WGU D344 PREMIUM EXAM PREP GUIDE
WITH COMPLETE QUESTIONS AND
ACCURATE ANSWERS
◉ Precordial Movement
Answer: Palpate for precordial activity in general. You may feel
"extras" such as thrills or exaggerated
ventricular impulses.
◉ PMI /or Apical Pulse
Answer: Palpate for the point of maximal impulse (PMI or apical
pulse). It is normally located in the 4th or 5th intercostal space
just medial to the midclavicular line and is less than the size of a
quarter
◉ Capillary refill times
Answer: greater than 2-3 seconds suggest PVD arterial blockage
heart failure or shock
◉ aortic area
Answer: listen with diaphragm at the RIGHT 2nd interspace near
the sternum
◉ pulmonic area
,Answer: listen with the diaphragm at the LEFT 2nd interspace
near the sternum
◉ tricuspid area
Answer: Listen with the diaphragm at the left 3rd, 4th, and 5th
interspaces near the sternum
◉ use the bell
Answer: while listening to the heart at the left 4th and 5th
interspace near the sternum
◉ mitral area/PMI
Answer: listen with diaphragm at the apex
◉ Edema, Cyanosis, and Clubbing
Answer: 1. Check for the presence of edema (swelling) of the feet
and lower legs.
2. Check for the presence of cyanosis (blue color) of the feet or
hands.
3. Check for the presence of clubbing of the fingers.
◉ Clubbing
Answer: a) Normal = 160 degrees
b) Curved = 160 degrees or less
c) Early clubbing = 180 degrees
, ◉ Examination Abdomen
Answer: when assessing start in the RLQ over ileocecal valve
Watch the pt's face for signs of discomfort during the examination
◉ Abdomen contour of in a newborn
Answer: is normally protuberant and soft
◉ Abdomen contour in a child
Answer: is normally symmetric and slightly rounded
◉ Percussion of Abdomen
Answer: 1.Percuss in all four quadrants (clockwise) using proper
technique: Inspect - Auscultation -Percuss-Palpatel
2. Categorize what you hear as tympanic or dull. Tympany is
normally present over most of the abdomen in the supine
position. Unusual dullness may be a clue to an underlying
abdominal mass or full bladder
◉ Splenic dullness
Answer: Percuss the lowest costal interspace in the left anterior
axillary line. This area is normally tympanic
Ask the pt to take a deep breath and percuss this area again
dullness in this area is a sign of ____ dullness
WITH COMPLETE QUESTIONS AND
ACCURATE ANSWERS
◉ Precordial Movement
Answer: Palpate for precordial activity in general. You may feel
"extras" such as thrills or exaggerated
ventricular impulses.
◉ PMI /or Apical Pulse
Answer: Palpate for the point of maximal impulse (PMI or apical
pulse). It is normally located in the 4th or 5th intercostal space
just medial to the midclavicular line and is less than the size of a
quarter
◉ Capillary refill times
Answer: greater than 2-3 seconds suggest PVD arterial blockage
heart failure or shock
◉ aortic area
Answer: listen with diaphragm at the RIGHT 2nd interspace near
the sternum
◉ pulmonic area
,Answer: listen with the diaphragm at the LEFT 2nd interspace
near the sternum
◉ tricuspid area
Answer: Listen with the diaphragm at the left 3rd, 4th, and 5th
interspaces near the sternum
◉ use the bell
Answer: while listening to the heart at the left 4th and 5th
interspace near the sternum
◉ mitral area/PMI
Answer: listen with diaphragm at the apex
◉ Edema, Cyanosis, and Clubbing
Answer: 1. Check for the presence of edema (swelling) of the feet
and lower legs.
2. Check for the presence of cyanosis (blue color) of the feet or
hands.
3. Check for the presence of clubbing of the fingers.
◉ Clubbing
Answer: a) Normal = 160 degrees
b) Curved = 160 degrees or less
c) Early clubbing = 180 degrees
, ◉ Examination Abdomen
Answer: when assessing start in the RLQ over ileocecal valve
Watch the pt's face for signs of discomfort during the examination
◉ Abdomen contour of in a newborn
Answer: is normally protuberant and soft
◉ Abdomen contour in a child
Answer: is normally symmetric and slightly rounded
◉ Percussion of Abdomen
Answer: 1.Percuss in all four quadrants (clockwise) using proper
technique: Inspect - Auscultation -Percuss-Palpatel
2. Categorize what you hear as tympanic or dull. Tympany is
normally present over most of the abdomen in the supine
position. Unusual dullness may be a clue to an underlying
abdominal mass or full bladder
◉ Splenic dullness
Answer: Percuss the lowest costal interspace in the left anterior
axillary line. This area is normally tympanic
Ask the pt to take a deep breath and percuss this area again
dullness in this area is a sign of ____ dullness
