cardio function, heart and neck vessels

Question 1

T/ F:

normal nail bed angle is 180`

Answer 1

False

Question 2

T/ F:

capillary refill is normal if colour returns in less than 1-2 sec

Answer 2

True

Question 3

T/F:

a positive Horman’s sign is normal

Answer 3

False

Question 4

T/ F:

the femoral artery is always located at a 45` angle to pt’s umbilicus

Answer 4

True

Question 5

a function of the venous system is :

a) to hold more blood when blood volume increases
b) to conserve fluid and plasma proteins that leak out of the capillaries
c) to form a major part of the immune system that defends the body against disease
d) to absorb lipids from the intestinal tract

Answer 5

a) to hold more blood when blood volume increases

Question 6

the organs that aid the lymphatic system are:

a) liver, lymph nodes and stomach
b) pancreas, small intestine and thymus
c) spleen, tonsils and thymus
d) pancreas, spleen and tonsils

Answer 6

c) spleen, tonsils and thymus

Question 7

Ms Ting has come for a prenatal visit. she complains of dependent oedema, varicosities in the legs and haemorrhoids. the best response is:

a) ‘If these symptoms persist we will perform an amniocentesis.’
b) ‘ If these symptoms persist, we will discuss having you hospitalised.’
c) ‘ the symptoms are caused by the pressure of the growing uterus on the viens. they are usual conditions of pregnancy.’
d) ‘ at this time, the symptoms are a minor inconvenience. you should learn to accept them.’

Answer 7

a) “If these symptoms persist we will perform an amniocentesis.’

Question 8

a pulse with an amp of 3+ would be considered:

a) bounding
b) absent
c) normal
d) weak

Answer 8

c) normal

Question 9

inspection of a persons right hand reveals a red, swollen area. to further assess for infection you would palpate the:

a) cervical node
b) axillary node
c) epitrochlear node
d) inguinal node

Answer 9

b) axillary node

Question 10

in order to screen for deep vein thrombosis in the leg you would:

a) measure the circumference of the ankle
b) check the temp with the palm of your hand
c) compress the dorsalis pedis pulse, looking for blood return
d) measure the widest point of the leg with a tape measure

Answer 10

a) measure the circumference of the ankle

Question 11

during the examination of lower extremities, you are unable to palpate the poplitesl pulse. you shoud:

a) proceed with the examination. it is often impossible to palpate this pulse
b) refer pt to a vascular surgeon for further evaluation
c) schedule the pt for a venogram
d) schedule the pt for a arteriogram

Answer 11

d) schedule the pt for a arteriogram

Question 12

while reviewing a medical record a notation of 4+ oedema on the R leg is noted. This type of oedema is described as:

a) mild pitting, no perceptible swelling
b) moderate pitting, indentation subsides rapidly
c) deep pitting, leg looks swollen
d) very deep pitting, indentation lasts a long time

Answer 12

b) moderate pitting, indentation subsides

Question 13

after raising the legs 30cm off the table then having the pt sit back up and dangling leg. colour should return in:

a) 5 sec or less
b) 10 sec or less
c) 15 sec
d) 30 sec

Answer 13

d) 30 sec

Question 14

a 54 y/o woman with 5 kids has varicose veins of lower extremities. her most characteristic sign is:

a) reduced arterial circulation
b) blanching, death like appearance of extremity on elevation
c) loss of hair on feet and toes
d) dilated, tortuous superficial bluish vessels

Answer 14

a) reduced arterial circulation

Question 15

atrophic skin changes that occur with peripheral arterial insuff include:

a) thin, shiny with loss of hair
b) brown discolouration
c) thick leathery skin
d) slow healing blisters on the skin

Answer 15

c) tick leathery skin

Question 16

intermittent claudication is:

a) muscular pain relieved by exercise
b) neurological pain relieved by exercise
c) muscular pain brought on by exercise
d) neurological pain brought on by exercise

Answer 16

a) muscular pain relieved by exercise

Question 17

a known risk factor for venous ulcer development is:

a) obesity
b) male gender
c) Hx of hyperthyroidism
d) daily aspirin therapy

Answer 17

c) Hx of hyperthyroidism

Question 18

Brawny oedema is :

a) acute in onset
b) soft
c) non-pitting
d) associated with diminished pulses

Answer 18

c) non-pitting

Question 19

the praecordium is:

a) a synonym for the mediastinum
b) the area on the chest where the apical impulse is felt
c) the area on the anterior chest overlying the heart and great vessels
d) a synonym for the area where the superior and inferior venae cavae return unoxy venous blood to the R side f the heart

