NURS5461 PART 2 EXAM | QUESTIONS AND ANSWERS | 2026
UPDATE WITH COMPLETE SOLUTION
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
--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
- 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
--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
--therapy for ventricular arrhythmia - -- NO THERAPY unless pt is highly symptomatic
- first choice: Beta blocker
--most common meds that contribute to bradyarrhhythmias: - -- beta blockers
- diltiazem
- verpamil
- amiodarone
- cholinesterase inhibitors
--gold standard for valvular disorders - -ECHO
--diagnosis of HF is used by - -- CXR
- BNP
- EKG
- CBC, CMP, UA, trop, CK
- ECHO
--metolazone is used in HF to - -help decrease edema
--drug of choice for acute bronchitis - -SABA
--most common causative agents of community acquired pneumonia - -- Strep pneumonia
- myoplasma pneumoniae
- chlamydia pneumoniae
- Legionella
--diagnostic testing required for pneumonia - -CXR
- CBC w/ diff
- Sputum culture
--outpt tx for pneumonia includes which drugs? - -- Amoxicillin
- Azithromycin
- Clarithromycin
- Doxycycline
UPDATE WITH COMPLETE SOLUTION
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
--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
- 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
--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
--therapy for ventricular arrhythmia - -- NO THERAPY unless pt is highly symptomatic
- first choice: Beta blocker
--most common meds that contribute to bradyarrhhythmias: - -- beta blockers
- diltiazem
- verpamil
- amiodarone
- cholinesterase inhibitors
--gold standard for valvular disorders - -ECHO
--diagnosis of HF is used by - -- CXR
- BNP
- EKG
- CBC, CMP, UA, trop, CK
- ECHO
--metolazone is used in HF to - -help decrease edema
--drug of choice for acute bronchitis - -SABA
--most common causative agents of community acquired pneumonia - -- Strep pneumonia
- myoplasma pneumoniae
- chlamydia pneumoniae
- Legionella
--diagnostic testing required for pneumonia - -CXR
- CBC w/ diff
- Sputum culture
--outpt tx for pneumonia includes which drugs? - -- Amoxicillin
- Azithromycin
- Clarithromycin
- Doxycycline
