Chapter 14: Heart
Test Bank—Nursing
MULTIPLE CHOICE
1. Which two heart chambers are most anterior in the chest?
a. Both atria
b. Both ventricles
c. The right atrium and ventricle
d. The left atrium and ventricle
ANS: C
The most anterior surface of the heart is formed by the right ventricle. The heart is turned
ventrally on its axis, putting its right side more forward. The left atrium is above the left
ventricle, forming the most posterior aspect of the heart.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. The condition in which a patient’s heart is rotated or displaced to the right or is situated as a
mirror image of the expected position is called:
a. amyloidosis.
b. coarctation.
c. dextrocardia.
d. situs inversus.
ANS: C
Dextrocardia occurs when the heart is displaced or rotated to the right or is a complete mirror
image of the expected finding. Amyloidosis is a metabolic disorder marked by amyloid
deposits in organs and tissues. Coarctation is the compression of the walls of a vessel, such as
an aortic coarctation. Situs inversus occurs when the heart and stomach are displaced to the
right and the liver is located to the left.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 294
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Heart position can vary depending on body habitus. In a short stocky individual, you would
expect the heart to be located:
a. more to the right and hanging more vertically.
b. more to the left and lying more horizontally.
c. riding higher in the chest and pushed anteriorly.
d. hanging lower in the chest and riding more vertically.
ANS: B
The position of the heart varies depending on body build, configuration of the chest, and level
of the diaphragm. A tall slender person’s heart tends to hang vertically and is positioned
centrally. A stocky short person’s heart tends to lie more to the left and more horizontally.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 294
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
,4. Which cardiac structure is responsible for the heart’s pumping action?
a. Pericardium
b. Epicardium
c. Myocardium
d. Endocardium
ANS: C
The myocardium is the thick muscular middle layer responsible for the pumping action of the
heart. The pericardium is the tough, double-walled, fibrous sac that protects the heart. The
epicardium is the thin outermost muscle layer that covers the heart and extends onto the great
vessels. The endocardium is the innermost layer that lines the chambers of the heart and
covers heart valves.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Contraction of the ventricles causes:
a. closure of the atrioventricular valves.
b. closure of the pulmonic and aortic valves.
c. opening of the auricular septa.
d. opening of the mitral and tricuspid valves.
ANS: A
When the ventricles contract the semilunar valves, the pulmonic and aortic valves open,
causing blood to rush into the pulmonary artery and the aorta. At this time, the tricuspid and
mitral valves close, preventing backflow into the atria. When the atria contract, the tricuspid
and mitral valves open, allowing blood flow into the ventricles. When the ventricles relax
during diastole (ventricles are filling), the aortic and pulmonic valves close, preventing
backflow into the ventricles.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 297
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Which two structures together form the primary muscle mass of the heart?
a. Right and left ventricles
b. Left ventricle and the aorta
c. Right and left atria
d. Left atrium and the pulmonary vein
ANS: A
The ventricles are large, thick-walled chambers that pump blood to the lungs and throughout
the body. The right and left ventricles together form the primary muscle mass of the heart. The
left ventricle pumps blood through the aortic valve into the aorta, which provides blood to the
rest of the body. The right and left atria pump blood through the tricuspid and mitral valves to
the ventricles. The pulmonary vein pumps oxygenated blood from the lungs to the left atria.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. The major heart sounds are normally created by:
a. valves opening.
b. valves closing.
, c. the rapid movement of blood.
d. rubbing together of the cardiac walls.
ANS: B
At the beginning of systole, ventricular contraction raises the pressure in the ventricles and
forces the mitral and tricuspid valves closed, which produces the first heart sound S1, “lub.”
When the pressure in the ventricles falls, below that of the aorta and pulmonary artery, and
when the ventricles are almost empty, the aortic and pulmonic valves close, producing the
second heart sound S2, “dub.” Valve opening is usually a silent event.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 297
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. Ms. Sharpe is a 22-year-old secretary. She presents with fatigue, malaise, and a rash. On
auscultation of her heart, you note murmurs of mitral regurgitation and aortic stenosis. She
reports a recent severe sore throat. You suspect:
a. angina.
b. acute rheumatic fever.
c. cardiac amyloidosis.
d. aortic sclerosis.
ANS: B
Acute rheumatic fever is a systemic connective tissue disease that occurs after a streptococcal
pharyngitis or skin infection. It may result in serious cardiac valvular involvement of the
mitral or aortic valve. Often, the valve becomes stenotic and regurgitant. Prevention is
adequate treatment of the streptococcal pharyngitis or skin infection.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 331
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
9. A grade IV mitral regurgitation murmur would:
a. be described as a diastolic murmur.
b. not be expected to have a thrill.
c. radiate to the axilla.
d. be heard best at the base.
ANS: C
A grade IV murmur would have a thrill; a mitral regurgitation murmur is best heard at the
apex, is holosystolic, and would radiate to the axilla.
DIF: Cognitive Level: Applying (Application) REF: p. 306
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
10. Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of
the stimulus through the atria is the:
a. P wave.
b. PR interval.
c. QRS complex.
d. ST segment.
