NR 305 Health Assessment Week 5: Cardiovascular and Peripheral
Vascular Systems 2026 |Chamberlain College
1. Where is the apical pulse located in a healthy adult?
A. Second intercostal space, right sternal border
B. Fifth intercostal space, left midclavicular line
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, right midclavicular line
Answer: B
Rationale: The apical pulse, also known as the point of maximal impulse (PMI), is normally
found at the fifth intercostal space at or just medial to the left midclavicular line.
2. Which heart sound is caused by the closure of the atrioventricular (AV)
valves?
A. S1
B. S2
C. S3
D. S4
Answer: A
Rationale: S1 occurs with the closure of the AV valves (mitral and tricuspid) and signals
the beginning of systole.
,3. The S2 heart sound is loudest at which location?
A. Apex
B. Base
C. Left lower sternal border
D. Fifth intercostal space
Answer: B
Rationale: The S2 sound is loudest at the base of the heart, which corresponds to the
upper portion of the heart where the great vessels emerge.
4. Which condition is characterized by a blowing, swishing sound heard with the
bell of the stethoscope over an artery?
A. Thrill
B. Murmur
C. Bruit
D. Gallop
Answer: C
Rationale: A bruit is a blowing, swishing sound indicating blood flow turbulence, usually
due to local vascular cause such as atherosclerotic narrowing.
5. What does a ‘3+’ pulse indicate on the standard four-point scale?
A. Normal
B. Weak, thready
C. Full, bounding
D. Absent
Answer: C
Rationale: On the standard 0 to 3+ scale used in many nursing texts, 3+ is full/bounding,
2+ is normal, 1+ is weak, and 0 is absent.
, 6. The nurse is performing a Modified Allen test. What is the purpose of this
assessment?
A. To evaluate for Deep Vein Thrombosis
B. To measure the ankle-brachial index
C. To assess the patency of the ulnar artery
D. To check for pitting edema
Answer: C
Rationale: The Modified Allen test is used to evaluate the adequacy of collateral circulation
via the ulnar artery before cannulating the radial artery.
7. Which heart sound is often referred to as a ‘ventricular gallop’ and can be a
sign of heart failure in older adults?
A. S3
B. S2
C. S1
D. S4
Answer: A
Rationale: S3 occurs immediately after S2 when the ventricles are resistant to filling
during the early rapid filling phase, often seen in fluid overload or heart failure.
8. A palpable vibration on the chest wall that feels like the purring of a cat is
called a:
A. Heave
B. Thrill
C. Bruit
D. Lift
Answer: B
Rationale: A thrill is a palpable vibration that signifies turbulent blood flow and often
accompanies loud murmurs.
Vascular Systems 2026 |Chamberlain College
1. Where is the apical pulse located in a healthy adult?
A. Second intercostal space, right sternal border
B. Fifth intercostal space, left midclavicular line
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, right midclavicular line
Answer: B
Rationale: The apical pulse, also known as the point of maximal impulse (PMI), is normally
found at the fifth intercostal space at or just medial to the left midclavicular line.
2. Which heart sound is caused by the closure of the atrioventricular (AV)
valves?
A. S1
B. S2
C. S3
D. S4
Answer: A
Rationale: S1 occurs with the closure of the AV valves (mitral and tricuspid) and signals
the beginning of systole.
,3. The S2 heart sound is loudest at which location?
A. Apex
B. Base
C. Left lower sternal border
D. Fifth intercostal space
Answer: B
Rationale: The S2 sound is loudest at the base of the heart, which corresponds to the
upper portion of the heart where the great vessels emerge.
4. Which condition is characterized by a blowing, swishing sound heard with the
bell of the stethoscope over an artery?
A. Thrill
B. Murmur
C. Bruit
D. Gallop
Answer: C
Rationale: A bruit is a blowing, swishing sound indicating blood flow turbulence, usually
due to local vascular cause such as atherosclerotic narrowing.
5. What does a ‘3+’ pulse indicate on the standard four-point scale?
A. Normal
B. Weak, thready
C. Full, bounding
D. Absent
Answer: C
Rationale: On the standard 0 to 3+ scale used in many nursing texts, 3+ is full/bounding,
2+ is normal, 1+ is weak, and 0 is absent.
, 6. The nurse is performing a Modified Allen test. What is the purpose of this
assessment?
A. To evaluate for Deep Vein Thrombosis
B. To measure the ankle-brachial index
C. To assess the patency of the ulnar artery
D. To check for pitting edema
Answer: C
Rationale: The Modified Allen test is used to evaluate the adequacy of collateral circulation
via the ulnar artery before cannulating the radial artery.
7. Which heart sound is often referred to as a ‘ventricular gallop’ and can be a
sign of heart failure in older adults?
A. S3
B. S2
C. S1
D. S4
Answer: A
Rationale: S3 occurs immediately after S2 when the ventricles are resistant to filling
during the early rapid filling phase, often seen in fluid overload or heart failure.
8. A palpable vibration on the chest wall that feels like the purring of a cat is
called a:
A. Heave
B. Thrill
C. Bruit
D. Lift
Answer: B
Rationale: A thrill is a palpable vibration that signifies turbulent blood flow and often
accompanies loud murmurs.
