Quiz 2/Pratical review

Question 1

Aortic

Answer 1

right second IC space
lateral to sternum
diaphragm

Question 2

Pulomonic

Answer 2

left second IC space
lateral to sternum
diaphragm

Question 3

Tricuspid

Answer 3

left fourth IC space

diaphragm

Question 4

Mitral

Answer 4

fifth IC space
midclavicular line
apex
diaphragm

Question 5

Erb’s point

Answer 5

left third IC space

bell

Question 6

Murmurs

Answer 6

left third IC space

bell

Question 7

S1

Answer 7

mitral
left 5th IC space
diaphragm
being of ventrical systole

Question 8

S2

Answer 8

Aortic or Pulomonic
diaphragm
start of ventricle diastole

Question 9

S3

Answer 9

apex of heart (mitral space)
left sidelying; flexed to 45 degrees
bell
early diastole
Kentucky

Question 10

S4

Answer 10

apex of heart
bell
late diastole
Tennessee

Question 11

Clinical manifestations of right ventricular failure

Answer 11

• Dependent edema
• JVD
• Weight gain
• Liver engorgement, abdominal pain
• Ascites
• Anorexia, nausea, bloating
• Cyanosis
• Right sided S3

Question 12

Signs and symptoms of left ventricular failure:

Answer 12

pulmonary congestion

low cardiac output

Question 13

Signs and symptoms of pulmonary congestion

Answer 13

• Dyspnea, dry cough
• Orthopnea
• Paroxysmal nocturnal dyspnea
• Pulmonary rales, wheezing
• s/s of acute pulmonary edema (dyspnea, pallor or cyanosis, diaphoresis, tachycardia, anxiety, agitation)

Question 14

Signs and symptoms of low cardiac output

Answer 14

• Hypotension
• Tachycardia
• Lightheadedness, dizziness
• Fatigue, weakness
• s/s of peripheral hypoperfusion (weak, thready pulse, vasoconstriction)
• poor exercise tolerance
• S3 and sometimes S4 (3rd heart sound or ventricular gallop, 4th heart sound or atrial gallop)

Question 15

Signs and Symptoms of CHF

Answer 15

rales
heart sounds (S3)
jugular venous distention
changes in extremities
weight gain
sinus tachycardia
pulsus alternans
peripheral edema

Question 16

Treatment of stage 1 hypertension

Answer 16

thiazide diuretics, ACE inhibitor, angiotensin II receptor blockers, B blocker, calcium channel blocker
(one drug)

Question 17

Treatment of stage 2 hypertension

Answer 17

two-drug combo: thiazide and ACE or other

Question 18

What does insulin do?

Answer 18

suppresses glucose production by the liver and promotes glucose transport across the cell membrane
• Plays a role in synthesis of glycogen, fat and protein

Question 19

Four types of diabetes:

Answer 19

Type 1
Type 2
Gestational
Result of secondary causes

Question 20

Prevention/treatment of venous thrombosis or PE for INR

Answer 20

2.0-3.0

Question 21

Prosthetic heart valves for INR:

Answer 21

2.5-3.5

Question 22

Prevention of recurrent MI for INR

Answer 22

2.5-3.5

Question 23

S1

Answer 23

Event – closing of tricuspid and mitral valve
Corresponding event – onset of ventricular systole
Location to auscultate – tricuspid ( 4th and 5th intercostal space, L sternal border) mitral (L 5th intercostal space midclavicular line)
Best heard with – diaphragm

Question 24

S2

Answer 24

Event – closing of the aortic and pulmonic valves
Corresponding event – start of ventricular diastole
Location to auscultate – aortic (2nd intercostal space at R sternal border) pulmonic (2nd intercostal space at L sternal border)
Best heard with – diaphragm

Question 25

S3

Answer 25

abnormal “ventricular gallop”
Event – possible CHF indicative of ventricular dysfunction
Corresponding event – early diastole
Location to auscultate – apex of the heart (pt L sidelying 45 deg forward)
Best heard with – bell

Question 26

S4

Answer 26

abnormal “atrial gallop”
Event – increase resistance to ventricular filling
Corresponding event – late diastole (just before S1)
Location to auscultate – apex of the heart
Best heard with – bell