NR 507 Cardiovascular Exam Study Guide
a blowing, holosystolic murmur Ans✓✓✓ A patient with mitral regurgitation
would most likely present with
Afterload. Ans✓✓✓ Hypertension has its most immediate effect on:
An early, high-pitched diastolic murmur heard at the left lower sternal border
A diastolic rumbling murmur heart at the apex of the heart
A systolic crescendo-decrescendo murmur heart at the left upper sternal border
(All of the above) Ans✓✓✓ The patient with aortic regurgitation would most
likely present with:
Aortic Regurgitation Ans✓✓✓ Heart Valve Disorders
A woman brings her 67-year old father to see the NP at the primary care clinic.
The patient reports that he has experienced shortness of breath for the last two
months that has continued to get progressively worse. He expresses great
concern that this development has kept him from participating in his Silver
Sneaker's program that he enjoys with his friends. He reports that he can barely
walk a city block or walk up the stairs in his home without becoming short of
breath. Upon exam, the NP notes a blood pressure of 180/58 mmHg and
peripheral pulses are palpable at 4+. The cardiac exam reveals several murmurs:
an early diastolic murmur that is high-pitched located loudest at the left lower
sternal border; a diastolic rumbling sound heard at the heart's apex and a systolic
crescendo-decrescendo murmur heard at the left upper sternal border. A chest x-
ray is performed at the office and shows pulmonary edema and cardiomegaly.
Aortic Stenosis Ans✓✓✓ Heart Valve Disorders
, A 64-year old female reports to the primary care office with a complaint of
"fainting". She reported that the episode occurred while she was engaged in her
usual low impact aerobics class. She also noticed, for the first time, during
exercise that her heart "hurt". The NP conducts a symptom analysis of the chest
pain and determined that the patient describes it as chest pressure. The patient
reports no dyspnea with exercise and denies orthopnea or paroxysmal nocturnal
dyspnea. On examination, the NP notes that all vital signs are normal, lungs are
clear to auscultation; There is a laterally displaced, sustained apical impulse and a
grade 4/6 mid-systolic crescendo-decrescendo murmur, heard loudest at the base
and radiating to the neck. There is also an S4 gallop. no peripheral edema noted.
There is a laterally displaced, sustained apical impulse and a grade 4/6 mid-
systolic crescendo-decrescendo murmur, heard loudest at the base and radiating
to the neck. There is also an S4 gallop. The NP performs an ECG in the office and
discovers left ventricular hypertrophy.
C.G. has several risk factors contributing to the development of CAD: Ans✓✓✓ 1)
male
2) family history of CAD
3) hypertension
4) smoking
CAD should strongly be suspected and further testing to assess the extent of the
patient's disease including: Ans✓✓✓ Electrocardiogram (ECG), cardiac enzymes
& troponin, lipids, and cardiac stress test. In most cases, the patient will be
referred to and co-managed by a cardiologist. Treatment will include both non-
pharmacological and pharmacological management of the disease.
Cardiovascular disorders Ans✓✓✓ Cardiovascular disorders are prevalent in
primary care. Many of the disorders develop over several years, due to the risk
factors to which individuals have been exposed. For each disorder covered in this
unit, a discussion of risk factors will be included. For the concepts covered below,
a blowing, holosystolic murmur Ans✓✓✓ A patient with mitral regurgitation
would most likely present with
Afterload. Ans✓✓✓ Hypertension has its most immediate effect on:
An early, high-pitched diastolic murmur heard at the left lower sternal border
A diastolic rumbling murmur heart at the apex of the heart
A systolic crescendo-decrescendo murmur heart at the left upper sternal border
(All of the above) Ans✓✓✓ The patient with aortic regurgitation would most
likely present with:
Aortic Regurgitation Ans✓✓✓ Heart Valve Disorders
A woman brings her 67-year old father to see the NP at the primary care clinic.
The patient reports that he has experienced shortness of breath for the last two
months that has continued to get progressively worse. He expresses great
concern that this development has kept him from participating in his Silver
Sneaker's program that he enjoys with his friends. He reports that he can barely
walk a city block or walk up the stairs in his home without becoming short of
breath. Upon exam, the NP notes a blood pressure of 180/58 mmHg and
peripheral pulses are palpable at 4+. The cardiac exam reveals several murmurs:
an early diastolic murmur that is high-pitched located loudest at the left lower
sternal border; a diastolic rumbling sound heard at the heart's apex and a systolic
crescendo-decrescendo murmur heard at the left upper sternal border. A chest x-
ray is performed at the office and shows pulmonary edema and cardiomegaly.
Aortic Stenosis Ans✓✓✓ Heart Valve Disorders
, A 64-year old female reports to the primary care office with a complaint of
"fainting". She reported that the episode occurred while she was engaged in her
usual low impact aerobics class. She also noticed, for the first time, during
exercise that her heart "hurt". The NP conducts a symptom analysis of the chest
pain and determined that the patient describes it as chest pressure. The patient
reports no dyspnea with exercise and denies orthopnea or paroxysmal nocturnal
dyspnea. On examination, the NP notes that all vital signs are normal, lungs are
clear to auscultation; There is a laterally displaced, sustained apical impulse and a
grade 4/6 mid-systolic crescendo-decrescendo murmur, heard loudest at the base
and radiating to the neck. There is also an S4 gallop. no peripheral edema noted.
There is a laterally displaced, sustained apical impulse and a grade 4/6 mid-
systolic crescendo-decrescendo murmur, heard loudest at the base and radiating
to the neck. There is also an S4 gallop. The NP performs an ECG in the office and
discovers left ventricular hypertrophy.
C.G. has several risk factors contributing to the development of CAD: Ans✓✓✓ 1)
male
2) family history of CAD
3) hypertension
4) smoking
CAD should strongly be suspected and further testing to assess the extent of the
patient's disease including: Ans✓✓✓ Electrocardiogram (ECG), cardiac enzymes
& troponin, lipids, and cardiac stress test. In most cases, the patient will be
referred to and co-managed by a cardiologist. Treatment will include both non-
pharmacological and pharmacological management of the disease.
Cardiovascular disorders Ans✓✓✓ Cardiovascular disorders are prevalent in
primary care. Many of the disorders develop over several years, due to the risk
factors to which individuals have been exposed. For each disorder covered in this
unit, a discussion of risk factors will be included. For the concepts covered below,
