NURS 509 EXAM ADVANCED PHYSICAL
ASSESSMENT TEST BANK EXAMINATION
TEST 2026 FULL QUESTIONS AND
ACCURATE EXPLANATIONS GRADED A+
⩥ Where is it best to auscultate the Aortic Valve? Answer: Second
intercostal space at the right sternal border.
⩥ Where is it best to auscultate the Pulmonic Valve? Answer: Second
intercostal space at the left sternal border.
⩥ Where is it best to auscultate the Mitral Valve? Answer: At the APEX
of the heart, Left intercostal space, mid clavicular line.
⩥ Where is it best to auscultate the Tricuspid Valve? Answer: Fourth
Intercostal space at the left sternal border.
⩥ What is "Erb's Point"? Answer: Third left intercostal space left of
sternum, mid clavicular line. This is where S1 and S2 can both be
auscultated.
⩥ What is S1 and where is it best heard? Answer: S1 is the closure of the
mitral and tricuspid valves (AV) during early systole, and is best heard
toward the apex of the heart.
,⩥ What is S2 and where is it best heard? Answer: S2 is closure of the
aortic and pulmonic valves (semi lunar valves) during late systole, and is
best heard in the tricuspid area (4th intercostal space to the left of the
sternal border)
⩥ What is S3, where is it heard and what does it represent? Answer: S3
represents passive flow of blood from the atria against a distended or
non-compliant ventricles during early to mid-diastole. It is best heard
over the apex of the heart with the BELL of the stethoscope (sometimes
with the patient in the left lateral recumbent position) and is usually very
to hear. It may sound like the word Ken-TUCK-y with a "gallop" Can be
associated with High Cardiac Output patients (septic, athletes,
pregnancies) ischemic CM, Hyperthyroidism, and anemia
⩥ What is S4, where is it heard and what does it represent? Answer: S4
represents more vigorous flow of blood through the atria into the
ventricles which cannot expand any further during late diastole and early
systole. It is best heard over the apex of the heart with the BELL of the
stethoscope (sometimes with the patient in the left lateral recumbent
positions). Can be associated with LVH or RVH, AS, pulmonary HTN
and Stenosis of any of the valves.
⩥ What is a Split S1? Answer: May occur in RBBB and with PVC's
⩥ What is Fixed Splitting of S1? Answer: May occur with ASD and RV
failure
, ⩥ What is Wide Splitting of S2? Answer: Is associated with delayed
closure of the Pulmonic valve and may indicated pulmonic stenosis and
RBBB or by early closure of the Aortic valve in mitral regurgitation.
⩥ Paradoxical Splitting of S2? Answer: Occurs only on expiration and is
associated with delayed closure of the aortic vales, usually as a result of
LBBB.
⩥ What is meant by a Physiologic S3? Answer: Usually confined to
children, young adults and pregnant women as a result of rapid early
ventricular filling. It is low pitched and is best heard with the BELL of
the stethoscope at the apex or the left sternal border.
⩥ What is meant by a Pathologic S3? Answer: Also called a
VENTRICULAR GALLOP, is heard in adults with decreased cardiac
contractility, HF. It is the same as a physiologic S3 but has pathologic
basis.
⩥ What is an Opening Snap? Answer: This is caused by a stenotic mitral
or tricuspid valve and is heard in early diastole along the lower left
sternal border. Best heard with the diaphragm of stethoscope.
⩥ What is a Heart Murmur? Answer: A murmur is a prolonged extra
sound heard during systole or diastole. They are caused by disruption of
blood flow into, through or out of the heart.
ASSESSMENT TEST BANK EXAMINATION
TEST 2026 FULL QUESTIONS AND
ACCURATE EXPLANATIONS GRADED A+
⩥ Where is it best to auscultate the Aortic Valve? Answer: Second
intercostal space at the right sternal border.
⩥ Where is it best to auscultate the Pulmonic Valve? Answer: Second
intercostal space at the left sternal border.
⩥ Where is it best to auscultate the Mitral Valve? Answer: At the APEX
of the heart, Left intercostal space, mid clavicular line.
⩥ Where is it best to auscultate the Tricuspid Valve? Answer: Fourth
Intercostal space at the left sternal border.
⩥ What is "Erb's Point"? Answer: Third left intercostal space left of
sternum, mid clavicular line. This is where S1 and S2 can both be
auscultated.
⩥ What is S1 and where is it best heard? Answer: S1 is the closure of the
mitral and tricuspid valves (AV) during early systole, and is best heard
toward the apex of the heart.
,⩥ What is S2 and where is it best heard? Answer: S2 is closure of the
aortic and pulmonic valves (semi lunar valves) during late systole, and is
best heard in the tricuspid area (4th intercostal space to the left of the
sternal border)
⩥ What is S3, where is it heard and what does it represent? Answer: S3
represents passive flow of blood from the atria against a distended or
non-compliant ventricles during early to mid-diastole. It is best heard
over the apex of the heart with the BELL of the stethoscope (sometimes
with the patient in the left lateral recumbent position) and is usually very
to hear. It may sound like the word Ken-TUCK-y with a "gallop" Can be
associated with High Cardiac Output patients (septic, athletes,
pregnancies) ischemic CM, Hyperthyroidism, and anemia
⩥ What is S4, where is it heard and what does it represent? Answer: S4
represents more vigorous flow of blood through the atria into the
ventricles which cannot expand any further during late diastole and early
systole. It is best heard over the apex of the heart with the BELL of the
stethoscope (sometimes with the patient in the left lateral recumbent
positions). Can be associated with LVH or RVH, AS, pulmonary HTN
and Stenosis of any of the valves.
⩥ What is a Split S1? Answer: May occur in RBBB and with PVC's
⩥ What is Fixed Splitting of S1? Answer: May occur with ASD and RV
failure
, ⩥ What is Wide Splitting of S2? Answer: Is associated with delayed
closure of the Pulmonic valve and may indicated pulmonic stenosis and
RBBB or by early closure of the Aortic valve in mitral regurgitation.
⩥ Paradoxical Splitting of S2? Answer: Occurs only on expiration and is
associated with delayed closure of the aortic vales, usually as a result of
LBBB.
⩥ What is meant by a Physiologic S3? Answer: Usually confined to
children, young adults and pregnant women as a result of rapid early
ventricular filling. It is low pitched and is best heard with the BELL of
the stethoscope at the apex or the left sternal border.
⩥ What is meant by a Pathologic S3? Answer: Also called a
VENTRICULAR GALLOP, is heard in adults with decreased cardiac
contractility, HF. It is the same as a physiologic S3 but has pathologic
basis.
⩥ What is an Opening Snap? Answer: This is caused by a stenotic mitral
or tricuspid valve and is heard in early diastole along the lower left
sternal border. Best heard with the diaphragm of stethoscope.
⩥ What is a Heart Murmur? Answer: A murmur is a prolonged extra
sound heard during systole or diastole. They are caused by disruption of
blood flow into, through or out of the heart.
