NSG Physical Assessment Exam 3
QUESTIONS AND VERIFIED CORRECT
ANSWERS GRADED A+ LATEST 100%
GUARANTEED PASS
Myocardial Infarction
(irreversible heart damage because of myocardial ischemia) - CORRECT ANSWER-C: Heavy, tight
pressing
O: Discomfort occurring with or without exertion
L: Across the chest and may radiate to shoulders, jaws, neck, or upper abdomen
D: Lasts 20 minutes up to hours
S: Often moderate to severe pain
P: Rest does not relieve
A: May occur with nausea, vomiting, weakness, and sweating
Aortic Dissecting Aneurysm
(tear in the wall lining the aorta) - CORRECT ANSWER-C: Tearing, ripping sensation
O: Abrupt
L: In chest radiating to neck, back, or abdomen
D: Lasting for hours
S: Severe
P: Aggravated by hypertension. Relieved only with treatment
A: Also seen with difficulty swallowing, hoarseness, leg pain, and syncope
,Pericarditis
(inflammation of the parietal pleura next to the pericardium) - CORRECT ANSWER-C: Sharp,
stabbing, pounding feeling when heart beats
O: Ongoing
L: Pericardial pain radiating to shoulders or neck
D: Ongoing
S: Severe
P: Aggravated by breathing position changes, coughing, and may be relieved with sitting forward
A: May also be seen with fever, weakness, tiredness, coughing, trouble breathing, and/or pain
when swallowing
Pain Patterns (areas) with Myocardial Ischemia - CORRECT ANSWER-Left chest
Left neck
Left arm down the ulnar side, forearm, and hand
R chest and arm (if severe)
Jaw, epigastric, and back
Inspect anterior thorax for apical impulse and abnormal pulsations/heaves/lifts - CORRECT
ANSWER-Normal: Apical impulse may or may not be visible
Abnormal: Any pulsation other than apical impulse like heaves or lifts are abnormal.
Could suggest enlarged ventricle
Palpate apical impulse using fingerpads in fifth intercostal space at midclavicular line (May need
to reposition fingers/press deeper or lighten pressure or pt may need to roll to left side if you
cannot palpate it) - CORRECT ANSWER-Normal: Small gentle tap. May not be palpable if obese
or has large breasts
Abnormal: If large, displaced, more forceful, suspect cardiac enlargement
,Palpate for abnormal pulsations using palmar or ulnar surfaces to palpate apex, LSB, base -
CORRECT ANSWER-Normal: No pulsations or vibrations
Abnormal: "Thrill", a pulsation usually associated with a murmur
How does the nurse auscultate and what is making the sounds, what are landmarks, and what
are normal and abnormal findings? - CORRECT ANSWER-Listen for valves to CLOSE
Auscultate to identify S1 (Mitral & Tricuspid) and S2 (Pulmonary & Aortic)
S1 corresponds to carotid pulse
S2 loudest at base
S1 loudest at apex
What are pediatric variations?
(heart assessment) - CORRECT ANSWER-Poor weight gain
Delayed development
Difficulty feeding
Inability to tolerate physical activity or play
Squatting behavior
Excessive irritability
Circumoral or central cyanosis
What are geriatric variations? - CORRECT ANSWER-Thickening of heart walls
Decreased elasticity of heart and arteries, reduced pumping ability
Decreased cardiac output, reduced maximum heart rate
Location of heart sounds may vary due to physical changes like kyphosis
Atrial fibrillation is a common dysrhythmia
, ★Know how to read a 6-second telemetry strip - CORRECT ANSWER-Each tiny box is 0.04
seconds
Each larger box is 0.20 seconds
Looking for a P wave, QRS complex, and T wave
Count number of R waves (largest spike) and multiply by 10 to find heart rate
Distance between each R wave equal= regular tempo (heart rhythm)
P wave present before each QRS complex= good electrical conduction in SA node
Stenosis - CORRECT ANSWER-DEF: Narrowing of a valve, cannot open all the way
Insufficiency: Incomplete closure of valve, may allow blood to leak backwards (regurgitation)
RF: rheumatic heart disease following rheumatic fever
S/S: Often asymptomatic, palpitations, SOB, fatigue, angina, thrusts/heaves, auscultate a
murmur over the place you would normally auscultate the valve, we are not diagnosing
murmurs-just listen extra tones with diaphragm or for a vascular tone with bell
Medical treatment: Echo to dx, meds that affect diuresis, preload, afterload, heart rate and
stroke volume, surgical intervention like valve repair, replacement, balloon to decrease
constriction
Heart failure - CORRECT ANSWER-Left sided: Left ventricle doesn't pump blood forward so it
backs up to the lungs
Right sided: Right ventricle doesn't pump blood forward so it backs up to the system
