The Human Heart: Anatomy, Functions & Disorders Solved Quiz
The Human Heart is the central organ of the circulatory system and a vital topic for every nursing exam. In today's Daily Nursing Mock Test, we have covered the entire spectrum of the Heart- from basic Anatomy & Physiology to complex Cardiac Disorders.
This comprehensive quiz includes questions on Heart Chambers, Valves, Blood Flow, Conduction System, and common conditions like Myocardial Infarction and Heart Failure. Whether you are preparing for AIIMS NORCET, CHO, or NCLEX, these mixed cardiac questions will test your overall knowledge.
Which structure is known as the natural pacemaker of the heart?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the Sinoatrial node initiates electrical impulses at the highest rate (60-100/min), setting the heart rhythm. Option A is incorrect because the Atrioventricular node is the secondary pacemaker (40-60/min). Option D is incorrect because Purkinje fibers are the last resort (20-40/min).
What is the primary route of administration for Nitroglycerin in a patient experiencing acute angina pectoris?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the sublingual route provides rapid absorption into systemic circulation, bypassing the liver (first-pass metabolism) for immediate relief. Option C is incorrect because oral administration is too slow for acute attacks. Option D is incorrect due to erratic absorption.
The closure of which valves produces the first heart sound (S1)?
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✅ Answer: B
Rationale: lanation: Answer B is correct because S1 ("Lubb") is caused by the closure of atrioventricular (Mitral and Tricuspid) valves at the beginning of systole. Option A is incorrect because closure of semilunar valves causes the S2 ("Dubb") sound.
Which enzyme is considered the most specific and sensitive marker for myocardial infarction?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Troponin I is highly specific to cardiac muscle damage and remains elevated for 7-10 days. Option A is incorrect because Creatine Kinase-MB returns to normal faster. Option C is incorrect because Myoglobin is the earliest marker but is not specific to the heart.
Which blood vessel carries deoxygenated blood from the heart to the lungs?
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✅ Answer: C
Rationale: lanation: Answer C is correct because the Pulmonary Artery is the only artery in the adult body that carries deoxygenated blood (Right ventricle to lungs). Option A is incorrect because Pulmonary Veins carry oxygenated blood to the left atrium.
In an Electrocardiogram, the P wave represents which physiological event?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the P wave indicates the electrical impulse traveling through the atria causing contraction. Option A is incorrect because the QRS complex represents ventricular depolarization. Option C is incorrect because the T wave represents ventricular repolarization.
A nurse should withhold Digoxin and notify the physician if the apical pulse rate of an adult patient is below which value?
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✅ Answer: A
Rationale: lanation: Answer A is correct because Digoxin slows the heart rate; administering it when the pulse is below 60 can cause severe bradycardia or heart block. Options B, C, and D are incorrect because these rates are generally safe for administration.
Which layer of the heart wall is responsible for the pumping action of the heart?
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✅ Answer: C
Rationale: lanation: Answer C is correct because the Myocardium consists of specialized cardiac muscle tissue that contracts to pump blood. Option B is incorrect because the Pericardium is the protective outer sac. Option D is incorrect because the Endocardium is the inner lining.
Which of the following is a classic sign of Left-Sided Heart Failure?
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✅ Answer: D
Rationale: lanation: Answer D is correct because left ventricular failure causes blood to back up into the lungs, leading to fluid accumulation (Pulmonary Edema). Options A, B, and C are incorrect because they are classic signs of Right-Sided Heart Failure due to systemic congestion.
The volume of blood pumped by the heart in one minute is known as what?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Cardiac Output is calculated as Stroke Volume multiplied by Heart Rate (approx 5L/min). Option A is incorrect because Stroke Volume is the amount pumped per beat. Option C is incorrect because Tidal Volume relates to respiration.
What is the normal range of Central Venous Pressure (CVP)?
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✅ Answer: A
Rationale: lanation: Answer A is correct because the normal CVP ranges from 2-7 mmHg (or 3-8 cmH2O), reflecting right atrial pressure and fluid status. Option B is incorrect because values above 10 mmHg indicate hypervolemia or right heart failure. Options C and D are critically high values.
At which anatomical location is the apical pulse best heard in an adult?
