Advanced Health Assessment - Questions Part 1 And
Answers Verified 100% Correct
When palpating the abdomen, you should note whether the liver is enlarged in the:
A. left lower quadrant.
B. midepigastric region.
C. periumbilical area.
D. right upper quadrant. - ANSWER: D
The liver is located in the right upper quadrant of the abdomen.
One major function of the liver is to:
A. secrete pepsin.
B. emulsify fats.
C. store glycogen.
D. absorb bile. - ANSWER: C
The liver plays a metabolic role; it converts glucose to glycogen, stores it, and then
converts glycogen back to glucose as needed by the body.
To estimate heart size by percussion, you should begin tapping at the:
A. anterior axillary line.
B. left sternal border.
C. midclavicular line.
D. midsternal line. - ANSWER: A
Estimating the size of the heart can be done by percussion. Begin tapping at the
anterior axillary line, moving medially along the intercostal spaces toward the sternal
border. The change from a resonant to a dull note marks the cardiac border.
Normal heart sounds are best heard:
A. directly over the semilunar and bicuspid heart valves.
B. over areas where blood flows after it passes through a valve.
C. near the carotid vessels.
D. over the central sternum. - ANSWER: B
Normal heart sounds are best heard in areas where the blood flows after it passes
through a valve in the direction of blood flow.
To hear diastolic heart sounds, you should ask patients to:
A. lie on their back.
B. lie on their left side.
C. lie on their right side.
,D. sit up and lean forward. - ANSWER: B
Left lateral recumbent is the best position to hear the low-pitched filling sounds in
diastole with the bell of the stethoscope. Sitting up and leaning forward is the best
position in which to hear relatively high-pitched murmurs with the diaphragm of the
stethoscope. Right lateral recumbent position is the best position for evaluating right
rotated heart of dextrocardia.
A third heart sound is created by:
A. atrial contraction.
B. ventricular contraction.
C. diastolic filling.
D. regurgitation between the right and left ventricles. - ANSWER: C
Diastole is a relatively passive interval until ventricular filling is almost complete.
Diastole occurs when the ventricle is filling with blood from the atria and the filling
sometimes produces a third heart sound, S3.
You are listening to a patient's heart sounds in the aortic and pulmonic areas. The
sound becomes asynchronous during inspiration. The prevalent heart sound in this
area is most likely: A. S1.
B. S2.
C. S3.
D. S4. - ANSWER: B
S2 marks the closure of the semilunar valves, which indicates the end of systole, and is
best heard in the aortic and pulmonic areas. It is higher pitched and shorter than S1. S2
typically splits during inspiration.
The bell of the stethoscope placed at the apex is more useful than the diaphragm for
hearing:
A. pericardial friction rub.
B. high-pitched murmurs.
C. presystolic gallops.
D. systolic ejection sounds. -
ANSWER: C
Using the bell of the stethoscope at the apex is more useful for hearing low-pitched
presystolic gallops. The patient should lie in the supine or left lateral recumbent position.
You are conducting an examination of Mr. Curtis's heart and blood vessels
and auscultate a grade III murmur. The intensity of this murmur is: A. barely
discernible.
,B. moderately loud.
C. loud with palpable thrill.
D. very loud without a stethoscope. - ANSWER: B
The intensity of a grade III murmur is described as moderately loud. Barely discernible
is a grade I murmur. Loud with a palpable thrill is a grade IV murmur. Very loud without
a stethoscope is a grade VI murmur.
A grade I or II murmur, without radiation and of medium pitch, is a common variation
found in:
A. school-age children.
B. older women.
C. middle-age men.
D. older adults. - ANSWER: A
Many murmurs, particularly in children and adolescents and especially in young
athletes, have no apparent cause. These are usually grade I or II murmurs that are
usually midsystolic and without radiation; are medium pitched; and are blowing, brief,
and often accompanied by splitting of S2.
An example of a functional heart murmur is one that is caused by:
A. anemia.
B. ventricular septal defect.
C. atrial septal defect.
D. mitral valve prolapse. - ANSWER: A
A functional heart murmur is a harmless heart murmur made by a healthy heart beating
strongly. High-output demands that increase the speed of blood flow can cause
murmurs. Anemia, pregnancy, and thyrotoxicosis can cause these functional heart
murmurs.
