(2026/2027) | Newest Version | A+
Verified
• Peripheral Edema . CORRECT ANSWER: Grading:
1+ Slight Pitting, no visible distortion, disappears rapidly.
2+ A Somewhat Deeper Pit than in 12+, but again no readily detectable distortion,
disappears in 10-15 seconds.
3+ Noticeably Deep Pit that may last more than a minute; dependent extremity looks
fuller and swollen.
4+ Very Deep Pit that lasts as long as 2-5 min; dependent extremity is grossly distorted.
• Ammonia in breath odor . CORRECT ANSWER: Uremia (ammonia)
• Grading of Pulses . CORRECT ANSWER: 4+ Bounding
3+ Full, Increased
2+ Expected
1+ Diminished, barely palpable
0 Absent, not palpable
• Acute Limb Ischemia (ALI) . CORRECT ANSWER: Stage I - Viable - No sensory
impairment - No motor impairment - Audible Arterial Doppler Signal - Audible Venous
Dopler Signal
Stage IIa - Marginally Threatened - Minimal Sensory Impairment - No Motor Impairment
- Often inaudible Arterial Doppler Signal - Audible Venous Doppler Signal
Stage IIb - Immediately Threatened - Rest Pain Sensory Impairment - Mild to moderate
Motor Impairment - Inaudible Arterial Doppler Signal - Audible Venous Doppler Signal
Stage III - Irreversible - Anesthetic Sensory Impairment - Paralytic/rigor Motor
Impairment - Inaudible Arterial Doppler Signal - Inaudible Venous Doppler Signal
• Assessment for Peripheral Arterial Disease . CORRECT ANSWER: Site of Pain is
Distal to the Narrowing.
Note:
Pulses (strong, weak or possibly absent)
Possible systolic bruits over the arteries that may extend through diastole.
Loss of expected body warmth.
Localized pallor and cyanosis.
Collapsed superficial veins, with delay in venous filling.
Thin, atrophied skin; muscle atrophy.
• Varicosity Findings In Pregnant Women . CORRECT ANSWER: With increasing
cardiac output beginning in the 1st trimester, the pulse may be more easily palpated,
with an abrupt rise and rapid fall. With increasing blood volume in the second trimester,
jugular a and v waves may be easier to see. JVP should remain normal. Peripheral
, edema is a common finding as the pregnancy progresses. Varicose veins can develop
during pregnancy and in the postpartum period.
• Heart Sounds . CORRECT ANSWER: S1 - Closure of the mitral and tricuspid (AV)
Valves, indicates the beginning of systole. Best heard toward the apex.
S2 - Closure of the aortic and pulmonic (semilunar) Valves, indicates the end of systole.
Best heard in the aortic and pulmonic areas. Higher pitch and shorter duration.
S3 - Best heard when the patient is in the left lateral decubitus (recumbent) position.
Ventricular Gallup - Ken-Tuck-Y
S4 - Most commonly heard in the older patients, but may be heard at any age when
there is increased resistance to filling because the ventricular walls have lost
compliance. Atrial Gallup - Ten-nes-see
• Examination Technique for the Apical Pulse . CORRECT ANSWER: PMI Point of
Maximal Impulse typically noted at the left 5th intercostal space, midclavicular line in
adults, and 4th intercostal space medial to the nipple in children.
If the apical impulse is more vigorous than expected, characterize it as a "heave" or
"lift." Pg 337
• Grading of Heart Murmurs . CORRECT ANSWER: Grade I - Barely audible in quiet
room
Grade II - Quiet but clearly audible
Grade III - Moderately loud
Grade IV - Loud, associated with thrill
Grade V - Very loud, thrill easily palpable
Grade VI - Very loud, audible with stethoscope not in contact with chest, thrill palpable
and visible
• Cardiac Examination Findings for Rheumatic Fever . CORRECT ANSWER: Carditis
Mitral or Aortic Valve becomes stenotic and regurgitant.
Chest Pain
Palpitations
Murmurs of mitral regurgitation and aortic insufficiency
Cardiomegaly
Friction rub of pericarditis
Signs of CHF
• Types of Shortness of Breath . CORRECT ANSWER: Orthopnea - Difficulty Breathing
While Lying Down
Platypnea - Shortness of breath is relieved when lying down or worsens when standing
up
Tachypnea - Faster than 20 breaths per minute
Bradypnea - Slower than 12 breaths per minute
• Cocaine Use Findings in Heart and Lungs . CORRECT ANSWER: Severe, acute
chest pain.