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✅ Answer: C
Rationale: lanation: Answer C is correct because the apex of the heart is located at the 5th intercostal space at the left mid-clavicular line (mitral area). Option A is incorrect because this is the aortic area. Option B is incorrect because this roughly corresponds to the tricuspid area.
Which medication is the specific antidote for Heparin overdose?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Protamine Sulfate binds to Heparin to neutralize its anticoagulant effect. Option A is incorrect because Vitamin K is the antidote for Warfarin. Option D is incorrect because Calcium Gluconate is used for Magnesium toxicity or hypocalcemia.
Tetralogy of Fallot includes all of the following defects EXCEPT:
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✅ Answer: D
Rationale: lanation: Answer D is correct because Tetralogy of Fallot consists of four defects: VSD, Pulmonary Stenosis, Overriding Aorta, and Right Ventricular Hypertrophy, not Atrial Septal Defect. Option A, B, and C are incorrect because they are standard components of this condition.
Which microorganism is the most common cause of Rheumatic Heart Disease?
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✅ Answer: B
Rationale: lanation: Answer B is correct because an untreated pharyngeal infection with Group A Beta-Hemolytic Streptococcus triggers an autoimmune reaction damaging heart valves. Option A is incorrect because Staph aureus typically causes infective endocarditis.
What is the earliest clinical sign of Digoxin toxicity?
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✅ Answer: B
Rationale: lanation: Answer B is correct because gastrointestinal symptoms like anorexia, nausea, and vomiting are usually the first signs of toxicity. Option A is incorrect because visual disturbances (yellow/green halos) occur later. Option C is incorrect as it is a cardiac effect, not typically the first sign.
The difference between Systolic blood pressure and Diastolic blood pressure is called:
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✅ Answer: C
Rationale: lanation: Answer C is correct because Pulse Pressure is the mathematical difference between systolic and diastolic pressure (Normal ~40 mmHg). Option B is incorrect because Pulse Deficit is the difference between apical and radial pulse rates.
In Cardiopulmonary Resuscitation (CPR) for an adult, what is the correct ratio of compressions to breaths?
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✅ Answer: B
Rationale: lanation: Answer B is correct because current guidelines recommend a compression-to-ventilation ratio of 30:2 for adults. Option A is incorrect because 15:2 is used for children/infants with two rescuers.
ECG changes showing ST-segment elevation are indicative of which condition?
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✅ Answer: B
Rationale: lanation: Answer B is correct because ST-segment elevation (STEMI) indicates acute myocardial injury/infarction. Option A is incorrect because Ischemia typically shows ST depression or T-wave inversion. Option D is incorrect because Pericarditis shows diffuse ST elevation, not localized.
Pain in the calf on dorsiflexion of the foot (Homan's sign) indicates which condition?
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✅ Answer: A
Rationale: lanation: Answer A is correct because Homan's sign is suggestive of DVT, although it is not specific and generally no longer recommended for diagnosis due to risk of embolus. Option B is incorrect because Varicose veins present with tortuous veins.
Which artery supplies the majority of the left ventricle and is often termed the "widow maker"?
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✅ Answer: C
Rationale: lanation: Answer C is correct because the Left Anterior Descending (LAD) artery supplies the front and bottom of the left ventricle; blockage here leads to massive MI. Option A is incorrect because the RCA supplies the right side and inferior wall.
Which of the following is considered a non-modifiable risk factor for hypertension?
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✅ Answer: C
Rationale: lanation: Answer C is correct because genetic factors and family history cannot be changed by the patient. Options A, B, and D are incorrect because they are lifestyle factors that can be modified through behavior changes.
A "Machinery-like" murmur is the characteristic sign of which congenital heart defect?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the continuous flow of blood from the high-pressure aorta to the low-pressure pulmonary artery creates a continuous machinery murmur. Option A is incorrect because ASD causes a split S2.
Which diagnostic test is the standard for continuous recording of cardiac electrical activity over 24-48 hours?
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✅ Answer: B
Rationale: lanation: Answer B is correct because a Holter monitor is a portable device used to record heart rhythm for 24 hours or more to detect intermittent arrhythmias. Option A is incorrect because an Echo visualizes structure, usually in a short session.
Which blood biomarker is most useful for diagnosing Heart Failure?
