NR509 APEA Test Cardio / NR 509 APEA Exam Cardio (Latest-2021): Advanced physical assessment: Chamberlain College of Nursing |100% Correct Q & A|
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... [Show More] 509 APEA Test (Cardio) / NR509 APEA Exam (Cardio) (Latest): Advanced physical assessment: Chamberlain College of Nursing
NR509 APEA Test Cardio / NR 509 APEA Exam Cardio (Latest): Advanced physical assessment: Chamberlain College of Nursing
Question 1:
The lymphatic ducts drain into the:
arterial system.
venous system.
arteriovenous system.
capillary bed.
Question 2:
While auscultating the patient's heart, a medium, soft murmur is audible. It is pansystolic and heard loudest at the apex with radiation to the left axilla. These findings are consistent with:
tricuspidregurgitation.
mitral regurgitation.
a ventricular septal defect.
an innocent murmur.
Question 3:
Which of the following group of symptoms would be suggestive of an infant experiencing a congenital heart defect associated with a decreased pulmonary blood flow pattern?
Tissue perfusion greater than 3 seconds, bluish colored skin, and poor feeding
Abnormal heart sounds, capillary refill less than 2 seconds, and oxygen saturation less than 95%
Capillary refill less than 2 seconds, tissue perfusion less than 3 seconds, and oxygen saturation greater than 95%
Poor feeding, audible heart murmur, and oxygen saturation greater than 95%
Question 4:
Right atrial pressure can be determined by:
palpating the carotid pulse.
identifying the pulsations of the right jugular vein.
analyzing the arterial blood gases.
assessing for dependent edema.
Question 5:
When assessing the heart rate of a healthy 13-month-old child, which one of the following sites is the most appropriate for this child?
Apical pulse at the 5th intercostal space right midclavicular line
Apical pulse between the 3rd and 4th intercostal space in the left midclavicular line
Apical pulse to the right of the midclavicular line in the 3rd intercostal space
Apical pulse in the 5th intercostal space left midclavicular line
Question 6:
The infraorbital or maxillary, buccinator, and supramandibular lymph nodes drain lymphatic fluid from the:
palpebral conjunctiva and the skin adjacent to the ear within the temporal region.
eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek.
mouth, throat, and face.
posterior part of the temporoparietal region.
Question 7:
The external iliac lymph nodes drain lymphatic fluid from the following areas except the:
urinary bladder.
prostate.
uterus.
gluteal region.
Question 8:
The amplitude of the pulse in a patient in cardiogenic shock would most likely appear:
bounding.
thready.
normal.
as a bruit.
Question 9:
When auscultating the heart for aortic insufficiency, ask the patient to:
lie supine and inhale.
exhale while standing.
turn to the left side and breath deeply.
sit up, lean forward, and exhale.
Question 10:
The horizontal superficial inguinal lymph nodes are located in the anterior thigh below the inguinal ligament and drain lymphatic fluid from all of these areas except:
lower abdomen.
buttock.
testes.
lower vagina.
Question 11:
When auscultating the point of maximal impulse (PMI), apex of the heart, in an adult, the stethoscope is placed at the:
third intercostal space to the left of the midclavicular line.
fifth intercostal space to the left of the midclavicular line.
fourth intercostal space to the right of the midclavicular line.
fifth intercostal space to the right of the midclavicular line.
Question 12:
Deep cervical lymph nodes drain lymphatic fluid from the:
head and neck.
breasts.
mouth, throat, and face.
posterior part of the temporoparietal region.
Question:
Which of the following symptoms would necessitate the need for further evaluation in the newborn?
Blue hands and feet within an hour after birth
Blood glucose level 45 mg/dl.
Dusky cyanotic when crying
Deep sleep one hour after birth
Question:
Symptoms of acrocyanosis in the newborn include:
bluish color of the tongue.
bluish color of the mucous membranes.
bluish color of the feet.
bluish color of the abdomen.
Question:
A heart rate of 100-180 beats per minute in an adult is considered:
normal sinus rhythm.
sinus tachycardia.
supraventriculartachycardia.
ventricular tachycardia.
