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WorksheetsNUR 216 Exam 3 Study Guide: Cardiac and Peripheral Vascular
Total questions: 89
Worksheet time: 44mins
What heart sounds are referred to as 'Lub' and 'Dub' in the cardiac cycle?
S1 and S2
S2 and S3
S3 and S4
S1 and S3
Which valves close to produce the 'Lub' (S1) sound?
A) Aortic and pulmonic valves
B) Mitral and tricuspid valves
C) Tricuspid and pulmonic valves
D) Mitral and aortic valves
The 'Dub' (S2) sound is best heard at the ________.
base
apex
left sternal border
mitral area
What is the correct order of the electrical conduction pathway in the heart?
AV node → SA node → bundle of His → bundle branches → Purkinje fibers
SA node → AV node → bundle of His → bundle branches → Purkinje fibers
Bundle of His → SA node → AV node → Purkinje fibers
AV node → bundle branches → SA node → Purkinje fibers
The SA node is known as the ________ of the heart.
pacemaker
valve
artery
ventricle
Where is the aortic landmark of the precordium located?
2nd intercostal space, right sternal border
2nd intercostal space, left sternal border
3rd intercostal space, left sternal border
4th intercostal space, left sternal border
The direction of blood flow through the heart starting from when deoxygenated blood returns to the heart is:
Right atrium → Right ventricle → Pulmonary artery → Lungs → Left atrium → Left ventricle → Aorta
Left atrium → Left ventricle → Pulmonary artery → Lungs → Right atrium → Right ventricle → Aorta
Right ventricle → Right atrium → Pulmonary vein → Lungs → Left ventricle → Left atrium → Aorta
Right atrium → Left atrium → Right ventricle → Left ventricle → Aorta → Lungs
Family history concerning hypertension, heart attack, or stroke is important in health history assessment.
True
False
What instrument is needed for a general cardiac physical assessment?
Bell and diaphragm
Otoscope
Thermometer
Reflex hammer
What is the normal range for heart rate?
60-100 BPM
30-50 BPM
100-140 BPM
120-160 BPM
A heart rate less than 50 BPM is called ________.
bradycardia
tachycardia
arrhythmia
hypertension
A heart rate greater than 100 BPM is called ________.
tachycardia
bradycardia
arrhythmia
asystole
What is a sign of hypoxemia (low levels of oxygen in the bloodstream)?
Cyanosis
Fever
Bradycardia
Hypertension
Jaundice
How should jugular vein distention be assessed?
In semi-fowler’s or sitting up at ≥ 90°
Lying completely flat
Standing on tiptoes
While performing Valsalva maneuver
What is considered an abnormal finding when inspecting for heaves/lifts during a physical examination?
Visible outward thrust of precordium
Symmetrical chest movement with respiration
Absence of visible chest movement
Normal heart sounds on auscultation
When palpating landmarks before auscultating, what should you feel with your finger pads?
Pulsation
Warmth
Crepitus
Tenderness
True or False: A thrill (pulsation palpable with palmar surface of hand) is a normal finding during palpation.
True
False
Which of the following is NOT a recommended strategy to pick up on possible murmurs during auscultation?
Auscultate all 5 landmarks for several seconds with diaphragm and bell
Listen over patient’s gown
Have patient sit forward and hold their breath
Do not auscultate while patient is prone or right lateral recumbent
List one symptom of possible exacerbation of congestive heart failure that requires follow-up with a provider.
Excessive weight gain despite poor PO intake, increased fatigue or difficulty tolerating exercise, difficulty sleeping (paroxysmal nocturnal dyspnea)
Mild headache after exercise
Temporary muscle soreness after physical activity
Slight increase in appetite with no other symptoms
Left-sided heart failure is primarily associated with which type of problems?
Lung/pulmonary problems
Liver problems
Renal/kidney problems
Gastrointestinal problems
Right-sided heart failure may cause which of the following?
Cyanosis/hypoxemia
Peripheral edema/weight gain
Pulmonary problems
Increased fatigue
What is the normal finding for pulses during a peripheral vascular assessment?
+2, regular rhythm, equal bilaterally
+4, irregular rhythm, unequal bilaterally
0, absent pulse, unequal bilaterally
+1, weak and thready, irregular rhythm
Raynaud’s phenomenon causes which color changes in the extremities?
