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you are performing a thorough cardiac exam which of the following chambers of the
heart can you assess by palpitation?
A. left atrium
B. right atrium
C. right ventricle
D. sinus node - ANSWERS-C. right ventricle
the right ventricle occupies most of the anterior cardiac surfaces and is easily
accessible to palpitaiton
you are performing a cardiac examination on a patient with shortness of breath and
palpitations. you listen to the heart with the patient sitting upright, then have him change
to a supine position and finally have him turn onto his left side in the left lateral
decubitus position. which of the following valvular defects is best heard in this position?
A. aortic
B. pulmonic
C. mitral
D. tricuspid - ANSWERS-C. mitral
you are concerned that a patient has an aortic regurgitation murmur. which is the best
position to accentuate the murmur?
,A. upright
B. upright but leaning forward
C. supine
D. left lateral decubitus - ANSWERS-B. upright but leaning forward
a 68 year old waiter comes to your clinic for evaluation of fatigue. you perform a cardiac
examination and find that his pulse is less than 60. which of the following conditions
could be responsible for this heart rate?
A. second degree AV block
B. atrial flutter
C. sinus arrhythmia
D. a. fib - ANSWERS-A. second degree AV block
where is the point of maximal impulse (PMI) normally located?
A. left 5th intercostal space, 7 to 9 cm lateral to the sternum
B. left 5th intercostal space 10 to 12 cm lateral to the sternum
C. in the left 5th intercostal space in the anterior axillary line
D. in the left 5th intercostal space in the midaxillary line . - ANSWERS-A. left 5th
intercostal space, 7 to 9 cm lateral to the sternum not midaxillary line its the
midclavicular line
PMI is the best place to listen for mitral valve murmurs as well as S3 and S4
which of the following events occurs at the start of diastole?
A. closure of the tricuspid valve
B. opening of the pulmonic valve
C. closure of the aortic valve
D. production of the first heart sound (S1) - ANSWERS-C. closure of the aortic valve
which is true of a third heart sound (S3)?
, A. it marks atrial contraction
B. it reflects normal compliance of the left ventricle
C. it is caused by rapid deceleration of blood against the ventricular wall
D. it is not heard in atrial fibrillation - ANSWERS-C. it is caused by rapid deceleration of
blood against the ventricular wall
S4 is head with atrial contraction and is absent in atrial fibrillation for this reason.
S4 indicates a stiff or thickened left ventricle as in hypertension or left ventricular
hypertrophy
which is true of splitting of the heart second heard sound?
A. it is best heard over the pulmonic area with the bell of the stethoscope
B. it normally increases with exhalation
C. it is best heard over the apex
D. it does not vary with respiration - ANSWERS-A. it is best heard over the pulmonic
area with the bell of the stethoscope
which of the following is true of jugular venous pressure (JVP) measurement?
A. it is measured with the patient at a 45 degree angle
B. the vertical height of the blood column in centimeters, plus 5cm is the JVP
C. a JVP below 9 cm is abnormal
D. it is measured above - ANSWERS-B. the vertical height of the blood column in
centimeters, plus 5cm is the JVP
JVP is important for fluid status any measurement greater than 4cm above the sternal
angle is abnormal
which of the following regarding jugular venous pulsations is a systolic phenomenon?
A. the y descent
B. the x descent
C. the upstroke of the A wave