advanced physical assessment - Cardiovascular assessment questions with correct answers
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Course
NURS 3323
Institution
NURS 3323
How do you tell the difference between the right internal JVP and the carotid pulse on examination? Correct Answer-Rt internal JVP is inward, twice per heartbeat and not palpable. Pulsations eliminated by light pressure
on the vein(s) just above the sternal
end of the clavicle. Ht of pulse change...
advanced physical assessment - Cardiovascular
assessment questions with correct answers
How do you tell the difference between the right internal JVP and the
carotid pulse on examination? Correct Answer-Rt internal JVP is
inward, twice per heartbeat and not palpable. Pulsations eliminated by
light pressure
on the vein(s) just above the sternal
end of the clavicle. Ht of pulse changes with
position, normally dropping as the
patient becomes more upright. Height of pulsations usually falls with
inspiration
carotid pulse pulses outward, palpable, once per heart beat, ht of pulse is
not changed by position or inspiration.
how do you check for Paradoxical Pulse Correct Answer-During BP,
note the first Korotkoff sound. then continue to decrease to hear when
the sound NO LONGER disappears with inspiration (becomes regular
and doesn't skip a sound). 3-4 normal. over 10 = very positive
You can hear diastole when? Correct Answer-between S2 and S1
you can hear systole when? Correct Answer-between S1 and S2
S1 is usually louder than S2 at Correct Answer-the apex;
,S2 is usually louder than S1 at Correct Answer-the base.
1. The nurse is assessing the cardiovascular system of several patients.
Who of the patients will the nurse have the most challenging attempt to
palpate for the apical impulse?
a. A pre-school child
b. A frail 22-year old male
c. A 56-year old with aortic insufficiency
d. A patient with an increased anteroposterior chest diameter Correct
Answer-Ans: (D)
The apical impulse is easily palpated in children and adults with a thin
frame. Challenges palpating the apical impulse include increased
anteroposterior chest diameter, obesity or a thick chest.
1. In which of the following clients will the nurse expect the apical
impulse to be displaced laterally?
a. A COPD client with barrel chest
b. A client with hypotension
c. A client with hypothyroidism
d. A client with endocarditis Correct Answer-Ans: (A)
In patients with chronic obstructive pulmonary disease, the most
prominent palpable impulse or PMI may be in the xiphoid or epigastric
area as a result of right ventricular hypertrophy.
,1. Which of the following is accurate with ventricular pressures?
a. Systole is the period of ventricular contraction
b. In systole, the aortic valve is closed
c. In diastole, the mitral valve is closed
d. Systole is the period of atrial contraction Correct Answer-Ans: (A)
Systole is the period of ventricular contraction while diastole is the
period of ventricular relaxation. During systole the aortic valve is open,
allowing pumping of blood from the left ventricle into the aorta. The
mitral valve is closed, thereby preventing backflow of blood to the left
atrium. In contrast, during diastole the aortic valve is closed, preventing
regurgitation of blood from the aorta back into the left ventricle. The
mitral valve is open, allowing blood to flow from the left atrium into the
relaxed left ventricle.
1. The nurse is performing a complete physical examination on a
hypertensive client. In auscultating the chest, which of the following
nursing technique needs further evaluation?
a. Auscultates for the pulmonic sounds at the 2nd and 3rd intercostal
space at the sternal boarder
b. Auscultates for the mitral sounds at the point of maximal impulse
c. Auscultates for the aortic sounds at the 5th intercostal space
midclavicular line
d. Auscultates for the tricuspid sounds at the left lower sternal border
Correct Answer-Ans: (C)
Sounds and murmurs arising from the mitral valve are best heard at or
near the cardiac apex. Tricuspid sounds are heard best at or near the
lower left sternal border. Murmurs arising from the pulmonic valve are
, usually heard best in the 2nd and 3rd ICS at the sternal border. Murmurs
originating in the aortic valve may be heard anywhere from the right 2nd
intercostal space to the apex.
1. Which of the following components of a normal ECG is correct?
a. QRS complex corresponds to ventricular repolarization
b. P wave corresponds to atrial depolarization
c. T wave coincides with ventricular depolarization
d. R wave is the downward deflection from ventricular depolarization
Correct Answer-Ans: (B)
The P wave of an ECG component corresponds to the atrial
depolarization. The QRS complex represents ventricular depolarization.
The Q wave is a downward deflection from septal depolarization and
followed by the R wave which is an upward deflection from ventricular
depolarization. The S wave is a downward deflection following an R
wave. The T wave coincides with ventricular repolarization.
1. The new nurse wants to understand how the heart works as a pump. In
her review, which of the following describes the load that stretches the
cardiac muscle before contraction?
a. Stroke volume
b. Preload
c. Afterload
d. Myocardial contractility Correct Answer-Ans: (B)
Preload refers to the amount of blood that stretches the cardiac muscle
before contraction, or the volume of blood in the right ventricle at the
end of diastole. Stroke volume refers to the volume of blood ejected with
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