2
NURS5461 Part 2 Exam with verified detailed answers || || || || || || ||
auscultation of a murmur in the right sternal border indicates problem with - ✔✔aortic
|| || || || || || || || || || || || || ||
valve
auscultation of a murmur in the left upper sternal border indicates problem with -
|| || || || || || || || || || || || || ||
✔✔pulmonic valve ||
auscultation of a murmur in the left lower sternal border indicates problem with -
|| || || || || || || || || || || || || ||
✔✔tricuspid valve, aortic valve || || ||
auscultation of a murmur in the apex indicates problem with - ✔✔mitral valve
|| || || || || || || || || || || ||
causes of aortic stenosis - ✔✔- bicuspid aortic valve (congenital condition)
|| || || || || || || || || ||
- age-related calcification (smoking, HTN, HLD)
|| || || || ||
- rheumatic fever/heart disease
|| || ||
S&S of aortic stenosis - ✔✔- Left ventricular hypertrophy - PMI is shifted/displaced
|| || || || || || || || || || || ||
- Syncope
||
- Angina
||
- Dyspnea
||
- Pulsus parvus
|| ||
- MAHA
||
pulsus parvus et tardus - ✔✔small, weak pulse that is slow to rise
|| || || || || || || || || || || ||
,2
MAHA stands for - ✔✔microangiopathic hemolytic anemia
|| || || || || ||
what happens in MAHA? - ✔✔RBCs get sheared as they travel across very tight valve, break
|| || || || || || || || || || || || || || ||
apart ---> hemolytic anemia
|| || || ||
what type of murmur is heard with aortic stenosis? - ✔✔systolic ejection murmur w/
|| || || || || || || || || || || || || ||
crescendo/decrescendo
causes of aortic regurgitation - ✔✔- 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? - ✔✔early diastolic murmur with
|| || || || || || || || || || || || || ||
decrescnedo on left sternal border || || || ||
causes of mitral stenosis - ✔✔- rheumatic fever*** Characteristic
|| || || || || || || ||
- endocarditis
||
what type of murmur is heard with mitral stenosis - ✔✔diastolic rumble w/ opening snap
|| || || || || || || || || || || || || ||
causes of mitral regurgitation - ✔✔- anything that causes LV dilation (stretches the heart
|| || || || || || || || || || || || || ||
and valves are no longer able to come together properly)
|| || || || || || || || ||
- rheumatic fever
|| ||
- endocarditis
||
,2
- papillary muscle dysfunction
|| || ||
- calcification of valve
|| || ||
what type of murmur is heard with mitral regurgitation - ✔✔hollow systolic murmur at the
|| || || || || || || || || || || || || || ||
apex; flat murmur, starts at S1
|| || || || ||
best position for pt to be in to hear extra heart sounds - ✔✔left lateral decubitus position
|| || || || || || || || || || || || || || || ||
S3 heart sound indicates what problem? - ✔✔volume overload --> too much blood volume
|| || || || || || || || || || || || ||
S4 heart sound indicates what problem? - ✔✔pressure overload - very bad - like in HTN
|| || || || || || || || || || || || || || ||
mitral valve prolapse is caused by - ✔✔- idiopathic
|| || || || || || || ||
- connective tissue disorder (Marfans, Ehler Danos)
|| || || || || ||
mitral valve prolapse murmur is a - ✔✔systolic murmur w/ late/mid systolic click
|| || || || || || || || || || || ||
the valve closures best heard at the base of the heart are - ✔✔aortic and pulmonic
|| || || || || || || || || || || || || || ||
S1 coincides with the - ✔✔carotid artery pulse
|| || || || || || ||
strongest risk factor for CVD in older adults is - ✔✔elevated systolic blood pressure
|| || || || || || || || || || || || ||
a pt that comes in with tiredness and shortness of breath should be suspected for -
|| || || || || || || || || || || || || || || ||
✔✔Acute coronary syndrome || ||
, 2
all pts with suspected ACS should receive what medications? - ✔✔Aspirin (regardless of
|| || || || || || || || || || || || ||
age)
Metoprolol or atenolol || ||
ACE inhibitor ||
Statin
ABCs of ACS - ✔✔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 - ✔✔stress test || || || || || ||
all pts with chronic CAD should get what meds? - ✔✔- high dose statin
|| || || || || || || || || || || || ||
- aspirin
||
- ACE inhibitors (if pt has CAD, PAD, or DM)
|| || || || || || || || ||
CCBs are contraindicated in pts with - ✔✔HEART FAILURE or if EF < 40%
|| || || || || || || || || || || || ||
the drug of choice to prevent stroke in valvular a. fib is... - ✔✔warfarin
|| || || || || || || || || || || || ||
optimal candidates for warfarin therapy in pts with afib: - ✔✔- renal insufficiency
|| || || || || || || || || || || ||
- can do INR testing
|| || || ||
- self testing machine for INR testing
|| || || || || ||
- are concerned with a reversal strategy
|| || || || || ||