ANS: A
Test Bank—Nursing
MULTIPLE CHOICE
1. Which two heart chambers are most anterior in the chest?
a. Both atria
b. Both ventricles
c. The right atrium and ventricle
d. The left atrium and ventricle
ANS: C
The most anterior surface of the heart is formed by the right ventricle. The heart is turned
ventrally on its axis, putting its right side more forward. The left atrium is above the left
ventricle, forming the most posterior aspect of the heart.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. The condition in which a patient’s heart is rotated or displaced to the right or is situated as a
mirror image of the expected position is called:
a. amyloidosis.
b. coarctation.
c. dextrocardia.
d. situs inversus.
ANS: C
Dextrocardia occurs when the heart is displaced or rotated to the right or is a complete mirror
image of the expected finding. Amyloidosis is a metabolic disorder marked by amyloid
deposits in organs and tissues. Coarctation is the compression of the walls of a vessel, such as
an aortic coarctation. Situs inversus occurs when the heart and stomach are displaced to the
right and the liver is located to the left.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 294
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Heart position can vary depending on body habitus. In a short stocky individual, you would
expect the heart to be located:
a. more to the right and hanging more vertically.
b. more to the left and lying more horizontally.
c. riding higher in the chest and pushed anteriorly.
d. hanging lower in the chest and riding more vertically.
ANS: B
The position of the heart varies depending on body build, configuration of the chest, and level
of the diaphragm. A tall slender person’s heart tends to hang vertically and is positioned
centrally. A stocky short person’s heart tends to lie more to the left and more horizontally.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 294
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
,4. Which cardiac structure is responsible for the heart’s pumping action?
a. Pericardium
b. Epicardium
c. Myocardium
d. Endocardium
ANS: C
The myocardium is the thick muscular middle layer responsible for the pumping action of the
heart. The pericardium is the tough, double-walled, fibrous sac that protects the heart. The
epicardium is the thin outermost muscle layer that covers the heart and extends onto the great
vessels. The endocardium is the innermost layer that lines the chambers of the heart and
covers heart valves.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Contraction of the ventricles causes:
a. closure of the atrioventricular valves.
b. closure of the pulmonic and aortic valves.
c. opening of the auricular septa.
d. opening of the mitral and tricuspid valves.
ANS: A
When the ventricles contract the semilunar valves, the pulmonic and aortic valves open,
causing blood to rush into the pulmonary artery and the aorta. At this time, the tricuspid and
mitral valves close, preventing backflow into the atria. When the atria contract, the tricuspid
and mitral valves open, allowing blood flow into the ventricles. When the ventricles relax
during diastole (ventricles are filling), the aortic and pulmonic valves close, preventing
backflow into the ventricles.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 297
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Which two structures together form the primary muscle mass of the heart?
a. Right and left ventricles
b. Left ventricle and the aorta
c. Right and left atria
d. Left atrium and the pulmonary vein
ANS: A
The ventricles are large, thick-walled chambers that pump blood to the lungs and throughout
the body. The right and left ventricles together form the primary muscle mass of the heart. The
left ventricle pumps blood through the aortic valve into the aorta, which provides blood to the
rest of the body. The right and left atria pump blood through the tricuspid and mitral valves to
the ventricles. The pulmonary vein pumps oxygenated blood from the lungs to the left atria.
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 295
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. The major heart sounds are normally created by:
a. valves opening.
b. valves closing.
, c. the rapid movement of blood.
d. rubbing together of the cardiac walls.
ANS: B
At the beginning of systole, ventricular contraction raises the pressure in the ventricles and
forces the mitral and tricuspid valves closed, which produces the first heart sound S1, “lub.”
When the pressure in the ventricles falls, below that of the aorta and pulmonary artery, and
when the ventricles are almost empty, the aortic and pulmonic valves close, producing the
second heart sound S2, “dub.” Valve opening is usually a silent event.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 297
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. Ms. Sharpe is a 22-year-old secretary. She presents with fatigue, malaise, and a rash. On
auscultation of her heart, you note murmurs of mitral regurgitation and aortic stenosis. She
reports a recent severe sore throat. You suspect:
a. angina.
b. acute rheumatic fever.
c. cardiac amyloidosis.
d. aortic sclerosis.
ANS: B
Acute rheumatic fever is a systemic connective tissue disease that occurs after a streptococcal
pharyngitis or skin infection. It may result in serious cardiac valvular involvement of the
mitral or aortic valve. Often, the valve becomes stenotic and regurgitant. Prevention is
adequate treatment of the streptococcal pharyngitis or skin infection.
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 331
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
9. A grade IV mitral regurgitation murmur would:
a. be described as a diastolic murmur.
b. not be expected to have a thrill.
c. radiate to the axilla.
d. be heard best at the base.
ANS: C
A grade IV murmur would have a thrill; a mitral regurgitation murmur is best heard at the
apex, is holosystolic, and would radiate to the axilla.
DIF: Cognitive Level: Applying (Application) REF: p. 306
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
10. Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of
the stimulus through the atria is the:
a. P wave.
b. PR interval.
c. QRS complex.
d. ST segment.
ANS: A