Question:
Tissue ischemia is usually observed when assessing a patient with peripheral artery disease (PAD). What other symptom could be observed?
Peripheral edemaIntermittent claudication.
A brownish discoloration to the skin of the affected leg
Bounding pulses in the affected leg
Question:
When performing a cardiovascular assessment on a healthy 2-year-old child:
expect to hear a swooshing sound during diastole.
place the stethoscope over the fifth intercostal space to the left of the mid-clavicular line.
auscultate the heart sounds in all four cardiac areas.
expect to hear an S4 sound.
Question:
A disparity between the brachial and femoral pulses in a 4-month-old could indicate:
an atrial septal defect (ASD).
Tetralogy of Fallot.
coarctation of the aorta (COA).
tricuspid atresia (TA).
Question:
The right lymph duct drains lymphatic fluid from all the following areas except the:
right side of the head.
right upper thorax.
rightarm.
right leg.
Question:
When auscultating the apex of the heart in an 8-year-old, the bell of the stethoscope should be placed at the:
third intercostal space lateral to the midclavicular line.
fifth intercostal space to the left of the midclavicular line.
fourth intercostal space lateral of the midclavicular line.
fifth intercostal space to the right of the midclavicular line.
Question:
In order to assess for varicosities in the lower extremities, position the patient:
lyingsupine.
standing.
sitting facing forward.
squatting facing the examiner.
Question:
A patient complains of a tight, bursting pain in the calf that increases with walking. Elevation of the leg sometimes relieves the pain. These symptoms may be consistent with:
intermittent claudication.
Raynaud'sdisease.
deep venous thrombosis.
superficial thrombophlebitis.
Question:
Symptoms of orthostatic hypotension include all of the following except:
syncope.
unsteadiness.
visualblurring.
respiratory rate greater than 30.
Question:
A three-week-old infant presents with a generalized lacy, reticulated blue discoloration of the skin. This is suggestive of:
mongolian spots.
harlequin color changes.
acrocyanosis.
cutismarmorata.
Question:
The supraclavicular lymph nodes are located:
along the anterior edge of the trapezius.
deep in the angle formed by the clavicle and the sternomastoid muscle.
superficially to the sternomastoid muscle.
midway between the angle and the tip of the mandible.
Question:
In an adult patient, auscultate the sounds arising from the mitral valve by placing the stethoscope:
near the apex of the heard between the 5th and 6th intercostal spaces in the mid-clavicular line.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left sternal border.
between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 2nd and 3rd intercostal spaces at the right sternal border.
Question:
The tonsillar lymph node is located:
at the angle of the mandible.
in front of the ear.
at the base of the skull posteriorly.
superficial to the mastoid process.
Question:
A bruit heard in the epigastric area with both systolic and diastolic components is suggestive of:
renal artery stenosis.
aortic regurgitation.
femoral artery occlusion.
an aortic aneurysm.
Question:
Presence of a heart murmur in a child would be considered organic if the child:
is 18-months-old and was recently diagnosed with anemia.
was a 3-year-old, afebrile and diagnosed with an upper respiratory infection.
was a 10-month-old who presented with a temperature of 103 °F.
was a 2-year-old with a congenital heart defect.
Question:
A patient complaints of a sharp, knifelike pain that begins in the chest and radiates to the tip of the shoulder and to the neck. This type of chest pain is suggestive of:
pericarditis.
an aortic dissection.
anginapectoris.
a myocardial infarction.
Question:
In order to bring the ventricular apex closer to the chest wall when assessing the point of maximal impulse (PMI), ask the patient to:
liesupine.
situp.
turn to the left side.
lean forward.
Question:
The preauricular lymph node is located:
at the angle of the mandible.
in front of the ear.
at the base of the skull posteriorly.
superficial to the mastoid process.
Question:
To auscultate the heart sounds arising from the pulmonic valve in an adult patient, place the stethoscope:
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-clavicular line.
