NSG 320 Exam 2: (Latest 2026/2027 Update) Cardiovascular &
Respiratory Assessment, Heart Sounds, & Clinical Reasoning | Q&A |
Grade A | 100% Correct (Verified Answers) – Nursing Program
Subject: NSG 320 – Medical-Surgical Nursing / Cardiovascular & Respiratory Assessment
Source: NSG 320 Exam 2 Blueprint 2026/2027 Format: Q&A Guide with Rationale | Verified Grade A
1. What is the pacemaker of the heart?
Correct Answer: SA node (sinoatrial node)
1. SA node generates electrical impulses (60-100 bpm) that initiate cardiac contraction.
2. Impulse travels to AV node, then Bundle of His, Purkinje fibers.
3. AV node is backup pacemaker (40-60 bpm); ventricles (20-40 bpm) as last resort.
2. What is the normal flow of blood through the heart?
Correct Answer: SVC/IVC → Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary
Arteries → Lungs → Pulmonary Veins → Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Aorta → Body
1. Right side pumps deoxygenated blood to lungs; left side pumps oxygenated blood to body.
2. Valves prevent backflow and help build up pressure for ejection.
3. Starling's law: more filling during diastole → more forceful contraction.
3. What are the purposes of heart valves?
Correct Answer: Prevent backflow and help build up pressure during ventricular contraction
1. Atrioventricular (AV) valves: tricuspid (right), mitral (left) – open during diastole.
2. Semilunar valves: pulmonic and aortic – open during systole.
3. Valve disorders cause murmurs (turbulent blood flow).
4. What is Starling's law?
Correct Answer: The more the heart is filled during diastole, the more forcefully it contracts (increased preload =
increased stroke volume)
1. Within physiologic limits, increased end-diastolic volume increases myocyte stretch and contractility.
2. In heart failure, excessive stretch leads to decreased contractility (decompensation).
3. Preload is affected by venous return and filling pressures.
5. What can clubbing of the fingers indicate?
Correct Answer: Chronic hypoxia (e.g., COPD, cystic fibrosis, congenital heart disease)
1. Clubbing results from chronic low oxygen levels and increased platelet-derived growth factor.
2. Early sign: loss of Lovibond angle (nail base angle >180°).
3. Reversal of clubbing occurs if underlying hypoxia is corrected (rare).
6. What does jugular vein distention (JVD) indicate?
Correct Answer: Elevated central venous pressure (CVP), often due to right-sided heart failure or fluid overload
1. Normal JVP is <4 cm above sternal angle; elevate HOB 30-45° to assess.
2. Distended neck veins that do not flatten with inspiration (Kussmaul sign) suggest constrictive pericarditis or right HF.
3. Causes: HF, pulmonary HTN, pericardial effusion, SVC syndrome.
Respiratory Assessment, Heart Sounds, & Clinical Reasoning | Q&A |
Grade A | 100% Correct (Verified Answers) – Nursing Program
Subject: NSG 320 – Medical-Surgical Nursing / Cardiovascular & Respiratory Assessment
Source: NSG 320 Exam 2 Blueprint 2026/2027 Format: Q&A Guide with Rationale | Verified Grade A
1. What is the pacemaker of the heart?
Correct Answer: SA node (sinoatrial node)
1. SA node generates electrical impulses (60-100 bpm) that initiate cardiac contraction.
2. Impulse travels to AV node, then Bundle of His, Purkinje fibers.
3. AV node is backup pacemaker (40-60 bpm); ventricles (20-40 bpm) as last resort.
2. What is the normal flow of blood through the heart?
Correct Answer: SVC/IVC → Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary
Arteries → Lungs → Pulmonary Veins → Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Aorta → Body
1. Right side pumps deoxygenated blood to lungs; left side pumps oxygenated blood to body.
2. Valves prevent backflow and help build up pressure for ejection.
3. Starling's law: more filling during diastole → more forceful contraction.
3. What are the purposes of heart valves?
Correct Answer: Prevent backflow and help build up pressure during ventricular contraction
1. Atrioventricular (AV) valves: tricuspid (right), mitral (left) – open during diastole.
2. Semilunar valves: pulmonic and aortic – open during systole.
3. Valve disorders cause murmurs (turbulent blood flow).
4. What is Starling's law?
Correct Answer: The more the heart is filled during diastole, the more forcefully it contracts (increased preload =
increased stroke volume)
1. Within physiologic limits, increased end-diastolic volume increases myocyte stretch and contractility.
2. In heart failure, excessive stretch leads to decreased contractility (decompensation).
3. Preload is affected by venous return and filling pressures.
5. What can clubbing of the fingers indicate?
Correct Answer: Chronic hypoxia (e.g., COPD, cystic fibrosis, congenital heart disease)
1. Clubbing results from chronic low oxygen levels and increased platelet-derived growth factor.
2. Early sign: loss of Lovibond angle (nail base angle >180°).
3. Reversal of clubbing occurs if underlying hypoxia is corrected (rare).
6. What does jugular vein distention (JVD) indicate?
Correct Answer: Elevated central venous pressure (CVP), often due to right-sided heart failure or fluid overload
1. Normal JVP is <4 cm above sternal angle; elevate HOB 30-45° to assess.
2. Distended neck veins that do not flatten with inspiration (Kussmaul sign) suggest constrictive pericarditis or right HF.
3. Causes: HF, pulmonary HTN, pericardial effusion, SVC syndrome.