QUESTIONS AND VERIFIED CORRECT
ANSWERS GRADED A+ LATEST 100%
GUARANTEED PASS
Myocardial Infarction
(irreversible heart damage because of myocardial ischemia) - CORRECT ANSWER-C: Heavy, tight
pressing
O: Discomfort occurring with or without exertion
L: Across the chest and may radiate to shoulders, jaws, neck, or upper abdomen
D: Lasts 20 minutes up to hours
S: Often moderate to severe pain
P: Rest does not relieve
A: May occur with nausea, vomiting, weakness, and sweating
Aortic Dissecting Aneurysm
(tear in the wall lining the aorta) - CORRECT ANSWER-C: Tearing, ripping sensation
O: Abrupt
L: In chest radiating to neck, back, or abdomen
D: Lasting for hours
S: Severe
P: Aggravated by hypertension. Relieved only with treatment
A: Also seen with difficulty swallowing, hoarseness, leg pain, and syncope
,Pericarditis
(inflammation of the parietal pleura next to the pericardium) - CORRECT ANSWER-C: Sharp,
stabbing, pounding feeling when heart beats
O: Ongoing
L: Pericardial pain radiating to shoulders or neck
D: Ongoing
S: Severe
P: Aggravated by breathing position changes, coughing, and may be relieved with sitting forward
A: May also be seen with fever, weakness, tiredness, coughing, trouble breathing, and/or pain
when swallowing
Pain Patterns (areas) with Myocardial Ischemia - CORRECT ANSWER-Left chest
Left neck
Left arm down the ulnar side, forearm, and hand
R chest and arm (if severe)
Jaw, epigastric, and back
Inspect anterior thorax for apical impulse and abnormal pulsations/heaves/lifts - CORRECT
ANSWER-Normal: Apical impulse may or may not be visible
Abnormal: Any pulsation other than apical impulse like heaves or lifts are abnormal.
Could suggest enlarged ventricle
Palpate apical impulse using fingerpads in fifth intercostal space at midclavicular line (May need
to reposition fingers/press deeper or lighten pressure or pt may need to roll to left side if you
cannot palpate it) - CORRECT ANSWER-Normal: Small gentle tap. May not be palpable if obese
or has large breasts
Abnormal: If large, displaced, more forceful, suspect cardiac enlargement
,Palpate for abnormal pulsations using palmar or ulnar surfaces to palpate apex, LSB, base -
CORRECT ANSWER-Normal: No pulsations or vibrations
Abnormal: "Thrill", a pulsation usually associated with a murmur
How does the nurse auscultate and what is making the sounds, what are landmarks, and what
are normal and abnormal findings? - CORRECT ANSWER-Listen for valves to CLOSE
Auscultate to identify S1 (Mitral & Tricuspid) and S2 (Pulmonary & Aortic)
S1 corresponds to carotid pulse
S2 loudest at base
S1 loudest at apex
What are pediatric variations?
(heart assessment) - CORRECT ANSWER-Poor weight gain
Delayed development
Difficulty feeding
Inability to tolerate physical activity or play
Squatting behavior
Excessive irritability
Circumoral or central cyanosis
What are geriatric variations? - CORRECT ANSWER-Thickening of heart walls
Decreased elasticity of heart and arteries, reduced pumping ability
Decreased cardiac output, reduced maximum heart rate
Location of heart sounds may vary due to physical changes like kyphosis
Atrial fibrillation is a common dysrhythmia
, ★Know how to read a 6-second telemetry strip - CORRECT ANSWER-Each tiny box is 0.04
seconds
Each larger box is 0.20 seconds
Looking for a P wave, QRS complex, and T wave
Count number of R waves (largest spike) and multiply by 10 to find heart rate
Distance between each R wave equal= regular tempo (heart rhythm)
P wave present before each QRS complex= good electrical conduction in SA node
Stenosis - CORRECT ANSWER-DEF: Narrowing of a valve, cannot open all the way
Insufficiency: Incomplete closure of valve, may allow blood to leak backwards (regurgitation)
RF: rheumatic heart disease following rheumatic fever
S/S: Often asymptomatic, palpitations, SOB, fatigue, angina, thrusts/heaves, auscultate a
murmur over the place you would normally auscultate the valve, we are not diagnosing
murmurs-just listen extra tones with diaphragm or for a vascular tone with bell
Medical treatment: Echo to dx, meds that affect diuresis, preload, afterload, heart rate and
stroke volume, surgical intervention like valve repair, replacement, balloon to decrease
constriction
Heart failure - CORRECT ANSWER-Left sided: Left ventricle doesn't pump blood forward so it
backs up to the lungs
Right sided: Right ventricle doesn't pump blood forward so it backs up to the system
