NURS620 PRACTICE SET OF 390
QUESTIONS AND CORRECT DETAILED
ANSWERS
Is a lift or heave found on inspection, palpation or auscultation?
Found during inspection
Where are lifts or heaves inspected?
Lifting of the chest during systole at the LLSB
What does a lift or heave mean?
Associated with right ventricular hypertrophy
What are some abnormal pulsations?
Lifts or heaves
Thrills
Is a thrill found on inspection, palpation or auscultation?
Found during palpation
What does a thrill feel like?
Feels like vibrating/purring cat at 2nd or 3rd ICS
,What does a thrill indicate?
Indicates aortic stenosis or hypertension
If felt on the left - could indicate pulmonary problems
How are heart sounds characterized?
Frequency (pitch)
Intensity (loudness)
Duration
Timing in the cardiac cycle
ECG
What are the four basic heart sounds?
S1, S2, S3, S4
ECG
What does PASS stand for?
Pulmonic and Aortic Stenosis yields systolic murmurs
ECG
What does PAID stand for?
Pulmonic and Aortic Insufficiency yields Diastolic Murmurs
RCG
PVC
PVC
ECG
ST evelvation at the J point
possible MI
,ECG
Atrial fibrillation
atrial activity is poorly defined
risk for rapid ventricular response
increase risk for stroke, MI
ECG
Atrial flutter
irregular beating of the atria; often described as "a-flutter with 2 to 1 block or 3 to 1 block"
ECG
Paroxysmal SVT
Sudden onset, usually initiated by premature beat and also stops abruptly
Usually narrow QRS tachycardias
ECG
V Tach
sustained (lasting > 30sec) vs unsustained
mono formic (uniformed) vs polymorphic vs tornadoes de pointes
ECG
Tosades de Pointes
Flutter 250-350
- type of vtach, can lead to vfib
- ribbon like fashion (hallmark: up and downward deflection of QRS)
- d/t hypomagnesium
ECG
1st degree AV block
prolonged PR interval
, ECG
2nd degree AV block
wenckeback/Mobitz type I
usually no s/s if rate drops dramatically CO will decrease.
More P waves than QRS
PR INTERVAL INCREASED until QRS is dropped.
ECG
2nd degree AV block type 2
PR Intervals are constant until non-conducted P wave occurs
There must be two consecutive constant PR interval to diagnose.
ECG
3rd degree AV blocks
Will see complete AV dissociation because the atria and ventricles are each controlled by
separate pacemakers
This is an emergency
Will require a pacemaker
ECG
The Heart Poem
ECG
Right Bundle Branch Block
Widened QRS (>0.12s)
The second half of the QRS complex are oriented RIGHTward and ANTERIORLY because
the right ventricle is depolarized after the left
ECG
Left bundle branch block (LBBB)
QUESTIONS AND CORRECT DETAILED
ANSWERS
Is a lift or heave found on inspection, palpation or auscultation?
Found during inspection
Where are lifts or heaves inspected?
Lifting of the chest during systole at the LLSB
What does a lift or heave mean?
Associated with right ventricular hypertrophy
What are some abnormal pulsations?
Lifts or heaves
Thrills
Is a thrill found on inspection, palpation or auscultation?
Found during palpation
What does a thrill feel like?
Feels like vibrating/purring cat at 2nd or 3rd ICS
,What does a thrill indicate?
Indicates aortic stenosis or hypertension
If felt on the left - could indicate pulmonary problems
How are heart sounds characterized?
Frequency (pitch)
Intensity (loudness)
Duration
Timing in the cardiac cycle
ECG
What are the four basic heart sounds?
S1, S2, S3, S4
ECG
What does PASS stand for?
Pulmonic and Aortic Stenosis yields systolic murmurs
ECG
What does PAID stand for?
Pulmonic and Aortic Insufficiency yields Diastolic Murmurs
RCG
PVC
PVC
ECG
ST evelvation at the J point
possible MI
,ECG
Atrial fibrillation
atrial activity is poorly defined
risk for rapid ventricular response
increase risk for stroke, MI
ECG
Atrial flutter
irregular beating of the atria; often described as "a-flutter with 2 to 1 block or 3 to 1 block"
ECG
Paroxysmal SVT
Sudden onset, usually initiated by premature beat and also stops abruptly
Usually narrow QRS tachycardias
ECG
V Tach
sustained (lasting > 30sec) vs unsustained
mono formic (uniformed) vs polymorphic vs tornadoes de pointes
ECG
Tosades de Pointes
Flutter 250-350
- type of vtach, can lead to vfib
- ribbon like fashion (hallmark: up and downward deflection of QRS)
- d/t hypomagnesium
ECG
1st degree AV block
prolonged PR interval
, ECG
2nd degree AV block
wenckeback/Mobitz type I
usually no s/s if rate drops dramatically CO will decrease.
More P waves than QRS
PR INTERVAL INCREASED until QRS is dropped.
ECG
2nd degree AV block type 2
PR Intervals are constant until non-conducted P wave occurs
There must be two consecutive constant PR interval to diagnose.
ECG
3rd degree AV blocks
Will see complete AV dissociation because the atria and ventricles are each controlled by
separate pacemakers
This is an emergency
Will require a pacemaker
ECG
The Heart Poem
ECG
Right Bundle Branch Block
Widened QRS (>0.12s)
The second half of the QRS complex are oriented RIGHTward and ANTERIORLY because
the right ventricle is depolarized after the left
ECG
Left bundle branch block (LBBB)