NURS5461 Part 2 Exam with verified detailed answers || || || || || || ||
auscultation of a murmur in the right sternal border indicates problem with - ✔✔aortic
|| || || || || || || || || || || || || ||
valve
auscultation of a murmur in the left upper sternal border indicates problem with -
|| || || || || || || || || || || || || ||
✔✔pulmonic valve ||
auscultation of a murmur in the left lower sternal border indicates problem with -
|| || || || || || || || || || || || || ||
✔✔tricuspid valve, aortic valve || || ||
auscultation of a murmur in the apex indicates problem with - ✔✔mitral valve
|| || || || || || || || || || || ||
causes of aortic stenosis - ✔✔- bicuspid aortic valve (congenital condition)
|| || || || || || || || || ||
- age-related calcification (smoking, HTN, HLD)
|| || || || ||
- rheumatic fever/heart disease
|| || ||
S&S of aortic stenosis - ✔✔- Left ventricular hypertrophy - PMI is shifted/displaced
|| || || || || || || || || || || ||
- Syncope
||
- Angina
||
- Dyspnea
||
- Pulsus parvus
|| ||
- MAHA
||
pulsus parvus et tardus - ✔✔small, weak pulse that is slow to rise
|| || || || || || || || || || || ||
,2
MAHA stands for - ✔✔microangiopathic hemolytic anemia
|| || || || || ||
what happens in MAHA? - ✔✔RBCs get sheared as they travel across very tight valve, break
|| || || || || || || || || || || || || || ||
apart ---> hemolytic anemia
|| || || ||
what type of murmur is heard with aortic stenosis? - ✔✔systolic ejection murmur w/
|| || || || || || || || || || || || || ||
crescendo/decrescendo
causes of aortic regurgitation - ✔✔- 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? - ✔✔early diastolic murmur with
|| || || || || || || || || || || || || ||
decrescnedo on left sternal border || || || ||
causes of mitral stenosis - ✔✔- rheumatic fever*** Characteristic
|| || || || || || || ||
- endocarditis
||
what type of murmur is heard with mitral stenosis - ✔✔diastolic rumble w/ opening snap
|| || || || || || || || || || || || || ||
causes of mitral regurgitation - ✔✔- anything that causes LV dilation (stretches the heart
|| || || || || || || || || || || || || ||
and valves are no longer able to come together properly)
|| || || || || || || || ||
- rheumatic fever
|| ||
- endocarditis
||
,2
- papillary muscle dysfunction
|| || ||
- calcification of valve
|| || ||
what type of murmur is heard with mitral regurgitation - ✔✔hollow systolic murmur at the
|| || || || || || || || || || || || || || ||
apex; flat murmur, starts at S1
|| || || || ||
best position for pt to be in to hear extra heart sounds - ✔✔left lateral decubitus position
|| || || || || || || || || || || || || || || ||
S3 heart sound indicates what problem? - ✔✔volume overload --> too much blood volume
|| || || || || || || || || || || || ||
S4 heart sound indicates what problem? - ✔✔pressure overload - very bad - like in HTN
|| || || || || || || || || || || || || || ||
mitral valve prolapse is caused by - ✔✔- idiopathic
|| || || || || || || ||
- connective tissue disorder (Marfans, Ehler Danos)
|| || || || || ||
mitral valve prolapse murmur is a - ✔✔systolic murmur w/ late/mid systolic click
|| || || || || || || || || || || ||
the valve closures best heard at the base of the heart are - ✔✔aortic and pulmonic
|| || || || || || || || || || || || || || ||
S1 coincides with the - ✔✔carotid artery pulse
|| || || || || || ||
strongest risk factor for CVD in older adults is - ✔✔elevated systolic blood pressure
|| || || || || || || || || || || || ||
a pt that comes in with tiredness and shortness of breath should be suspected for -
|| || || || || || || || || || || || || || || ||
✔✔Acute coronary syndrome || ||
, 2
all pts with suspected ACS should receive what medications? - ✔✔Aspirin (regardless of
|| || || || || || || || || || || || ||
age)
Metoprolol or atenolol || ||
ACE inhibitor ||
Statin
ABCs of ACS - ✔✔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 - ✔✔stress test || || || || || ||
all pts with chronic CAD should get what meds? - ✔✔- high dose statin
|| || || || || || || || || || || || ||
- aspirin
||
- ACE inhibitors (if pt has CAD, PAD, or DM)
|| || || || || || || || ||
CCBs are contraindicated in pts with - ✔✔HEART FAILURE or if EF < 40%
|| || || || || || || || || || || || ||
the drug of choice to prevent stroke in valvular a. fib is... - ✔✔warfarin
|| || || || || || || || || || || || ||
optimal candidates for warfarin therapy in pts with afib: - ✔✔- renal insufficiency
|| || || || || || || || || || || ||
- can do INR testing
|| || || ||
- self testing machine for INR testing
|| || || || || ||
- are concerned with a reversal strategy
|| || || || || ||
