Maryville 612 Exam 2 Advanced Health Assessment
Questions with Correct Answers
100% Verified Graded A+
1. What is S4 indicative of?
Answer: In the 2nd phase of ventricular filling, vibration in the valves, papillae, and
ventricular walls produce S4. When there is increased resistance to filling because
ventricular walls have lost compliance. HTN, CAD or increased stroke volume high output,
anemia, pregnancy, and thyrotoxicosis. A loud S4 suggest pathology and deserves additional
evaluation.
2. What is the apical PMI?
Answer: Point of maximal impulse (PMI), the point at which the apical impulses are most
readily seen or felt. Usually at the 5th ICS, midclavicular line in adults. 4th ICS medial to
nipple in children.
3. What is normal or abnormal in relation to PMI?
Answer: Normal- 1cm diameter, gentle, brief, not lasting as long as systole.
Abnormal- Heave or lift (vigorous apical pulse outside above normal parameters), most ofte
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, left sternal border, displacement.
Thrill- (palpable murmur, vibration) most often at base of heart right or left 2nd ICS.
4. When assessing family history what questions do you ask for CV his- tory?
Answer: Long QT syndrome. Marfan syndrome-genetic, connective tissue disease
MVR/MVP, AR, AD. DM, heart disease, HLD, HTN, obesity, congenital heart disease, morbidity,
mortality r/t heart, age at time of illness or death, especially young and middle age
relatives.
5. What questions do you ask for patient history in MI?
Answer: Heart surgery/hospi- talization for cardiac evaluation, congenital heart disease,
rhythm, acute rheumatic fever, Kawasaki disease.
6. What creates each heart sound?
Answer: S1-first heart sound (lub), ventricular contrac- tion, closure of the mitral and
tricuspid valve (AV valve), beginning of systole, heard best at apex, lower pitch.
S2-Second heart sound (dub), aortic and pulmonic valve closure (SL valves), end of systole,
best heard at base, higher pitch.
S3-Early passive diastole phase that causes distention in the ventricular walls and vibration,
ventricular filling phase, best heard in the left lateral recumbent position, Ken-TUCK-y,
right after S2.
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6
Questions with Correct Answers
100% Verified Graded A+
1. What is S4 indicative of?
Answer: In the 2nd phase of ventricular filling, vibration in the valves, papillae, and
ventricular walls produce S4. When there is increased resistance to filling because
ventricular walls have lost compliance. HTN, CAD or increased stroke volume high output,
anemia, pregnancy, and thyrotoxicosis. A loud S4 suggest pathology and deserves additional
evaluation.
2. What is the apical PMI?
Answer: Point of maximal impulse (PMI), the point at which the apical impulses are most
readily seen or felt. Usually at the 5th ICS, midclavicular line in adults. 4th ICS medial to
nipple in children.
3. What is normal or abnormal in relation to PMI?
Answer: Normal- 1cm diameter, gentle, brief, not lasting as long as systole.
Abnormal- Heave or lift (vigorous apical pulse outside above normal parameters), most ofte
1/
6
, left sternal border, displacement.
Thrill- (palpable murmur, vibration) most often at base of heart right or left 2nd ICS.
4. When assessing family history what questions do you ask for CV his- tory?
Answer: Long QT syndrome. Marfan syndrome-genetic, connective tissue disease
MVR/MVP, AR, AD. DM, heart disease, HLD, HTN, obesity, congenital heart disease, morbidity,
mortality r/t heart, age at time of illness or death, especially young and middle age
relatives.
5. What questions do you ask for patient history in MI?
Answer: Heart surgery/hospi- talization for cardiac evaluation, congenital heart disease,
rhythm, acute rheumatic fever, Kawasaki disease.
6. What creates each heart sound?
Answer: S1-first heart sound (lub), ventricular contrac- tion, closure of the mitral and
tricuspid valve (AV valve), beginning of systole, heard best at apex, lower pitch.
S2-Second heart sound (dub), aortic and pulmonic valve closure (SL valves), end of systole,
best heard at base, higher pitch.
S3-Early passive diastole phase that causes distention in the ventricular walls and vibration,
ventricular filling phase, best heard in the left lateral recumbent position, Ken-TUCK-y,
right after S2.
2/
6
