PCHA 2026 EXAMS TEST PAPER QUESTIONS AND
ANSWERS SURE A+
✔✔Ms. Key has a visible apical impulse in the seventh to eighth left intercostal space
lateral to the midclavicular line. Upon palpation, the impulse, which feels like a short
'tap', is approximately 5 cm in diameter and feels more forceful than usual. These
physical finding indicate: - ✔✔left ventricular enlargement
✔✔Which of the following is true regarding an S3 heart sound? - ✔✔S3 occurs early in
diastole.
✔✔Normal physiologic splitting of S2 occurs due to: - ✔✔early aortic valve closure and
late pulmonic valve closure.
✔✔When listening to heart sounds, the nurse knows that the valve closures that can be
heard best at the base of the heart are: - ✔✔aortic; pulmonic
✔✔During the precordial assessment on an 8-month pregnant patient, the nurse
palpates the apical impulse at the third to fourth left intercostal space lateral to the
midclavicular line. This would indicate: - ✔✔displacement of the heart from elevation of
the diaphragm.
✔✔A heart murmur: - ✔✔all of the above
- may be innocent and occur without evidence of structural abnormalities
- can be caused by a structural abnormality of a heart valve.
- may be caused by increased blood flow across a normal valve.
✔✔In your assessment of a 68-year-old male with recent onset of right-sided weakness,
you hear a blowing, swishing sound with the bell of the stethoscope over the left carotid
artery. This would best be described as a: - ✔✔bruit
✔✔The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous distention to the jaw when the head of his bed is elevated 45
degrees. The nurse knows that this finding indicates: - ✔✔increased pressure in the
right side of the heart.
✔✔During assessment of the cardiovascular system, it is important to: - ✔✔all of the
above
- use the bell and diaphragm when auscultating heart sounds
- assess for systemic signs of cardiovascular disease
- perform a thorough patient history
✔✔Assessment findings which may indicate cardiac disease include: - ✔✔pitting edema
, ✔✔In assessing a patient's major risk factors for heart disease, which would the nurse
want to include when taking a history? - ✔✔all of the above
- cigarette smoking
- hypertension
- high blood cholesterol
✔✔The patient has 20/100 vision. When the patient asks the nurse what this means,
the correct response would be: - ✔✔"This is a variation from normal and means that you
see at 20 feet what average eyes would see at 100 feet."
✔✔The patient presents to the hospital Emergency Department with a dilated left pupil,
left ptosis, and inability to look up, down, or medially with the left eye. These signs may
indicate a problem with: - ✔✔Left oculomotor nerve (CN III)
✔✔The patient visits the clinic complaining of excessive tearing in the left eye. The
nurse should assess the patient's eye for: - ✔✔lacrimal sac obstruction.
✔✔The patient comes to the clinic for a routine well patient yearly physical exam. The
patient has no complaints at this visit, and no history of any chronic illnesses. Upon
examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear
drainage; no masses or lesions are noted. No other symptoms are noted. These
findings are: - ✔✔normal findings
✔✔The size of the normal pupil is determined by: - ✔✔all of the above
- amount of light entering the eye
- closeness of the object being visualized
- function of cranial nerves II (optic) and III (oculomotor)
✔✔The patient comes to the clinic complaining of blurred vision when reading the
newspaper. After testing the patient's near vision, the nurse explains to the patient that
he has impaired near vision and discusses a possible reason for the condition. The
nurse determines the patient has understood the teaching when the patient states
presbyopia is usually due to: - ✔✔decreased ability of the lens to accommodate
✔✔Which of the following best describes the test performed to assess the function of
cranial nerve XII (hypoglossal)? - ✔✔Ask the patient to stick out his tongue and observe
for midline position.
✔✔Which of the following is true regarding assessment of the thyroid gland? - ✔✔The
physical characteristics of the thyroid gland tell you little about thyroid function.
✔✔The patient has come to the clinic with a chief complaint of a "lump under my chin".
