NSG-316 Exam 3
what does the first heart sound indicate? ANS: closure of the AV valves (beginning of systole)
what does the second heart sound indicate? ANS: closure of the semilunar valves (end of systole)
what does the third heart sound indicate? ANS: ventricular gallop, occurs with heart failure and volume
overload
what does the fourth heart sound indicate? ANS: atrial gallop, occurs with coronary artery disease
what conditions create a murmur? ANS: increased velocity of blood, decreased blood viscosity (ex
anemia), unusual openings occur in the chambers (ex dilated chamber/septal defect), and structural
defects in the valves (ex stenotic/narrowed valve, or an incompetent/regurgitant valve)
what does the P wave indicate? ANS: atrial depolarization
what happens during the PR interval? ANS: atrial depolarization and the impulse travels through the AV
node to the ventricles
what happens during the QRS complex? ANS: depolarization of the ventricles
what happens during the T wave? ANS: repolarization of the ventricles
What is cardiac output? ANS: the volume of blood in each systole times the number of beats per minute
what lifestyle factors could affect the development of cardiovascular disease? ANS: smoking, diet,
alcohol use, exercise, and stress
,what is the term for the thickening/stiffening of the large arteries? ANS: arteriosclerosis
What is angina pectoris? ANS: chest pain caused by inadequate flow of blood and oxygen to the heart
what is dyspnea? ANS: difficulty breathing/shortness of breath
What is orthopnea? ANS: difficulty breathing while lying down
what is a bruit? ANS: blowing, swishing sound indicating blood flow turbulence and is a marker for
atherosclerosis
where do you place your stethoscope to listen for bruits on the carotid artery? ANS: angle of the jaw
midcervical area
base of the neck
how do you distinugish the internal jugular pulse from the carotid pulse? ANS: it is lower and more
lateral, varies with respiration, not palpable, and drops/disappears when a person sits up.
what is a heave? ANS: More prominent thrust of the heart against the chest wall during systole
(ventricular hypertrophy-->increased workload)
where can you find the apical pulse? ANS: 5th intercostal space, mid-clavicular line
what conditions cause the apical pulse to become unpalpable? ANS: pulmonary emphysema (overriding
lungs), position, obsesity, and thick chest walls
, what conditions cause the apical pulse to become stronger? ANS: anxiety, fever, hyperthyroidism, and
anemia
What is a thrill? ANS: palpable vibration, which signifies turbulent blood flow
where is the aortic valve area? ANS: second right interspace at the right sternal border
where is the pulmonic valve area? ANS: second left intercostal space at the left sternal border
where is the tricuspid valve area? ANS: left lower sternal border
where is the mitral valve area? ANS: fifth interspace at around left midclavicular line
what part of the stethoscope should you use to listen for bruits? ANS: the bell
in what age group(s) is sinus arrhythmia normal? ANS: young adults and children
what is a premature beat? ANS: either an isolated beat is early, or when a pattern occurs in which every
third or fourth beat sounds early
what does it mean to be irregularly irregular? ANS: no pattern to the heart sounds (ex atrial fibrillation)
how do you check for a pulse deficit? ANS: Auscultate the apical beat while simultaneously palpating
the radial pulse
-Count of apical beat and radial pulse; every beat heard at the apex should perfuse the periphery and be
palpable; counts should be identical
If not, apical rate - radial rate = pulse deficit
what does the first heart sound indicate? ANS: closure of the AV valves (beginning of systole)
what does the second heart sound indicate? ANS: closure of the semilunar valves (end of systole)
what does the third heart sound indicate? ANS: ventricular gallop, occurs with heart failure and volume
overload
what does the fourth heart sound indicate? ANS: atrial gallop, occurs with coronary artery disease
what conditions create a murmur? ANS: increased velocity of blood, decreased blood viscosity (ex
anemia), unusual openings occur in the chambers (ex dilated chamber/septal defect), and structural
defects in the valves (ex stenotic/narrowed valve, or an incompetent/regurgitant valve)
what does the P wave indicate? ANS: atrial depolarization
what happens during the PR interval? ANS: atrial depolarization and the impulse travels through the AV
node to the ventricles
what happens during the QRS complex? ANS: depolarization of the ventricles
what happens during the T wave? ANS: repolarization of the ventricles
What is cardiac output? ANS: the volume of blood in each systole times the number of beats per minute
what lifestyle factors could affect the development of cardiovascular disease? ANS: smoking, diet,
alcohol use, exercise, and stress
,what is the term for the thickening/stiffening of the large arteries? ANS: arteriosclerosis
What is angina pectoris? ANS: chest pain caused by inadequate flow of blood and oxygen to the heart
what is dyspnea? ANS: difficulty breathing/shortness of breath
What is orthopnea? ANS: difficulty breathing while lying down
what is a bruit? ANS: blowing, swishing sound indicating blood flow turbulence and is a marker for
atherosclerosis
where do you place your stethoscope to listen for bruits on the carotid artery? ANS: angle of the jaw
midcervical area
base of the neck
how do you distinugish the internal jugular pulse from the carotid pulse? ANS: it is lower and more
lateral, varies with respiration, not palpable, and drops/disappears when a person sits up.
what is a heave? ANS: More prominent thrust of the heart against the chest wall during systole
(ventricular hypertrophy-->increased workload)
where can you find the apical pulse? ANS: 5th intercostal space, mid-clavicular line
what conditions cause the apical pulse to become unpalpable? ANS: pulmonary emphysema (overriding
lungs), position, obsesity, and thick chest walls
, what conditions cause the apical pulse to become stronger? ANS: anxiety, fever, hyperthyroidism, and
anemia
What is a thrill? ANS: palpable vibration, which signifies turbulent blood flow
where is the aortic valve area? ANS: second right interspace at the right sternal border
where is the pulmonic valve area? ANS: second left intercostal space at the left sternal border
where is the tricuspid valve area? ANS: left lower sternal border
where is the mitral valve area? ANS: fifth interspace at around left midclavicular line
what part of the stethoscope should you use to listen for bruits? ANS: the bell
in what age group(s) is sinus arrhythmia normal? ANS: young adults and children
what is a premature beat? ANS: either an isolated beat is early, or when a pattern occurs in which every
third or fourth beat sounds early
what does it mean to be irregularly irregular? ANS: no pattern to the heart sounds (ex atrial fibrillation)
how do you check for a pulse deficit? ANS: Auscultate the apical beat while simultaneously palpating
the radial pulse
-Count of apical beat and radial pulse; every beat heard at the apex should perfuse the periphery and be
palpable; counts should be identical
If not, apical rate - radial rate = pulse deficit