Red, white, and blue
Green, yellow, and orange
Purple, pink, and brown
Black, grey, and yellow
What are the abnormal findings for pulse strength?
0 (absent), +1 (weak), +3 or +4 (bounding)
0 (normal), +2 (strong), +3 (regular)
+1 (strong), +2 (bounding), +4 (absent)
+2 (weak), +3 (normal), +4 (strong)
A weak or absent pulse may indicate arterial insufficiency.
True
False
If you cannot palpate a peripheral pulse, what should you use?
Use a doppler
Apply a tourniquet
Start chest compressions
Give oxygen
If any pulse is irregular, what should you assess for?
Pulse deficit
Blood glucose level
Respiratory rate
Body temperature
Where is the carotid pulse located?
Neck between sternocleidomastoid muscle & trachea
Wrist near the base of the thumb
Behind the knee joint
On the top of the foot
What is the normal capillary refill time?
Less than 2 seconds
Less than 5 seconds
Less than 10 seconds
Less than 1 second
Capillary refill greater than 2 seconds may indicate which of the following?
Increased perfusion
Decreased perfusion
Normal circulation
High blood pressure
Pitting edema: What depth does 3+ pitting edema correspond to?
6mm
2mm
4mm
8mm
What are the main functions of the lymphatic system?
Eliminate waste/pathogens, regulate fluid & protein balance
Produce red blood cells and platelets
Control voluntary muscle movements
Regulate body temperature
Which of the following is NOT a structure of the lymphatic system?
Spleen
Thymus
Kidney
Tonsils
What is the function of the cerebellum?
Balance, motor coordination
Vision processing
Regulation of heart rate
Production of hormones
Which lobe of the brain is responsible for integrating sensory information?
Temporal
Parietal
Occipital
Frontal
Sensory functions include which of the following?
Seeing
Hearing
Smelling
Movement
Motor functions are responsible for: strength, ROM, gait, etc.
True
False
Mental status is ALWAYS a priority neuro assessment, as it is often an early sign that something is wrong in the elderly.
True
False
What is a key symptom of stroke that should be assessed immediately?
Bilateral muscle weakness
SUDDEN, UNILATERAL muscle weakness
Gradual memory loss
Persistent headache
If a patient has any kind of unequal strength or movement on one side of the body/face compared to the other, what should you do?
Perform a complete neuro exam
Ignore the symptoms and monitor later
Advise the patient to rest at home
Prescribe painkillers only
Contralateral deficits mean that a stroke in the right brain leads to ______-sided weakness.
left
right
upper
lower
Decorticate posturing is characterized by elbows ______ and shoulders ______ rotated.
flexed, internally
extended, externally
flexed, externally
extended, internally
To assess the Romberg test, the patient should stand with one arm in front and one arm behind them, and their eyes should be ______.
closed
open
covered with a cloth
looking at the ceiling
If a patient maintains balance during the Romberg test without swaying or stepping, the result is considered ______.
normal
abnormal
positive
inconclusive
Swaying, stepping, or moving arms to maintain balance during the Romberg test may indicate dysfunction of the ______.
cerebellum
frontal lobe
medulla oblongata
occipital lobe
The Glasgow Coma Scale is used to assess:
mild, moderate, or severe brain injury
lung function in asthma patients
blood sugar levels in diabetics
kidney function in renal failure
What are the steps in the general assessment sequence for musculoskeletal evaluation?
Inspection, palpation, assess ROM, assess strength
Palpation, inspection, assess strength, assess ROM
Assess strength, inspection, palpation, assess ROM
Assess ROM, palpation, inspection, assess strength
Persistent pain or swelling after injury requires ______ follow-up because it may indicate a fracture and the need to immobilize the extremity ASAP.
urgent
routine
delayed
annual
What is the effect of aging on strength/muscle mass and its associated risk?
Strength/muscle mass decreases with age, increasing the risk for falls.
Strength/muscle mass increases with age, reducing the risk for falls.
Strength/muscle mass remains unchanged with age, having no effect on fall risk.
Aging only affects bone density, not strength/muscle mass or fall risk.
If a patient runs out of NSAIDs like ibuprofen for chronic musculoskeletal pain, what should you expect?
Expect them to have pain/stiffness.
Expect their pain to improve spontaneously.
Expect them to develop a fever.
Expect them to have no change in symptoms.
