NURS5461 PART 2 EXAM | QUESTIONS AND ANSWERS
| 2026 UPDATE WITH COMPLETE SOLUTION
auscultation of a murmur in the right sternal border indicates problem with
Answer - aortic valve
auscultation of a murmur in the left upper sternal border indicates problem
with Answer - pulmonic valve
auscultation of a murmur in the left lower sternal border indicates problem
with Answer - tricuspid valve, aortic valve
auscultation of a murmur in the apex indicates problem with Answer - mitral
valve
causes of aortic stenosis Answer - - bicuspid aortic valve (congenital condition)
- age-related calcification (smoking, HTN, HLD)
- rheumatic fever/heart disease
S&S of aortic stenosis Answer - - Left ventricular hypertrophy - PMI is
shifted/displaced
- Syncope
- Angina
- Dyspnea
,- Pulsus parvus
- MAHA
pulsus parvus et tardus Answer - small, weak pulse that is slow to rise
MAHA stands for Answer - microangiopathic hemolytic anemia
what happens in MAHA? Answer - RBCs get sheared as they travel across very
tight valve, break apart ---> hemolytic anemia
what type of murmur is heard with aortic stenosis? Answer - systolic ejection
murmur w/ crescendo/decrescendo
causes of aortic regurgitation Answer - - aneurysm of the aortic annulus/ring --
won't allow valve to close
- Tertiary syphillis
- Marfan's, Ehler Danos, CT disorders
- Endocarditis
- Rheumatic fever
what type of murmur is heard with aortic regurgitation? Answer - early
diastolic murmur with decrescnedo on left sternal border
causes of mitral stenosis Answer - - rheumatic fever*** Characteristic
- endocarditis
what type of murmur is heard with mitral stenosis Answer - diastolic rumble
w/ opening snap
,causes of mitral regurgitation Answer - - anything that causes LV dilation
(stretches the heart and valves are no longer able to come together properly)
- rheumatic fever
- endocarditis
- papillary muscle dysfunction
- calcification of valve
what type of murmur is heard with mitral regurgitation Answer - hollow
systolic murmur at the apex; flat murmur, starts at S1
best position for pt to be in to hear extra heart sounds Answer - left lateral
decubitus position
S3 heart sound indicates what problem? Answer - volume overload --> too
much blood volume
S4 heart sound indicates what problem? Answer - pressure overload - very bad
- like in HTN
mitral valve prolapse is caused by Answer - - idiopathic
- connective tissue disorder (Marfans, Ehler Danos)
mitral valve prolapse murmur is a Answer - systolic murmur w/ late/mid
systolic click
the valve closures best heard at the base of the heart are Answer - aortic and
pulmonic
, S1 coincides with the Answer - carotid artery pulse
strongest risk factor for CVD in older adults is Answer - elevated systolic blood
pressure
a pt that comes in with tiredness and shortness of breath should be suspected
for Answer - Acute coronary syndrome
all pts with suspected ACS should receive what medications? Answer - Aspirin
(regardless of age)
Metoprolol or atenolol
ACE inhibitor
Statin
ABCs of ACS Answer - A: ASA and antianginal therapy
B: Beta blockers and blood pressure
C: Cigarette smoking and cholesterol
D: Diet and diabetes
E: Exercise and Education
diagnostic for chronic CAD Answer - stress test
all pts with chronic CAD should get what meds? Answer - - high dose statin
- aspirin
- ACE inhibitors (if pt has CAD, PAD, or DM)
| 2026 UPDATE WITH COMPLETE SOLUTION
auscultation of a murmur in the right sternal border indicates problem with
Answer - aortic valve
auscultation of a murmur in the left upper sternal border indicates problem
with Answer - pulmonic valve
auscultation of a murmur in the left lower sternal border indicates problem
with Answer - tricuspid valve, aortic valve
auscultation of a murmur in the apex indicates problem with Answer - mitral
valve
causes of aortic stenosis Answer - - bicuspid aortic valve (congenital condition)
- age-related calcification (smoking, HTN, HLD)
- rheumatic fever/heart disease
S&S of aortic stenosis Answer - - Left ventricular hypertrophy - PMI is
shifted/displaced
- Syncope
- Angina
- Dyspnea
,- Pulsus parvus
- MAHA
pulsus parvus et tardus Answer - small, weak pulse that is slow to rise
MAHA stands for Answer - microangiopathic hemolytic anemia
what happens in MAHA? Answer - RBCs get sheared as they travel across very
tight valve, break apart ---> hemolytic anemia
what type of murmur is heard with aortic stenosis? Answer - systolic ejection
murmur w/ crescendo/decrescendo
causes of aortic regurgitation Answer - - aneurysm of the aortic annulus/ring --
won't allow valve to close
- Tertiary syphillis
- Marfan's, Ehler Danos, CT disorders
- Endocarditis
- Rheumatic fever
what type of murmur is heard with aortic regurgitation? Answer - early
diastolic murmur with decrescnedo on left sternal border
causes of mitral stenosis Answer - - rheumatic fever*** Characteristic
- endocarditis
what type of murmur is heard with mitral stenosis Answer - diastolic rumble
w/ opening snap
,causes of mitral regurgitation Answer - - anything that causes LV dilation
(stretches the heart and valves are no longer able to come together properly)
- rheumatic fever
- endocarditis
- papillary muscle dysfunction
- calcification of valve
what type of murmur is heard with mitral regurgitation Answer - hollow
systolic murmur at the apex; flat murmur, starts at S1
best position for pt to be in to hear extra heart sounds Answer - left lateral
decubitus position
S3 heart sound indicates what problem? Answer - volume overload --> too
much blood volume
S4 heart sound indicates what problem? Answer - pressure overload - very bad
- like in HTN
mitral valve prolapse is caused by Answer - - idiopathic
- connective tissue disorder (Marfans, Ehler Danos)
mitral valve prolapse murmur is a Answer - systolic murmur w/ late/mid
systolic click
the valve closures best heard at the base of the heart are Answer - aortic and
pulmonic
, S1 coincides with the Answer - carotid artery pulse
strongest risk factor for CVD in older adults is Answer - elevated systolic blood
pressure
a pt that comes in with tiredness and shortness of breath should be suspected
for Answer - Acute coronary syndrome
all pts with suspected ACS should receive what medications? Answer - Aspirin
(regardless of age)
Metoprolol or atenolol
ACE inhibitor
Statin
ABCs of ACS Answer - A: ASA and antianginal therapy
B: Beta blockers and blood pressure
C: Cigarette smoking and cholesterol
D: Diet and diabetes
E: Exercise and Education
diagnostic for chronic CAD Answer - stress test
all pts with chronic CAD should get what meds? Answer - - high dose statin
- aspirin
- ACE inhibitors (if pt has CAD, PAD, or DM)
