APEA – Cardiovascular Assessment 2025
| Complete Study Guide with Questions &
Rationales | Graded A+
To auscultate the tricuspid valve heart sounds in an adult patient, place the
stethoscope:
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-
clavicular line.
located between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
- ---✔✔✔ANSWER----between the 3rd, 4th, 5th, and 6th intercostal spaces
at the left lower sternal border.
To auscultate the heart sounds arising from the pulmonic valve in an adult patient,
place the stethoscope:
,near the apex of the heart between the 5th and 6th intercostal spaces in the mid-
clavicular line.
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
- ---✔✔✔ANSWER----between the 2nd and 3rd intercostal spaces at the left
sternal border.
What heart sounds are heard during auscultation of a man with Marfan syndrome
who has a known mitral valve prolapse?
An opening snap
A mid-systolic click
A flat blowing pitch
A fourth heart sound (S4) - ---✔✔✔ANSWER----A mid-systolic click
Pulse pressure is determined by subtracting diastolic blood pressure (DSP) from
systolic blood pressure (SBP). A widened pulse pressure means that:
the SBP drops 20 mm Hg within 3 minutes of standing.
the difference is >100 mm Hg.
the DBP is greater than the SBP.
the difference is 40 mm Hg. - ---✔✔✔ANSWER----the difference is >100
mm Hg.
A disease that may present as indigestion, but is precipitated by exertion and
relieved by rest is most likely:
, gastroesophageal reflux.
inflammatory bowel disease.
angina.
aortic stenosis. - ---✔✔✔ANSWER----angina.
A patient complains of some pain in the distal portions of her fingers on both
hands. She states that it tends to occur more frequently with exposure to cold.
These symptoms may be consistent with:
intermittent claudication.
Raynaud's disease.
deep venous thrombosis.
superficial thrombophlebitis. - ---✔✔✔ANSWER----Raynaud's disease.
Pain or cramping of the legs that occurs during exertion and is relieved by rest is
termed:
neurogenic claudication.
intermittent claudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease. - ---✔✔✔ANSWER----intermittent claudication.
A sudden, tearing, sharp pain that begins in the chest and radiates to the back or
into the neck is usually associated with:
angina pectoris.
a myocardial infarction.
| Complete Study Guide with Questions &
Rationales | Graded A+
To auscultate the tricuspid valve heart sounds in an adult patient, place the
stethoscope:
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-
clavicular line.
located between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
- ---✔✔✔ANSWER----between the 3rd, 4th, 5th, and 6th intercostal spaces
at the left lower sternal border.
To auscultate the heart sounds arising from the pulmonic valve in an adult patient,
place the stethoscope:
,near the apex of the heart between the 5th and 6th intercostal spaces in the mid-
clavicular line.
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
- ---✔✔✔ANSWER----between the 2nd and 3rd intercostal spaces at the left
sternal border.
What heart sounds are heard during auscultation of a man with Marfan syndrome
who has a known mitral valve prolapse?
An opening snap
A mid-systolic click
A flat blowing pitch
A fourth heart sound (S4) - ---✔✔✔ANSWER----A mid-systolic click
Pulse pressure is determined by subtracting diastolic blood pressure (DSP) from
systolic blood pressure (SBP). A widened pulse pressure means that:
the SBP drops 20 mm Hg within 3 minutes of standing.
the difference is >100 mm Hg.
the DBP is greater than the SBP.
the difference is 40 mm Hg. - ---✔✔✔ANSWER----the difference is >100
mm Hg.
A disease that may present as indigestion, but is precipitated by exertion and
relieved by rest is most likely:
, gastroesophageal reflux.
inflammatory bowel disease.
angina.
aortic stenosis. - ---✔✔✔ANSWER----angina.
A patient complains of some pain in the distal portions of her fingers on both
hands. She states that it tends to occur more frequently with exposure to cold.
These symptoms may be consistent with:
intermittent claudication.
Raynaud's disease.
deep venous thrombosis.
superficial thrombophlebitis. - ---✔✔✔ANSWER----Raynaud's disease.
Pain or cramping of the legs that occurs during exertion and is relieved by rest is
termed:
neurogenic claudication.
intermittent claudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease. - ---✔✔✔ANSWER----intermittent claudication.
A sudden, tearing, sharp pain that begins in the chest and radiates to the back or
into the neck is usually associated with:
angina pectoris.
a myocardial infarction.
