N125 Exam need to study Questions Solved
100% Correct |Verified Answers
What is hemoptysis? - ANSWER Spitting or coughing up blood
What subjective data should be collected for a heart and neck vessel assessment?
(11 things) - ANSWER 1. Chest pain: PQRSTU, had it before, associated symptoms
2. Dyspnea: after how much activity, change over time, positional, wake you up, ADLs
3. Orthopnea: how many pillows
4. Cough: OLDCART, associated factors, sputum characteristics
5. Fatigue: tire easily, onset, timing in day
6. Cyanosis or pallor
7. Edema (swelling in feet or legs): onset, changes, timing, symmetry, relief factors,
associated symptoms
8. Nocturia (frequently having to get up at night to pee)
9. Cardiac history: diseases and tests
10. Family cardiac history
11. Patient-centered care (nutrition, smoking, alcohol, exercise)
What is orthopnea? Why does it occur? - ANSWER Difficulty breathing when lying down.
Fluid moves down to the base of the lungs when sitting up. When laying down, the fluid
is covering a much larger surface area of the lung, impeding gas exchange.
What objective data should be collected for a heart and neck vessel assessment?
(4 categories) - ANSWER 1) Carotid arteries (palpate, auscultate for bruit)
2) Jugular veins (inspect external jugular veins with a light)
,3) Precordium
- Inspect the anterior chest
- Palpate the apical pulse
- Palpate across the precordium
4) Auscultate the heart sounds:
- Listen to S1 and S2 separately
- Listen for extra heart sounds and murmurs
What is normal and abnormal in an objective assessment of the carotid arteries? -
ANSWER Normal: contour is smooth with a brisk upstroke and slower
downstroke, strength is moderate and symmetric, no bruit
Abnormal: diminished pulse (decreased stroke volume, shock), increased
pulse (hyperkinetic states), bruit (turbulence through the vessel from
atherosclerotic narrowing)
When is a bruit audible? - ANSWER Bruit is audible when lumen occluded by 1/2 to 2/3,
increasing in strength until 2/3 occlusion. Note that complete occlusion has no bruit, so
no bruit doesn't mean no occlusion/lesion.
What is normal and abnormal in an objective assessment of the jugular veins? -
ANSWER Normal: veins not visible at all, or only visible in supine position.
Veins disappear as the person is raised to a sitting position
Abnormal: unilateral distension (local cause like kinking or aneurysm), still visible
above 45 degrees (increased central venous pressure)
What is normal and abnormal in an objective assessment of the precordium? (Hint:
there are three things you're assessing here.) - ANSWER 1) Anterior chest
Normal: may or may not see apical impulse
, Abnormal: heave/lift (sustained forceful thrusting of ventricle during systole
(ventricular hypertrophy),
2) Palpate the apical pulse
Normal: palpable in about half of adults (not obese people, people with thick chest
walls). Should be in 4th or 5th intercostal space (not both) at medial to MCL. Should be
1x2cm, with an amplitude that feels like a short, gentle tap. Duration should occupy only
the first half of systole.
Abnormal: Cardiac enlargement. Left ventricular dilation (pulse found down and to the
left), increased force and location without a change in location (left ventricular
hypertrophy and no dilation), apical pulse not palpable (pulmonary emphysema, due to
hyperinflated lungs that override the heart)
3) Palpate across the precordium
Normal: no other pulsations
Abnormal: thrill (palpable vibration, feels like a cat's purr), signifies turbulent
blood flow, which accompanies some heart murmurs.
If the apical pulse is at the midaxillary line, what does that mean? - ANSWER It
means the heart is enlarged (e.g. with chronic hypertension)
Where are the auscultatory areas for each heart valve? - ANSWER Aortic area - 2nd
right intercostal space, at sternal border
Pulmonic area - 2nd left intercostal space, at sternal border
Tricuspid area - 4th left intercostal space, at sternal border
Mitral area - 5th left intercostal space at midclavicular line
What is normal and abnormal in an assessment of the heart rate and rhythm? - ANSWER
Normal: Regular rhythm (though sinus arrhythmia - rhythm increases with breathing - is
normal in young adults and children), no pulse deficit
Abnormal: premature beat (beat/beats come early), irregularly-irregular (no pattern,
beats come rapidly at random intervals), pulse deficit
100% Correct |Verified Answers
What is hemoptysis? - ANSWER Spitting or coughing up blood
What subjective data should be collected for a heart and neck vessel assessment?
