Cardiology

Question 1

A NP hears a pan-systolic/holosystolic murmurs. Name the murmur and type of murmur.

Answer 1

Systolic murmur

Mitral regurgitation

Question 2

A NP hears a murmur at the apex of the heart and radiates to the axillae. It is loud and high pitch- blowing. The NP has to use the diaphragm to hear it. Name the murmur and type

Answer 2

Mitral regurgitation ( Most common regurg)
Systolic murmur

Question 3

A NP is caring for a patient with dehydration. The NP hears a murmur but after hydration the murmur is gone. Name the murmur and the type.

Answer 3

Physiologic Murmur

Systolic

Question 4

A Np hears a murmur at the 2nd ICS at the right sternal border. Radiating to the neck. It sounds harsh and noisy.

Name the murmur and the type.

Answer 4

Systolic murmur
Aortic Stenosis

Common in elderly due to calcification

Question 5

What are some things that are associated with a aortic stenosis?

Answer 5

Sudden Cardiac Death
LVH
Congenital defect in kids
Rheumatic fever
Angina 
Syncope

Question 6

A NP hears a Mid to late systolic click. Name that murmur

Answer 6

Systolic

MVP

Question 7

A Np hears a blowing high-pitched murmur. It is located at the 2 ICS right sternal border. Name that Murmur

Answer 7

Diastolic

Aortic Regurgitation

Question 8

A NP hears a opening snap crescendo murmur. It is located at the apex of the heart. Name the murmur

Answer 8

Diastolic

Mitral Stenosis

Question 9

Name all the Systolic murmurs

Answer 9

MR ASS PM MVP

Mitral Regurgitation
Aortic Stenosis
Physiologic Murmur
Mitral Valve Prolasp

Question 10

Name all your diastolic murmurs

Answer 10

MS ARDS. OR ARMS
Mitral Stenosis
Aortic Regurgitation

Question 11

Grade it: Barely audible

Answer 11

Grade: 1

Question 12

Grade it: audible but faint

Answer 12

Grade 2

Question 13

Grade it: Moderately loud: easily heard

Answer 13

Grade 3

Question 14

Grade it: Loud; associated with thrill

Answer 14

Grade 4

Question 15

Grade it: Vert loud; heard one corner of the stethoscope off the wall.

Answer 15

Grade 5

Question 16

Grade it: loudest; heard with out a stethoscope

Answer 16

Grade 6

Question 17

A NP hears a S3 gallop or ventricular gallop? What is this associated with?

Answer 17

CHF
Pregnancy
Benign in adolescent athletes
Thyrotoxicosis

Question 18

A NP hears a atrial gallop or atrial kick at the apex of the heart. Bell used. Name it. What is it associated with?

Answer 18

LVH
Normal in elderly
Poorly controlled HTN
Unstable angina

Question 19

What is associated with a split S2 heard at the pulmonic area?

Answer 19

Health athlete

Question 20

A NP is working in the ER. A patient is have a STEMI. A NP know what are the absolute contraindication for TPA?

Answer 20

Intracranial hemorrhage
Cerebral vascular lesion
Neoplasm
Ischemic stoke with last 3 months
Severe uncontrolled HTN

Question 21

A patient is experiencing a STEMI. What are some relative contraindications for TPA?

Answer 21

Chronic uncontrolled HTN
Ischemic stroke less than 3 months 
CPR compressions
Mayor surgery with the last 3 weeks
Recent internal bleeding 2-4 weeks ago
Pregnancy
Active PUD bleed
Oral anticoagulation therapy

Question 22

What will you see in a patient with hypertension retinopathy?

Answer 22

Silver and Copper Wire Arteriloes
AV nicking
Flame Shape hemorrhages - Black dots in the visual field
Papilla-edema

Question 23

A patient ask how with losing weight help with hypertension?

Answer 23

Every 10 kg loss - you will decrease 5-20 mm HG in your BP

Question 24

A Patient want the NP to explain the DASH diet?

Answer 24

Eat fresh fruit and veggies
Low sodium
High potassium
High Calcium
Eat fatty cold water fish 3x/ week

Question 25

The patient ask the NP how much sodium is allowed a day for hypertension,

Answer 25

2.4g/day

Question 26

A patient ask how much exercise is need to battle hypertension?

Answer 26

40 mins a day

3-4 days per week

Question 27

What is the criteria for Metabolic syndrome?

Answer 27

P: Pressure of 130/85
H: HDL<40 MEN HDL <50 Women
A: Abdominal obesity waist >35 inches WOMEN waist >40 in men\
T: Triglycerides >150
S: Sugars (FBS) 100