NURS 5461 PART 2 EXAM QUESTIONS AND ANSWERS | NURS
5461 PART 2 EXAM STUDY GUIDE & PRACTICE TEST 2026/2027
auscultation of a murmur in the right sternal border indicates problem with - ANS ✔✔aortic valve
auscultation of a murmur in the left upper sternal border indicates problem with - ANS ✔✔pulmonic
valve
auscultation of a murmur in the left lower sternal border indicates problem with - ANS ✔✔tricuspid
valve, aortic valve
auscultation of a murmur in the apex indicates problem with - ANS ✔✔mitral valve
causes of aortic stenosis - ANS ✔✔- bicuspid aortic valve (congenital condition)
- age-related calcification (smoking, HTN, HLD)
- rheumatic fever/heart disease
S&S of aortic stenosis - ANS ✔✔- Left ventricular hypertrophy - PMI is shifted/displaced
- Syncope
- Angina
- Dyspnea
- Pulsus parvus
- MAHA
pulsus parvus et tardus - ANS ✔✔small, weak pulse that is slow to rise
MAHA stands for - ANS ✔✔microangiopathic hemolytic anemia
what happens in MAHA? - ANS ✔✔RBCs get sheared as they travel across very tight valve, break apart ---
> hemolytic anemia
what type of murmur is heard with aortic stenosis? - ANS ✔✔systolic ejection murmur w/
crescendo/decrescendo
causes of aortic regurgitation - ANS ✔✔- 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? - ANS ✔✔early diastolic murmur with
decrescnedo on left sternal border
causes of mitral stenosis - ANS ✔✔- rheumatic fever*** Characteristic
,- endocarditis
what type of murmur is heard with mitral stenosis - ANS ✔✔diastolic rumble w/ opening snap
causes of mitral regurgitation - ANS ✔✔- 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 - ANS ✔✔hollow systolic murmur at the apex;
flat murmur, starts at S1
best position for pt to be in to hear extra heart sounds - ANS ✔✔left lateral decubitus position
S3 heart sound indicates what problem? - ANS ✔✔volume overload --> too much blood volume
S4 heart sound indicates what problem? - ANS ✔✔pressure overload - very bad - like in HTN
mitral valve prolapse is caused by - ANS ✔✔- idiopathic
- connective tissue disorder (Marfans, Ehler Danos)
mitral valve prolapse murmur is a - ANS ✔✔systolic murmur w/ late/mid systolic click
the valve closures best heard at the base of the heart are - ANS ✔✔aortic and pulmonic
S1 coincides with the - ANS ✔✔carotid artery pulse
strongest risk factor for CVD in older adults is - ANS ✔✔elevated systolic blood pressure
a pt that comes in with tiredness and shortness of breath should be suspected for - ANS ✔✔Acute
coronary syndrome
all pts with suspected ACS should receive what medications? - ANS ✔✔Aspirin (regardless of age)
Metoprolol or atenolol
ACE inhibitor
Statin
ABCs of ACS - ANS ✔✔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 - ANS ✔✔stress test
all pts with chronic CAD should get what meds? - ANS ✔✔- high dose statin
, - aspirin
- ACE inhibitors (if pt has CAD, PAD, or DM)
CCBs are contraindicated in pts with - ANS ✔✔HEART FAILURE or if EF < 40%
the drug of choice to prevent stroke in valvular a. fib is... - ANS ✔✔warfarin
optimal candidates for warfarin therapy in pts with afib: - ANS ✔✔- renal insufficiency
- can do INR testing
- self testing machine for INR testing
- are concerned with a reversal strategy
therapy for ventricular arrhythmia - ANS ✔✔- NO THERAPY unless pt is highly symptomatic
- first choice: Beta blocker
most common meds that contribute to bradyarrhhythmias: - ANS ✔✔- beta blockers
- diltiazem
- verpamil
- amiodarone
- cholinesterase inhibitors
gold standard for valvular disorders - ANS ✔✔ECHO
diagnosis of HF is used by - ANS ✔✔- CXR
- BNP
- EKG
- CBC, CMP, UA, trop, CK
- ECHO
metolazone is used in HF to - ANS ✔✔help decrease edema
drug of choice for acute bronchitis - ANS ✔✔SABA
most common causative agents of community acquired pneumonia - ANS ✔✔- Strep pneumonia
- myoplasma pneumoniae
- chlamydia pneumoniae
- Legionella
diagnostic testing required for pneumonia - ANS ✔✔CXR
- CBC w/ diff
- Sputum culture
outpt tx for pneumonia includes which drugs? - ANS ✔✔- Amoxicillin
- Azithromycin