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✅ Answer: B
Rationale: lanation: Answer B is correct because BNP is released by ventricles in response to stretch/pressure overload, making it specific for Heart Failure. Option A is incorrect because CRP is a marker of general inflammation.
A persistent dry cough is a common side effect of which class of antihypertensive drugs?
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✅ Answer: C
Rationale: lanation: Answer C is correct because ACE inhibitors (e.g., Enalapril) prevent the breakdown of bradykinin, leading to a dry cough. Option A is incorrect because Beta-blockers may cause bronchospasm but not typically a dry cough.
Using a blood pressure cuff that is too narrow for the patient's arm will result in:
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✅ Answer: B
Rationale: lanation: Answer B is correct because a narrow cuff requires more pressure to compress the artery, yielding a falsely elevated BP reading. Option A is incorrect because a cuff that is too wide yields a falsely low reading.
The nurse performs an Allen test before cannulating the radial artery to assess the patency of which artery?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the Allen test confirms that the ulnar artery can supply the hand with blood if the radial artery is occluded by the catheter. Option A is incorrect because the Brachial artery is proximal to the test site.
Frank-Starling Law of the heart states that:
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✅ Answer: B
Rationale: lanation: Answer B is correct because the law states that the greater the stretch of the ventricular muscle (preload), the greater the force of contraction. Option A refers to Sinus Arrhythmia.
What is the therapeutic reference range for the International Normalized Ratio (INR) for a patient on Warfarin therapy for DVT?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the target INR for standard anticoagulation (DVT/AFib) is 2.0 to 3.0. Option A is the normal range for a person not on anticoagulants. Option C and D indicate a high risk of bleeding.
Beck’s Triad is a classic collection of signs indicative of Cardiac Tamponade. It includes which of the following?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Beck's Triad specifically consists of three signs: hypotension (low arterial blood pressure), distended neck veins (JVD), and distant/muffled heart sounds, caused by fluid compressing the heart. Option A describes Cushing’s Triad (increased ICP).
Which electrolyte imbalance is most likely to cause "Tall, peaked T waves" on an Electrocardiogram (ECG)?
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✅ Answer: B
Rationale: lanation: Answer B is correct because high serum potassium (Hyperkalemia) alters repolarization, leading to tall, peaked T waves. Option A is incorrect because Hypokalemia causes flattened T waves and prominent U waves. Option C is incorrect because Hypocalcemia prolongs the QT interval.
What is the drug of choice for treating Supraventricular Tachycardia (SVT) if vagal maneuvers fail?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Adenosine momentarily blocks the AV node conduction to restore normal sinus rhythm in SVT. Option A is incorrect because Atropine is used for Bradycardia. Option C is incorrect because Epinephrine is used in cardiac arrest/anaphylaxis.
Which blood vessel is most commonly used for Coronary Artery Bypass Grafting (CABG) surgery?
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✅ Answer: A
Rationale: lanation: Answer A is correct because the Great Saphenous Vein (in the leg) is the longest vein and is commonly harvested for grafts. Option B is incorrect because deep veins like the Femoral are essential for venous return and not used for grafting.
A patient returns to the ward after a Cardiac Catheterization via the femoral artery. Which nursing intervention is the priority?
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✅ Answer: B
Rationale: lanation: Answer B is correct because keeping the leg straight prevents bleeding or hematoma formation at the femoral puncture site. Option A and C are incorrect because sitting up or walking increases pressure on the artery, risking hemorrhage.
The nurse is calculating the Mean Arterial Pressure (MAP) for a patient with a blood pressure of 120/60 mmHg. What is the MAP?
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✅ Answer: B
Rationale: lanation: Answer B is correct because MAP = [Systolic + 2(Diastolic)] / 3. Calculation: [120 + 2(60)] / 3 = 240 / 3 = 80 mmHg. Option A, C, and D are mathematically incorrect based on the formula.
Which of the following conditions is characterized by intermittent claudication (pain in legs during walking relieved by rest)?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Peripheral Arterial Disease (PAD) leads to ischemia in muscles during exercise, causing pain that subsides with rest. Option A is incorrect because DVT pain is usually constant and involves swelling/redness.