Answer 19

c) the area on the anterior chest overlying the heart and great vessels

Question 20

select the best positional description of the tricuspid valve:

a) left semilunar valve
b) right atrioventricular valve
c) left atrioventricular valve
d) right semilunar valve

Answer 20

b) right atrioventicular valve

Question 21

the function of the pulmonic valve is to:

a) divide the left atrium and left ventricle
b) guard the opening between the right atrium and right ventricle
c) protect the orifice between the right ventricle and the pulmonary artery
d) guard the entrance to the aorta from the left ventricle

Answer 21

c) protect the orifice between the right ventricle and pulmonary artery

Question 22

Atrial systole occurs:

a) during ventricular systole
b) during ventricular diastole
c) concurrently with ventricular systole
d) independently of ventricular function

Answer 22

b) during vent diastole

Question 23

the 2nd heart sound is the result of:

a) opening of mitral and tricuspid valves
b) closing of the mitral and tricuspid valves
c) opening of the aortic and pulmonic valves
d) closing of the aortic and pulmonic valves

Answer 23

d) closing of the aortic and pulmonic valve

Question 24

the examiner has estimated the jugular venous pressure. identify the ABNORMAL finding:

a) pt elevated to 30, internal jugular vein pulsation at 1cm above sternal angle b) pt elevated to 30, internal jugular vein pulsation at 2 cm above sternal angle
c) pt elevated to 40, internal jug vein pulsation at 1 cm above sternal angle d) pt elevated to 45, internal jugular vein pulsation at 4 cm above sternal angle

Answer 24

d) pt elevated at 45`, internal jugular vein pulsation at 4cm above sternal angle

Question 25

Palpating the apical impulse. the normal size is:

a) less than 1 cm
b) about 2 cm
c) is 3 cm
d) varies depending on size of the person

Answer 25

b) about 2 cm

Question 26

to listen to the pulmonic valve the stethoscope would have to be placed:

a) 2nd R interspace
b) 2nd L interspace
c) L lower sternal border
d) 5th interspace, L midclav line

Answer 26

b) 2nd L interspace

Question 27

select the statement that best differentiates a split s2 form s3:

a) s3 is lower pitched and is heard at the apex
b) s2 is heard at the L lower sternal border
c) the timing of s2 varies with respirations
d) s3 is heard at the base; timing varies with respirations

Answer 27

a) s3 is lower pitched and is heard at the apex

Question 28

select the best method of listening for a suspected pericardial friction rub:

a) with the diaphragm, pt sitting up and leaning forwards, breath held in expiration
b) using the bell with the patient leaning forwards
c) at the base during normal respiration
d) with the diaphragm, pt turned to the left side

Answer 28

a) with the diaphragm, pt sitting up and leaning forwards, breath held in expiration

Question 29

when auscultating the heart, your first step is to:

a) note rate and rhythm and then identify s1 and s2
b) listen for s3 and s4
c) listen for murmurs
d) identify all 4 sounds on the first round

Answer 29

a) not rate and rhythm and then identify s1 and s2

Question 30

a split s2 is most clearly heard in what area:

a) apical
b) pulmonic
c) tricuspid
d) aortic

Answer 30

b) pulmonic

Question 31

the stethoscope bell should be pressed lightly against the skin so that:

a) chest hair doesn’t simulate crackles
b) high pitched sounds can be heard better
c) it doesn’t act as a diaphragm
d) it doesn’t interfere with amp of heart sounds

Answer 31

c) it doesn’t act as a diaphragm

Question 32

a murmur heard after s1 and before s2 is classified as:

a) diastolic (possibly benign)
b) diastolic (always pathological)
c) systolic (possibly benign)
d) systolic ( always pathological)

Answer 32

c) systolic ( possibly benign)

Question 33

T/F:

from age 20-60 systolic BP increases by 20mmHg and another 20 mmHg between 60-80 y/o

Answer 33

True

Question 34

T/ F:

the overall size of the heart shrinks with aging

Answer 34

false

Question 35

T/F:

resting HR increases with age

Answer 35

False

Question 36

T/F:

cardiac output at rest does not change with aging

Answer 36

true

Question 37

T/F:

there is a decreased ability of the heart to augment cardiac output with exercise

Answer 37

true

Question 38

T/F:

there is an increased of bradyarrythmias and atrial ectopic beats with aging which are asymptomatic alothough they may compromise BP

Answer 38

False

Question 39

age related changes in the ECG occur as a result of histological changes on the conduction system

Answer 39

True