ATI MEDSURG 2 NUR 265 NEUROSHOCK and BURNS ACTUAL EXAM 2025

Venous or Arterial? wound is initially superficial and irregular in shape - Correct Ans-Venous Define precordium - Correct Ans-Chest area in front of heart S1 is the closing sound of what valves? - Correct Ans-Mitral and tricuspid (AV) (lub) S2 is the closing sound of what valves? - Correct Ans-Pulmonic and aortic (SL) (dub) Where is S1 best heard at? - Correct Ans-Apex Where is S2 best heard at? - Correct Ans-Base What does S3 indicate? - Correct Ans-Volume overload problem --- turn patient to left side to hear better Where is S3 heard in the cardiac cycle? - Correct Ans-Early diastole What does S4 indicate? - Correct Ans-Stiff ventricles --- lay patient lateral to hear better Where do you hear S4 in the cardiac cycle? - Correct Ans-Immediately before S1 Which side of the stethoscope is used to listen to extra heart sounds? - Correct Ans-Bell S3 is also called what? - Correct Ans-A ventricular gallop Where do you hear a murmur and where do you hear a bruit? What do they sound like? - Correct Ans-Blowing swooshing sound Murmur - heart Bruit - neck What is a lift/heave? - Correct Ans-- seen on inspection - see chest/heart move - d/t enlarged heart What is a thrill? - Correct Ans-Vibration What is all included in a cardiac hx/interview? - Correct Ans-- pain - sob - sleep position - dizzy/lightheaded - cough - cyanosis/pallor - fatigue - edema - nocturia - meds What else should be assessed for a cardiac interview for infants? - Correct Ans-- what was the mothers health during pregnancy? - cyanosis (breastfeeding, crying?) - eating without tiring? - meeting growth milestones? - how many naps? how long? What else should be assessed for a cardiac interview for children? - Correct Ans-- meeting growth milestones? - any blue coloring during activity? - able to keep up with age mates? - squatting to rest or knee-chest position while sleeping - chest pain? - family hx How do you inspect the jugular veins? - Correct Ans-Supine at a 45 degree angle During pregnancy, where does the hearts location shift and where is the PMI? - Correct Ans-Heart shifts upwards and to the right PMI changes to 4th ICS What are changes in pregnancy related to cardiovascular? - Correct Ans-- increase in plasma volume and RBC's - increased stroke volume - increased heart rate - increased cardiac output - peripheral vasodilation causes decreased BP (drops to lowest point in 2nd trimester) Where is the apex located in infants? - Correct Ans-4th ICS When is bradycardia in a newborn indicated at? - Correct Ans-Less than 100 When is bradycardia in a child indicated at? - Correct Ans-Less than 60 What are the s/s of an MI in women? - Correct Ans-- fatigue - sleep disturbance - sob - indigestion, nausea - radiating, aching pain - flushed What are cardiac changes in the elderly? - Correct Ans-- gradual increase in systolic BP - arteriosclerosis - left ventricular wall thickness - increased incidence of dysrhythmias - EKG changes - orthostatic hypotension What are s/s of right sided heart failure? - Correct Ans-- fatigue - increased peripheral venous pressure - ascites - enlarged liver and spleen - JVD - dependent edema - anorexia/ GI distress What are s/s of left sided heart failure? - Correct Ans-- paroxysmal nocturnal dyspnea - pulmonary congestion ( cough, crackles, wheeze, blood tinged sputum) - confusion - orthopnea - tachycardia - exertional dyspnea - fatigue - cyanosis Does lymph flow in 1 or 2 directions? - Correct Ans-1 In pregnant women, BP decreases, how is it possible if blood volume increases? - Correct Ans-BP drops due to hormones Why do pregnant women get LE edema and varicosities in legs? - Correct Ans-Due to pressure on inferior vena cava What is the difference between atherosclerosis and arteriosclerosis? - Correct Ans-Atherosclerosis: fatty deposits Arteriosclerosis: stiffening For peripheral vascular/lymphatics, what are we inspecting and palpating in the arms? - Correct Ans-- skin color/temp - capillary refill - symmetry - epitrochler nodes - radial pulse - ulnar pulse - brachial pulse Name the steps to the modified allen test - Correct Ans-- depress radial and ulnar arteries while person opens and closes fist - normal: blood returns via ulnar artery - occluded ulnar artery: no blood return For peripheral vascular and lymphatics what is inspected in the legs? - Correct Ans-- skin and hair - symmetry - temperature - calf muscle - pretibial edema - venous pattern For peripheral vascular and lymphatics what is palpated in the legs? - Correct Ans-- femoral pulse - popliteal pulse - posterior tibial pulse - dorsalis pedis pulse - edema - leg vein - inguinal lymph nodes Define telangiectasias - Correct Ans-Spider veins What are the three P's of occlusion? - Correct Ans-- pain - pallor - pulselessness ******KNOW SLIDE 33 ON LYMPHATIC POWERPOINT***** - Correct Ans- Venous or Arterial? Increased edema - Correct Ans-Venous Venous or Arterial? Skin is dry and flaky with brownish discoloration - Correct Ans-Venous Venous or Arterial? Leg elevation lessens pain - Correct Ans-Venous Venous or Arterial? Pedal pulses normal - Correct Ans-Venous Venous or Arterial? Nails are normal - Correct Ans-Venous Venous or Arterial? Wounds are proximal to the medial malleolus - Correct Ans-Venous Venous or Arterial? Pain is mild to moderate - Correct Ans-Venous