In a patient with Acute Myocardial Infarction, which isoenzyme of Creatine Kinase is elevated?
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✅ Answer: C
Rationale: lanation: Answer C is correct because CK-MB is specific to cardiac muscle tissue. Option A is incorrect because CK-MM is found in skeletal muscle. Option B is incorrect because CK-BB is found in brain tissue.
Which position is recommended for a patient suspected of having an Air Embolism?
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✅ Answer: B
Rationale: lanation: Answer B is correct because placing the patient in Trendelenburg on the left side traps the air in the apex of the right ventricle, preventing it from entering the pulmonary artery. Option A is incorrect as it may facilitate air movement to the brain.
The nurse observes "Osler’s nodes" (painful, red nodules on finger pads) in a patient. This is a sign of:
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✅ Answer: B
Rationale: lanation: Answer B is correct because Osler's nodes are immune complex depositions specific to Infective Endocarditis. Option A is incorrect because Rheumatic fever presents with subcutaneous nodules that are painless.
Which heart sound is referred to as a "Ventricular Gallop" and may be normal in children but indicates heart failure in adults?
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✅ Answer: C
Rationale: lanation: Answer C is correct because S3 follows S2 and is caused by rapid ventricular filling; it is a key sign of heart failure in older adults. Option D is incorrect because S4 is the "Atrial Gallop" occurring before S1.
A patient is prescribed Furosemide (Lasix) for heart failure. Which food should the nurse encourage the patient to consume?
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✅ Answer: A
Rationale: lanation: Answer A is correct because Furosemide is a loop diuretic that causes potassium loss; bananas and leafy greens are high in potassium. Option B and D are incorrect because they are high in sodium, which should be restricted in heart failure.
Which of the following is the definitive treatment for Ventricular Fibrillation?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Ventricular Fibrillation is a lethal rhythm with no cardiac output; unsynchronized defibrillation is the only effective way to reset the rhythm. Option C is incorrect because Cardioversion is used for rhythms with a pulse (e.g., unstable AFib).
Which finding is a major criterion in the Jones Criteria for diagnosing Rheumatic Fever?
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✅ Answer: C
Rationale: lanation: Answer C is correct because Sydenham’s Chorea is a Major Criterion. Options A, B, and D are incorrect because Arthralgia, Fever, and elevated ESR are Minor Criteria under the Jones classification system.
Before administering a Beta-Blocker (e.g., Metoprolol), which vital sign is most critical to assess?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Beta-blockers decrease heart rate; if the pulse is <60 bpm, the medication is typically held to prevent severe bradycardia. Option A is important but less directly affected than heart rate.
Raynaud’s phenomenon is characterized by color changes in the digits in response to cold or stress. What is the correct sequence of color change?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the sequence is White (ischemia/vasoconstriction) -> Blue (cyanosis/hypoxia) -> Red (rubor/reperfusion). Option A, C, and D are incorrect sequences.
The amount of blood remaining in the ventricle at the end of diastole is known as:
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✅ Answer: A
Rationale: lanation: Answer A is correct because Preload refers to the volume/stretch in the ventricles just before contraction (end-diastolic volume). Option B is incorrect because Afterload is the resistance the heart must overcome to pump blood.
Which diagnostic marker is used to monitor the effectiveness of Warfarin (Coumadin) therapy?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Prothrombin Time (PT) and INR are specific for the extrinsic pathway affected by Warfarin. Option A is incorrect because aPTT is used to monitor Heparin therapy.
A patient with Heart Failure is prescribed Enalapril. The nurse should monitor the patient for which common electrolyte disturbance?
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✅ Answer: C
Rationale: lanation: Answer C is correct because ACE inhibitors (like Enalapril) inhibit aldosterone, leading to sodium excretion and potassium retention (Hyperkalemia). Option B is incorrect because loop diuretics cause hypokalemia, but ACE inhibitors do the opposite.
Which of the following is an absolute contraindication for thrombolytic therapy (e.g., tPA) in a stroke or MI patient?
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✅ Answer: A
Rationale: lanation: Answer A is correct because active internal bleeding (e.g., GI bleed, hemorrhagic stroke) creates a life-threatening risk of massive hemorrhage if thrombolytics are given. Options B, C, and D are relative cautions or non-contraindications.