Mr. Jones and his wife have brought in their infant daughter for a routine visit. A
holosystolic murmur in an infant that is best heard along the left sternal border, is in
the third to fifth intercostal spaces, and does not radiate to the neck is indicative of: A.
ventricular septal defect.
B. patent ductus arteriosus.
C. pulmonary stenosis.
D. dextrocardia. - ANSWER: A
Regurgitation through the ventricular septal defect results in a holosystolic murmur that
is best heard along the left sternal border, is in the third to fifth intercostal spaces, and
does not radiate to the neck.
, A split second heart sound is:
A. abnormal.
B. greatest at the peak of inspiration.
C. heard best after forceful expiration.
D. supposed to disappear with deep inspiration. - ANSWER: B
Splitting of S2 is an expected event, because pressures are higher and depolarization
occurs earlier on the left side of the heart. Ejection times on the right are longer, and
the pulmonic valve closes a bit later than the aortic valve. Splitting of S2 is greatest at
the peak of inspiration. During expiration, the split may disappear.
The earliest sign of heart failure in an infant is frequently:
A. liver enlargement.
B. fluid in the lungs.
C. enlarged thyroid.
D. clubbing of the fingers. - ANSWER: A
If heart failure is suspected, note that the infant's liver may enlarge before there is any
suggestion of fluid in the lungs and that the left lobe of the liver may be more distinctly
enlarged than the right.
Chest pain with an organic cause in a child is most likely the result of:
A. cardiac disease.
B. asthma.
C. esophageal reflux. D. arthritis. - ANSWER: B
Unlike chest pain in adults, chest pain in children and adolescents is seldom caused by
a cardiac problem. More likely, the case is related to trauma, exercise-induced asthma,
or cocaine use.
Which dysrhythmia is a physiologic event during childhood?
A. First-degree AV block
B. Mobitz type II
C. Multifocal PVCs
D. Sinus arrhythmia -
ANSWER: D
Sinus arrhythmia is a physiologic event during childhood. The heart rate varies in a
cyclic pattern, usually faster on inspiration and slower on expiration. The heart rates of
children react with wider swings to stress, exercise, fever, or tension.
An increase in heart rate during inspiration, with a decrease in this rate
during expiration, is an expected finding in: A. adults under stress.
B. 4-year-old children.
Answers Verified 100% Correct
When palpating the abdomen, you should note whether the liver is enlarged in the:
A. left lower quadrant.
B. midepigastric region.
C. periumbilical area.
D. right upper quadrant. - ANSWER: D
The liver is located in the right upper quadrant of the abdomen.
One major function of the liver is to:
A. secrete pepsin.
B. emulsify fats.
C. store glycogen.
D. absorb bile. - ANSWER: C
The liver plays a metabolic role; it converts glucose to glycogen, stores it, and then
converts glycogen back to glucose as needed by the body.
To estimate heart size by percussion, you should begin tapping at the:
A. anterior axillary line.
B. left sternal border.
C. midclavicular line.
D. midsternal line. - ANSWER: A
Estimating the size of the heart can be done by percussion. Begin tapping at the
anterior axillary line, moving medially along the intercostal spaces toward the sternal
border. The change from a resonant to a dull note marks the cardiac border.
Normal heart sounds are best heard:
A. directly over the semilunar and bicuspid heart valves.
B. over areas where blood flows after it passes through a valve.
C. near the carotid vessels.
D. over the central sternum. - ANSWER: B
Normal heart sounds are best heard in areas where the blood flows after it passes
through a valve in the direction of blood flow.
To hear diastolic heart sounds, you should ask patients to:
A. lie on their back.
B. lie on their left side.
C. lie on their right side.
,D. sit up and lean forward. - ANSWER: B
Left lateral recumbent is the best position to hear the low-pitched filling sounds in
diastole with the bell of the stethoscope. Sitting up and leaning forward is the best
position in which to hear relatively high-pitched murmurs with the diaphragm of the
stethoscope. Right lateral recumbent position is the best position for evaluating right
rotated heart of dextrocardia.
A third heart sound is created by:
A. atrial contraction.
B. ventricular contraction.
C. diastolic filling.
D. regurgitation between the right and left ventricles. - ANSWER: C
Diastole is a relatively passive interval until ventricular filling is almost complete.
Diastole occurs when the ventricle is filling with blood from the atria and the filling
sometimes produces a third heart sound, S3.
