and Answers | 2026 Update | 100%
Correct – Galen College.
1. What is a bruit?
A. A normal heart sound
B. A swishing sound indicating turbulent blood flow
C. A sound produced by lung crackles
D. A cracking sound from joint movement
Correct Answer: B
Rationale: A bruit is an abnormal vascular sound caused by turbulent blood flow,
often due to arterial narrowing.
2. Which are the normal heart sounds?
A. S1 and S2
B. S2 and S3
C. S1 and S4
D. S3 and S4
Correct Answer: A
Rationale: The normal heart sounds, S1 and S2, reflect the closure of the
atrioventricular and semilunar valves, respectively.
3. S1 occurs when:
A. The semilunar valves close
B. The AV valves close
C. The atria contract
D. The ventricles fill
Correct Answer: B
, Rationale: S1 is generated when the AV (mitral and tricuspid) valves close at the
start of ventricular systole.
4. S2 is best heard at the:
A. Apex of the heart
B. Base of the heart (aortic and pulmonic areas)
C. Left sternal border
D. Epigastric region
Correct Answer: B
Rationale: S2, which corresponds to the closure of the semilunar valves (aortic
and pulmonic), is heard best at the base of the heart, specifically the aortic and
pulmonic auscultatory areas.
5. A third heart sound (S3) is:
A. Normally heard in adults over 50
B. Associated with rapid ventricular filling in early diastole
C. Always pathological
D. Best heard at the base of the heart
Correct Answer: B
Rationale: S3 occurs during early diastole when blood rapidly fills the ventricles. It
can be normal in children and young adults but may indicate volume overload in
older adults.
6. A fourth heart sound (S4) is:
A. Heard during ventricular systole
B. Caused by atrial contraction against a stiff ventricle
C. A normal finding in all age groups
D. Best heard with the diaphragm of the stethoscope
Correct Answer: B
, Rationale: S4 is generated when the atria contract against a non-compliant or
hypertrophic ventricle, often seen in conditions like hypertension or aortic
stenosis.
7. Which murmur is best heard at the left lower sternal border?
A. Aortic stenosis
B. Mitral stenosis
C. Tricuspid regurgitation
D. Pulmonic stenosis
Correct Answer: C
Rationale: Tricuspid regurgitation is typically best auscultated at the left lower
sternal border, often with an inspiratory increase in intensity.
8. A continuous murmur is most characteristic of:
A. Aortic stenosis
B. Mitral regurgitation
C. Patent ductus arteriosus
D. Hypertrophic cardiomyopathy
Correct Answer: C
Rationale: Patent ductus arteriosus produces a continuous "machine-like"
murmur due to persistent flow between the aorta and pulmonary artery
throughout systole and diastole.
9. The maneuver that increases the intensity of left-sided murmurs is:
A. Valsalva maneuver
B. Squatting
C. Inspiration
D. Standing suddenly
Correct Answer: B
, Rationale: Squatting increases venous return and systemic vascular resistance,
which augments left-sided murmurs such as aortic stenosis and mitral
regurgitation.
10. Which finding is most consistent with pericarditis?
A. Split S2
B. Pericardial friction rub
C. S3 gallop
D. Systolic ejection click
Correct Answer: B
Rationale: A pericardial friction rub, a high-pitched scratching sound, is the classic
auscultatory finding in pericarditis, caused by inflamed pericardial layers rubbing
together.
11. A systolic ejection click is most commonly associated with:
A. Mitral valve prolapse
B. Aortic stenosis
C. Pulmonic stenosis
D. Tricuspid regurgitation
Correct Answer: C
Rationale: A systolic ejection click is often heard in pulmonic stenosis (and less
commonly in aortic stenosis) and occurs at the onset of systole when the stenotic
valve opens.
12. Which heart sound is pathologic in adults but commonly heard in children and
young adults?
A. S1
B. S2
C. S3
D. S4
Correct Answer: C