A pediatric patient presents with blood pressure that is significantly higher in the upper extremities than in the lower extremities. Which condition does this finding suggest?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Coarctation of the Aorta is a narrowing of the aorta which obstructs blood flow, causing high pressure in the arms (proximal to narrowing) and low pressure/weak pulses in the legs. Option A is incorrect because PDA typically causes bounding pulses.
In an Electrocardiogram, a PR interval greater than 0.20 seconds indicates which type of arrhythmia?
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✅ Answer: A
Rationale: lanation: Answer A is correct because a consistent prolongation of the PR interval >0.20 seconds with a 1:1 P-to-QRS ratio is the definition of First-degree AV Block. Option C is incorrect because Third-degree block shows dissociation between P waves and QRS complexes.
The presence of a prominent "U wave" on an ECG is classically associated with which electrolyte disturbance?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Hypokalemia (low potassium) delays ventricular repolarization, often manifesting as a U wave following the T wave. Option A is incorrect because Hyperkalemia causes tall peaked T waves.
Which of the following instructions is most important for a patient carrying sublingual Nitroglycerin tablets?
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✅ Answer: B
Rationale: lanation: Answer B is correct because Nitroglycerin is highly sensitive to light and moisture; it must be kept in a dark, airtight glass container to maintain potency. Option A is incorrect because light degrades the drug. Option D is incorrect as it should dissolve slowly.
A patient with an artificial heart valve is scheduled for a dental extraction. The nurse anticipates a prescription for prophylactic antibiotics to prevent which condition?
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✅ Answer: B
Rationale: lanation: Answer B is correct because bacteria from the mouth can enter the bloodstream during dental procedures and colonize artificial valves, causing Infective Endocarditis. Option A is incorrect because Rheumatic fever is an autoimmune reaction, not a direct infection from dental work.
What is the normal range for Left Ventricular Ejection Fraction (LVEF)?
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✅ Answer: C
Rationale: lanation: Answer C is correct because a normal healthy heart pumps out 55-70% of the blood in the left ventricle with each contraction. Option A and B indicate systolic heart failure. Option D is rarely seen and may indicate a hyperdynamic state.
The difference between the apical pulse rate and the radial pulse rate is termed as:
Show Answer & Rationale
✅ Answer: B
Rationale: lanation: Answer B is correct because Pulse Deficit indicates that some heart contractions are too weak to produce a palpable peripheral pulse (common in Atrial Fibrillation). Option A is the difference between systolic and diastolic BP.
A high-pitched, scratchy sound heard during auscultation at the left sternal border is characteristic of:
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✅ Answer: B
Rationale: lanation: Answer B is correct because a Pericardial Friction Rub is caused by the inflamed layers of the pericardium rubbing together (Pericarditis). Option A produces a low-pitched rumble. Option D results in diminished breath sounds, not a heart sound.
To auscultate the Aortic Valve, the stethoscope should be placed at which anatomical landmark?
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✅ Answer: A
Rationale: lanation: Answer A is correct because the Aortic area is located at the 2nd ICS to the right of the sternum. Option B is the Pulmonic area. Option D is the Mitral/Apical area.
The DASH diet is primarily recommended for the management of which cardiovascular condition?
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✅ Answer: B
Rationale: lanation: Answer B is correct because the Dietary Approaches to Stop Hypertension (DASH) diet (rich in fruits, vegetables, low-fat dairy; low in saturated fat) is proven to lower blood pressure. Option A is incorrect because the diet lowers BP, which would worsen hypotension.
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Frequently Asked Questions (The Heart)
Q1: What is the correct pathway of blood flow through the heart?
Ans: Deoxygenated blood enters the Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Lungs (gets oxygen). Oxygenated blood returns to Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Body (Aorta).
Q2: Which part is known as the "Pacemaker" of the heart?
Ans: The Sinoatrial (SA) Node, located in the right atrium, is the natural pacemaker of the heart because it initiates the electrical impulses that set the heart rate.
Q3: Which enzyme is the most specific marker for Myocardial Infarction (Heart Attack)?
Ans: Troponin I and T are the most specific and sensitive cardiac markers for diagnosing myocardial injury or heart attack. They rise within 3-4 hours of injury
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