In the history, you note that the patient smokes and uses smokeless tobacco (tobacco
placed under the tongue). Upon physical exam, the practitioner notes enlarged,
ANSWERS SURE A+
✔✔Ms. Key has a visible apical impulse in the seventh to eighth left intercostal space
lateral to the midclavicular line. Upon palpation, the impulse, which feels like a short
'tap', is approximately 5 cm in diameter and feels more forceful than usual. These
physical finding indicate: - ✔✔left ventricular enlargement
✔✔Which of the following is true regarding an S3 heart sound? - ✔✔S3 occurs early in
diastole.
✔✔Normal physiologic splitting of S2 occurs due to: - ✔✔early aortic valve closure and
late pulmonic valve closure.
✔✔When listening to heart sounds, the nurse knows that the valve closures that can be
heard best at the base of the heart are: - ✔✔aortic; pulmonic
✔✔During the precordial assessment on an 8-month pregnant patient, the nurse
palpates the apical impulse at the third to fourth left intercostal space lateral to the
midclavicular line. This would indicate: - ✔✔displacement of the heart from elevation of
the diaphragm.
✔✔A heart murmur: - ✔✔all of the above
- may be innocent and occur without evidence of structural abnormalities
- can be caused by a structural abnormality of a heart valve.
- may be caused by increased blood flow across a normal valve.
✔✔In your assessment of a 68-year-old male with recent onset of right-sided weakness,
you hear a blowing, swishing sound with the bell of the stethoscope over the left carotid
artery. This would best be described as a: - ✔✔bruit
✔✔The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous distention to the jaw when the head of his bed is elevated 45
degrees. The nurse knows that this finding indicates: - ✔✔increased pressure in the
right side of the heart.
✔✔During assessment of the cardiovascular system, it is important to: - ✔✔all of the
above
- use the bell and diaphragm when auscultating heart sounds
- assess for systemic signs of cardiovascular disease
- perform a thorough patient history
✔✔Assessment findings which may indicate cardiac disease include: - ✔✔pitting edema
, ✔✔In assessing a patient's major risk factors for heart disease, which would the nurse
want to include when taking a history? - ✔✔all of the above
- cigarette smoking
- hypertension
- high blood cholesterol
✔✔The patient has 20/100 vision. When the patient asks the nurse what this means,
the correct response would be: - ✔✔"This is a variation from normal and means that you
see at 20 feet what average eyes would see at 100 feet."
✔✔The patient presents to the hospital Emergency Department with a dilated left pupil,
left ptosis, and inability to look up, down, or medially with the left eye. These signs may
indicate a problem with: - ✔✔Left oculomotor nerve (CN III)
✔✔The patient visits the clinic complaining of excessive tearing in the left eye. The
nurse should assess the patient's eye for: - ✔✔lacrimal sac obstruction.
✔✔The patient comes to the clinic for a routine well patient yearly physical exam. The
patient has no complaints at this visit, and no history of any chronic illnesses. Upon
examining the nasal cavity, the nasal septum is symmetrical with scant amount of clear
drainage; no masses or lesions are noted. No other symptoms are noted. These
findings are: - ✔✔normal findings
✔✔The size of the normal pupil is determined by: - ✔✔all of the above
- amount of light entering the eye
- closeness of the object being visualized
- function of cranial nerves II (optic) and III (oculomotor)
✔✔The patient comes to the clinic complaining of blurred vision when reading the
newspaper. After testing the patient's near vision, the nurse explains to the patient that
he has impaired near vision and discusses a possible reason for the condition. The
nurse determines the patient has understood the teaching when the patient states
presbyopia is usually due to: - ✔✔decreased ability of the lens to accommodate
✔✔Which of the following best describes the test performed to assess the function of
cranial nerve XII (hypoglossal)? - ✔✔Ask the patient to stick out his tongue and observe
for midline position.
✔✔Which of the following is true regarding assessment of the thyroid gland? - ✔✔The
physical characteristics of the thyroid gland tell you little about thyroid function.
✔✔The patient has come to the clinic with a chief complaint of a "lump under my chin".
In the history, you note that the patient smokes and uses smokeless tobacco (tobacco
placed under the tongue). Upon physical exam, the practitioner notes enlarged,