- Clarithromycin
- Doxycycline
5461 PART 2 EXAM STUDY GUIDE & PRACTICE TEST 2026/2027
auscultation of a murmur in the right sternal border indicates problem with - ANS ✔✔aortic valve
auscultation of a murmur in the left upper sternal border indicates problem with - ANS ✔✔pulmonic
valve
auscultation of a murmur in the left lower sternal border indicates problem with - ANS ✔✔tricuspid
valve, aortic valve
auscultation of a murmur in the apex indicates problem with - ANS ✔✔mitral valve
causes of aortic stenosis - ANS ✔✔- bicuspid aortic valve (congenital condition)
- age-related calcification (smoking, HTN, HLD)
- rheumatic fever/heart disease
S&S of aortic stenosis - ANS ✔✔- Left ventricular hypertrophy - PMI is shifted/displaced
- Syncope
- Angina
- Dyspnea
- Pulsus parvus
- MAHA
pulsus parvus et tardus - ANS ✔✔small, weak pulse that is slow to rise
MAHA stands for - ANS ✔✔microangiopathic hemolytic anemia
what happens in MAHA? - ANS ✔✔RBCs get sheared as they travel across very tight valve, break apart ---
> hemolytic anemia
what type of murmur is heard with aortic stenosis? - ANS ✔✔systolic ejection murmur w/
crescendo/decrescendo
causes of aortic regurgitation - ANS ✔✔- 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? - ANS ✔✔early diastolic murmur with
decrescnedo on left sternal border
causes of mitral stenosis - ANS ✔✔- rheumatic fever*** Characteristic
,- endocarditis
what type of murmur is heard with mitral stenosis - ANS ✔✔diastolic rumble w/ opening snap
causes of mitral regurgitation - ANS ✔✔- 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 - ANS ✔✔hollow systolic murmur at the apex;
flat murmur, starts at S1
best position for pt to be in to hear extra heart sounds - ANS ✔✔left lateral decubitus position
S3 heart sound indicates what problem? - ANS ✔✔volume overload --> too much blood volume
S4 heart sound indicates what problem? - ANS ✔✔pressure overload - very bad - like in HTN
mitral valve prolapse is caused by - ANS ✔✔- idiopathic
- connective tissue disorder (Marfans, Ehler Danos)
mitral valve prolapse murmur is a - ANS ✔✔systolic murmur w/ late/mid systolic click
the valve closures best heard at the base of the heart are - ANS ✔✔aortic and pulmonic
S1 coincides with the - ANS ✔✔carotid artery pulse
strongest risk factor for CVD in older adults is - ANS ✔✔elevated systolic blood pressure
a pt that comes in with tiredness and shortness of breath should be suspected for - ANS ✔✔Acute
coronary syndrome
all pts with suspected ACS should receive what medications? - ANS ✔✔Aspirin (regardless of age)
Metoprolol or atenolol
ACE inhibitor
Statin
ABCs of ACS - ANS ✔✔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 - ANS ✔✔stress test
all pts with chronic CAD should get what meds? - ANS ✔✔- high dose statin
, - aspirin
- ACE inhibitors (if pt has CAD, PAD, or DM)
CCBs are contraindicated in pts with - ANS ✔✔HEART FAILURE or if EF < 40%
the drug of choice to prevent stroke in valvular a. fib is... - ANS ✔✔warfarin
optimal candidates for warfarin therapy in pts with afib: - ANS ✔✔- renal insufficiency
- can do INR testing
- self testing machine for INR testing
- are concerned with a reversal strategy
therapy for ventricular arrhythmia - ANS ✔✔- NO THERAPY unless pt is highly symptomatic
- first choice: Beta blocker
most common meds that contribute to bradyarrhhythmias: - ANS ✔✔- beta blockers
- diltiazem
- verpamil
- amiodarone
- cholinesterase inhibitors
gold standard for valvular disorders - ANS ✔✔ECHO
diagnosis of HF is used by - ANS ✔✔- CXR
- BNP
- EKG
- CBC, CMP, UA, trop, CK
- ECHO
metolazone is used in HF to - ANS ✔✔help decrease edema
drug of choice for acute bronchitis - ANS ✔✔SABA
most common causative agents of community acquired pneumonia - ANS ✔✔- Strep pneumonia
- myoplasma pneumoniae
- chlamydia pneumoniae
- Legionella
diagnostic testing required for pneumonia - ANS ✔✔CXR
- CBC w/ diff
- Sputum culture
outpt tx for pneumonia includes which drugs? - ANS ✔✔- Amoxicillin
- Azithromycin
- Clarithromycin
- Doxycycline