You are listening to a patient's heart sounds in the aortic and pulmonic areas. The
sound becomes asynchronous during inspiration. The prevalent heart sound in this
area is most likely: A. S1.
B. S2.
C. S3.
D. S4. - ANSWER: B
S2 marks the closure of the semilunar valves, which indicates the end of systole, and is
best heard in the aortic and pulmonic areas. It is higher pitched and shorter than S1. S2
typically splits during inspiration.
The bell of the stethoscope placed at the apex is more useful than the diaphragm for
hearing:
A. pericardial friction rub.
B. high-pitched murmurs.
C. presystolic gallops.
D. systolic ejection sounds. -
ANSWER: C
Using the bell of the stethoscope at the apex is more useful for hearing low-pitched
presystolic gallops. The patient should lie in the supine or left lateral recumbent position.
You are conducting an examination of Mr. Curtis's heart and blood vessels
and auscultate a grade III murmur. The intensity of this murmur is: A. barely
discernible.
,B. moderately loud.
C. loud with palpable thrill.
D. very loud without a stethoscope. - ANSWER: B
The intensity of a grade III murmur is described as moderately loud. Barely discernible
is a grade I murmur. Loud with a palpable thrill is a grade IV murmur. Very loud without
a stethoscope is a grade VI murmur.
A grade I or II murmur, without radiation and of medium pitch, is a common variation
found in:
A. school-age children.
B. older women.
C. middle-age men.
D. older adults. - ANSWER: A
Many murmurs, particularly in children and adolescents and especially in young
athletes, have no apparent cause. These are usually grade I or II murmurs that are
usually midsystolic and without radiation; are medium pitched; and are blowing, brief,
and often accompanied by splitting of S2.
An example of a functional heart murmur is one that is caused by:
A. anemia.
B. ventricular septal defect.
C. atrial septal defect.
D. mitral valve prolapse. - ANSWER: A
A functional heart murmur is a harmless heart murmur made by a healthy heart beating
strongly. High-output demands that increase the speed of blood flow can cause
murmurs. Anemia, pregnancy, and thyrotoxicosis can cause these functional heart
murmurs.
Mr. Jones and his wife have brought in their infant daughter for a routine visit. A
holosystolic murmur in an infant that is best heard along the left sternal border, is in
the third to fifth intercostal spaces, and does not radiate to the neck is indicative of: A.
ventricular septal defect.
B. patent ductus arteriosus.
C. pulmonary stenosis.
D. dextrocardia. - ANSWER: A
Regurgitation through the ventricular septal defect results in a holosystolic murmur that
is best heard along the left sternal border, is in the third to fifth intercostal spaces, and
does not radiate to the neck.
, A split second heart sound is:
A. abnormal.
B. greatest at the peak of inspiration.
C. heard best after forceful expiration.
D. supposed to disappear with deep inspiration. - ANSWER: B
Splitting of S2 is an expected event, because pressures are higher and depolarization
occurs earlier on the left side of the heart. Ejection times on the right are longer, and
the pulmonic valve closes a bit later than the aortic valve. Splitting of S2 is greatest at
the peak of inspiration. During expiration, the split may disappear.
The earliest sign of heart failure in an infant is frequently:
A. liver enlargement.
B. fluid in the lungs.
C. enlarged thyroid.
D. clubbing of the fingers. - ANSWER: A
If heart failure is suspected, note that the infant's liver may enlarge before there is any
suggestion of fluid in the lungs and that the left lobe of the liver may be more distinctly
enlarged than the right.
Chest pain with an organic cause in a child is most likely the result of:
A. cardiac disease.
B. asthma.
C. esophageal reflux. D. arthritis. - ANSWER: B
Unlike chest pain in adults, chest pain in children and adolescents is seldom caused by
a cardiac problem. More likely, the case is related to trauma, exercise-induced asthma,
or cocaine use.
Which dysrhythmia is a physiologic event during childhood?
A. First-degree AV block
B. Mobitz type II
C. Multifocal PVCs
D. Sinus arrhythmia -
ANSWER: D
Sinus arrhythmia is a physiologic event during childhood. The heart rate varies in a
cyclic pattern, usually faster on inspiration and slower on expiration. The heart rates of
children react with wider swings to stress, exercise, fever, or tension.
An increase in heart rate during inspiration, with a decrease in this rate
during expiration, is an expected finding in: A. adults under stress.
B. 4-year-old children.
