The nurse is planning a presentation about coronary heart disease for a group of middle-aged adults. Which of the following should be included in the nurse’s teaching plan?

a. Hispanic clients have a higher incidence of CHD than black or white Americans.
b. The incidence of hypertension in the white population of the United States is greater than in the black population.
c. Women are more likely to have serious stenosis after a heart attack.
d. Lowering elevated cholesterol and BP decreases the risk of heart attack

Answer 20

d. Lowering elevated cholesterol and BP decreases the risk of heart attack

Question 21

The nurse is preparing to assess the cardiovascular system of an adult client with emphysema. The nurse anticipates that there may be some difficulty palpating the client’s

a. apical pulse.
b. breath sounds.
c. jugular veins.
d. carotid arteries.

Answer 21

a. apical pulse.

Question 22

The nurse is planning to auscultate a female adult client’s carotid arteries. The nurse should plan to

a. ask the client to hold her breath.
b. palpate the arteries before auscultation.
c. place the diaphragm of the stethoscope over the artery.
d. ask the client to breathe normally.

Answer 22

a. ask the client to hold her breath.

Question 23

While assessing an older adult client, the nurse detects a bruit over the carotid artery. The nurse should explain to the client that a bruit is

a. a normal sound heard in adult clients.
b. a wheezing sound.
c. associated with occlusive arterial disease.
d. heard when the artery is almost totally occluded.

Answer 23

c. associated with occlusive arterial disease.

Question 24

The nurse assesses a hospitalized adult client and observes that the client’s jugular veins are fully extended. The nurse contacts the client’s physician because the client’s signs are indicative of

a. pulmonary emphysema.
b. diastolic murmurs.
c. patent ductus arteriosus.
d. increased central venous pressure.

Answer 24

d. increased central venous pressure.

Question 25

While palpating the apex, left sternal border, and base in an adult client, the nurse detects a thrill. The nurse should further assess the client for

a. cardiac murmur.
b. left-sided heart failure.
c. constrictive pericarditis.
d. congestive heart failure.

Answer 25

a. cardiac murmur.

Question 26

The nurse is auscultating the heart sounds of an adult client. To auscultate Erb’s point, the nurse should place the stethoscope at the

a. second intercostal space at the right sternal border.
b. third to fifth intercostal space at the left sternal border.
c. apex of the heart near the midclavicular line (MCL).
d. fourth or fifth intercostal space at the left lower sternal border.

Answer 26

b. third to fifth intercostal space at the left sternal border.

Question 27

While auscultating an adult client’s heart rate and rhythm, the nurse detects a irregular pattern. The nurse should

a. assess the client for signs and symptoms of pulmonary disease.
b. document this as a normal finding.
c. schedule the client for an ECG.
d. refer the client to a physician.

Answer 27

d. refer the client to a physician.

Question 28

The nurse has assessed the heart sounds of an adolescent client and detects the presence of an S3 heart sound at the beginning of the diastolic pause. The nurse should instruct the client that she should

a. be referred to a cardiologist for further evaluation.
b. be examined again in 6 months.
c. restrict exercise and strenuous activities.
d. recognize that this finding is normal in adolescents.

Answer 28

d. recognize that this finding is normal in adolescents.

Question 29

While assessing an adult client, the nurse detects opening snaps early in diastole during auscultation of the heart. The nurse should refer the client to a physician because this is usually indicative of

a. pulmonary hypertension.
b. aortic stenosis.
c. mitral valve stenosis.
d. pulmonary hypotension.

Answer 29

c. mitral valve stenosis.

Question 30

The nurse detects paradoxical pulses in an adult client during an examination. The nurse should explain to the client that paradoxical pulses are usually indicative of

a. obstructive lung disease.
b. left-sided heart failure.
c. premature ventricular contractions.
d. aortic stenosis.

Answer 30

a. obstructive lung disease.