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FNP Certification Review|Cardiac review Questions and Answers 100% Pass
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FNP Certification Review|Cardiac review Questions andAnswers 100% Pass
Loud murmur that is easily heard once the stethoscope is placed on the chest. CORRECT
ANS-Grade 3 murmur
A louder murmur . First time that a thrill is present. A thrill is like a "palpable murmur."
CORRECT ANS-Grade 4 murmur
Very loud murmur heard with edge of stethoscope off chest. Thrill is more obvious.
CORRECT ANS-Grade 5 murmur
The murmur is so loud that it can be heard even with the stethoscope off the chest. The thrill
is easily palpated. CORRECT ANS-Grade 6 murmur
Murmurs that do not have a thrill are CORRECT ANS-Benign murmurs
All diastolic murmurs are CORRECT ANS-Abnormal
All benign murmurs occur during CORRECT ANS-Systole (S2)
S3 is a sign for CORRECT ANS-CHF
S4 is a sign for CORRECT ANS-LVH
,FNP Certification Review|Cardiac review Questions and
Answers 100% Pass
A split S2 is best heard at the CORRECT ANS-Pulmonic area
The most common cardiac arrhythmia in the United States—
a major cause of stroke;
classified as a supraventricular tachyarrhythmia.
may be asymptomatic. CORRECT ANS-Atrial Fibrillation (AF)
HTN, CAD, caffeine, nicotine, hyperthyroidism, alcohol intake
(" holiday heart"), heart failure, LVH, and others. CORRECT ANS-Risk factors for Afib
Episodes terminate with 7 days or less (usually in less than 24 hours). It is usually
asymptomatic. CORRECT ANS-Paroxysmal AF (intermittent or self-terminating)
CHADS2 Scoring System CORRECT ANS-C (CHF), H (HTN), A (age > 75 years), D (diabetes),
S2 (stroke/ TIA).
(score of 2 or more requires anticoagulation)
Patients complain of the sudden onset of heart palpitations accompanied by feelings of
weakness, dizziness, and dyspnea. They may complain of chest pain and feeling like passing
out (pre-syncope to syncope). Rapid and irregular pulse may be more than 110 beats per
minute with hypotension. CORRECT ANS-Atrial Fibrillation
, FNP Certification Review|Cardiac review Questions and
Answers 100% Pass
Diagnostic test for A fib CORRECT ANS-the 12-lead ECG (does not show discrete P waves).
Labs needed for new onset A fib CORRECT ANS-ECG, TSH, and electrolytes (calcium,
potassium, magnesium, sodium)
Other treatments for A fib CORRECT ANS-Consider 24-hr Holter monitor if paroxysmal AF.
Digoxin level (if on digoxin).
Order echocardiogram (rule out valvular pathology, which increases risk of stroke).
Lifestyle: Avoid stimulants (caffeine, nicotine, decongestants) and alcohol (some patients).
Medication treatment for A fib CORRECT ANS-Patients are referred to cardiologists for
medical management.
An option is cardioversion.
Rate control: Calcium-channel blockers, beta-blockers, or digoxin.
Antiarrhythmics such as amiodarone (Cordarone). Amiodarone has Black Box Warning of
pulmonary and liver damage. Simvastatin with amiodarone can cause rhabdomyolysis.
Warfarin (Coumadin) for anticoagulation. Baseline international normalized ratio (INR) and
CBC (check platelets).
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