(11 things) - ANSWER 1. Chest pain: PQRSTU, had it before, associated symptoms
2. Dyspnea: after how much activity, change over time, positional, wake you up, ADLs
3. Orthopnea: how many pillows
4. Cough: OLDCART, associated factors, sputum characteristics
5. Fatigue: tire easily, onset, timing in day
6. Cyanosis or pallor
7. Edema (swelling in feet or legs): onset, changes, timing, symmetry, relief factors,
associated symptoms
8. Nocturia (frequently having to get up at night to pee)
9. Cardiac history: diseases and tests
10. Family cardiac history
11. Patient-centered care (nutrition, smoking, alcohol, exercise)
What is orthopnea? Why does it occur? - ANSWER Difficulty breathing when lying down.
Fluid moves down to the base of the lungs when sitting up. When laying down, the fluid
is covering a much larger surface area of the lung, impeding gas exchange.
What objective data should be collected for a heart and neck vessel assessment?
(4 categories) - ANSWER 1) Carotid arteries (palpate, auscultate for bruit)
2) Jugular veins (inspect external jugular veins with a light)
,3) Precordium
- Inspect the anterior chest
- Palpate the apical pulse
- Palpate across the precordium
4) Auscultate the heart sounds:
- Listen to S1 and S2 separately
- Listen for extra heart sounds and murmurs
What is normal and abnormal in an objective assessment of the carotid arteries? -
ANSWER Normal: contour is smooth with a brisk upstroke and slower
downstroke, strength is moderate and symmetric, no bruit
Abnormal: diminished pulse (decreased stroke volume, shock), increased
pulse (hyperkinetic states), bruit (turbulence through the vessel from
atherosclerotic narrowing)
When is a bruit audible? - ANSWER Bruit is audible when lumen occluded by 1/2 to 2/3,
increasing in strength until 2/3 occlusion. Note that complete occlusion has no bruit, so
no bruit doesn't mean no occlusion/lesion.
What is normal and abnormal in an objective assessment of the jugular veins? -
ANSWER Normal: veins not visible at all, or only visible in supine position.
Veins disappear as the person is raised to a sitting position
Abnormal: unilateral distension (local cause like kinking or aneurysm), still visible
above 45 degrees (increased central venous pressure)
What is normal and abnormal in an objective assessment of the precordium? (Hint:
there are three things you're assessing here.) - ANSWER 1) Anterior chest
Normal: may or may not see apical impulse
, Abnormal: heave/lift (sustained forceful thrusting of ventricle during systole
(ventricular hypertrophy),
2) Palpate the apical pulse
Normal: palpable in about half of adults (not obese people, people with thick chest
walls). Should be in 4th or 5th intercostal space (not both) at medial to MCL. Should be
1x2cm, with an amplitude that feels like a short, gentle tap. Duration should occupy only
the first half of systole.
Abnormal: Cardiac enlargement. Left ventricular dilation (pulse found down and to the
left), increased force and location without a change in location (left ventricular
hypertrophy and no dilation), apical pulse not palpable (pulmonary emphysema, due to
hyperinflated lungs that override the heart)
3) Palpate across the precordium
Normal: no other pulsations
Abnormal: thrill (palpable vibration, feels like a cat's purr), signifies turbulent
blood flow, which accompanies some heart murmurs.
If the apical pulse is at the midaxillary line, what does that mean? - ANSWER It
means the heart is enlarged (e.g. with chronic hypertension)
Where are the auscultatory areas for each heart valve? - ANSWER Aortic area - 2nd
right intercostal space, at sternal border
Pulmonic area - 2nd left intercostal space, at sternal border
Tricuspid area - 4th left intercostal space, at sternal border
Mitral area - 5th left intercostal space at midclavicular line
What is normal and abnormal in an assessment of the heart rate and rhythm? - ANSWER
Normal: Regular rhythm (though sinus arrhythmia - rhythm increases with breathing - is
normal in young adults and children), no pulse deficit
Abnormal: premature beat (beat/beats come early), irregularly-irregular (no pattern,
beats come rapidly at random intervals), pulse deficit