Flexion is defined as:
Bending
Straightening
Moving away from midline
Moving toward midline
Extension is defined as:
Bending
Straightening
Moving away from midline
Moving toward midline
Abduction refers to:
Moving away from midline
Moving toward midline
Flexing foot
Pointing ankle down
Adduction refers to:
Moving away from midline
Moving toward midline
Flexing foot
Pointing ankle down
Dorsiflexion of the ankle/foot means:
Flexing foot to point toes up toward ceiling
Pointing ankle down
Moving away from midline
Flexing elbow
Plantar flexion of the ankle/foot means:
Flexing foot to point toes up toward ceiling
Pointing ankle down
Moving away from midline
Flexing elbow
What is the strength grade for: Unable to contract muscle (without gravity)?
0
1
2
3
What is the strength grade for: Able to contract muscle slightly?
1
2
3
4
What is the strength grade for: Able to move joint without gravity?
2
1
3
4
What is the strength grade for: Able to move joint against gravity?
3
1
2
4
What is the strength grade for: Able to move joint with full ROM against gravity with some resistance?
4
2
3
5
What is the strength grade for: Able to move joint with full ROM against gravity with full resistance?
5
3
2
4
What are the '5 P's' of neurovascular assessments following an injury?
Pain, paralysis, paresthesia, pallor, pulselessness
Pain, pressure, perspiration, pallor, pulse
Pain, paralysis, perspiration, pallor, pulse
Pain, paralysis, paresthesia, pallor, perspiration
What is a priority symptom that may indicate nerve damage from an injury?
Weak pulses
Paresthesia (numbness/tingling)
Warm extremity
Swelling
Fill in the blank: Osteoporosis is characterized by decreased ________ density.
bone
muscle
nerve
blood
Which of the following is NOT a reason why it is important to prevent falls in patients with osteoporosis?
A) Increased risk of fracture
B) Increased bone density
C) Decreased bone density
D) Height loss
Calcium and vitamin D are important for bone growth because ________ is necessary for our bodies to absorb calcium.
vitamin D
iron
potassium
vitamin C
Which spinal deformity is described as a 'hunchback' appearance and is commonly seen in older adults?
Scoliosis
Lordosis
Kyphosis
Osteoporosis
Scoliosis is an abnormal lateral curvature of the spine that is shaped like which letters?
A) A and B
B) C and S
C) D and E
D) F and G
Fill in the blank: Lordosis is an increased curvature of the ________ spine.
lumbar
cervical
thoracic
sacral
Which type of arthritis is known as 'wear and tear' arthritis?
Osteoarthritis
Rheumatoid arthritis
Kyphosis
Scoliosis
Bouchard's nodes are found in which joints?
Distal interphalangeal joints (DIPs)
Proximal interphalangeal joints (PIPs)
Metacarpophalangeal joints
Carpometacarpal joints
Bouchard's nodes can be seen in both osteoarthritis and rheumatoid arthritis.
True
False
The long fibers of connective tissue that attach to papillary muscles of the heart that enable the valves to properly open and close are called:
Chordae tendinae
Cardiac tendons
Cardiac ligaments
Myocardial tendinae
Which heart sound is best heard at the apex of the heart?
S3
S1
S4
S2
What is the primary function of the parietal lobe?
Regulating heart rate
Producing hormones
Processing sensory information
Controlling vision
During a peripheral vascular assessment, which finding would be considered abnormal?
+2, regular rhythm
+2, strong pulse
+1, weak and thready pulse
Equal pulses bilaterally
Which artery is commonly used to check the pulse at the wrist?
Carotid artery
Radial artery
Brachial artery
Femoral artery
Which part of the brain is primarily responsible for regulating breathing and heart rate?
Cerebellum
Medulla oblongata
Frontal lobe
Occipital lobe
What is the main function of the lymph nodes in the lymphatic system?
Filter lymph and trap pathogens
Store red blood cells
Produce insulin
Regulate blood pressure
Which pulse site is commonly used to assess circulation to the lower extremities?
Brachial
Carotid
Radial
Dorsalis pedis
What is a common sign of right-sided heart failure?
Shortness of breath
Peripheral edema
Pulmonary edema
Productive cough
Which of the following best describes a bounding pulse?
+1, weak and thready
0, absent
+4, very strong
+2, regular