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
Question:
To assess aortic pulsations in patients with carotid obstruction, assess the pulse using the:
temporal artery.
brachial artery.
femoralartery.
popliteal artery.
Question:
When screening a patient for peripheral arterial disease (PAD), one risk factor would include a history of:
smoking.
an implantation of a temporary internal pacemaker.
dysrhythmias.
peripheral edema.
Question:
The preauricular nodes drain lymphatic fluid from the:
palpebral conjunctiva and the skin adjacent to the ear within the temporal region.
eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek.
mouth, throat, and face.
posterior part of the temporoparietal region.
Question:
The ankle-brachial index is a screening test used to assess a person's risk for:
deep venous thrombosis.
peripheral artery disease.
venousinsufficiency.
thromboangiitis obliterans.
Question:
The internal iliac lymph nodes drain lymphatic fluid from the:
urinarybladder.
prostate.
uterus.
gluteal region.
Question:
Causes of orthostatic hypotension in older adults may include all of the following except:
diabetes.
cardiovasculardisorders.
medications.
impaired visual acuity.
Question:
A 5-year-old child presents with complaints of fever and headache. Examination reveals a heart rate of 157 beats/minute, respiratory rate of 40 breaths/minute, B/P 108/54, and a temperature of 102.6 °F. The increased heart rate is most likely related to:
an innocent heart murmur.
the child's age.
a sinus arrhythmia.
the child's febrile state.
Question:
The posterior chest wall and portions of the arms are drained by which group of lymph nodes?
Posterior mediastinal nodes
Subscapular nodes
Parasternalnodes
Intercostal nodes
Question:
A patient states that the only way he can sleep at night is to use several pillows or to sleep upright in a recliner. This sleep pattern is most consistent with:
paroxysmal nocturnal dyspnea.
obstructive lung disease.
anginapectoris.
decreased jugular venous pressure.
Question:
A disease that may present as indigestion, but is precipitated by exertion and relieved by rest is most likely:
gastroesophagealreflux.
inflammatory bowel disease.
angina.
aortic stenosis.
Question:
A patient suspected of having chronic venous insufficiency, may present with:
calfasymmetry.
a brownish discoloration just above the malleolus.
absent right pedal pulse.
decreased femoral pulse.
Question:
The great saphenous vein enters the deep venous system by way of the:
inferior vena cava.
iliacvein.
poplitealvein.
femoral vein.
Question:
Warning signs of peripheral artery disease may include all of the following except:
aching or numbness that limits walking.
non-healing lesions of the legs.
abdominal pain after meals with weight loss.
persistent cough.
Question:
On assessment, which one of the following symptoms would be noted as a compensatory response to chronic hypoxia?
Pulmonary hypertension
Dehydration
Hematocrit (HCT) of 55%
Hemoglobin (Hgb) of 8.5g/dl
Question:
A patient complains of some pain in the distal portions of her fingers on both hands. She states that it tends to occur more frequently with exposure to cold. These symptoms may be consistent with:
intermittentclaudication.
Raynaud's disease.
deep venous thrombosis.
superficial thrombophlebitis.
Question:
The patient has had an internal pacemaker in place for five years. Pacemaker failure is being considered because over the past few days, the patient has been experiencing episodes of:
hiccoughs.
chestpain.
wheezing.
hypertension.
Question:
The thoracic lymph duct drains lymphatic fluid from all the following areas except the:
right leg.
right upper thorax.
leftarm.
abdominal cavity.
Question:
When auscultating the heart, the displacement of the point of maximal impulse (PMI) is greater than 10 cm lateral to the midsternal line. This finding is consistent with:
right ventricular hypertrophy.
left ventricular hypertrophy.
pulmonarystenosis.
a normal PMI location.
Question:
A sudden, tearing, sharp pain that begins in the chest and radiates to the back or into the neck is usually associated with:
anginapectoris.
a myocardial infarction.
an aortic dissection.
pericarditis.
Question:
By placing the ball of the examiner's hand firmly on the chest, the examiner would be checking for:
bruits.
S1 and S2.
heaves.
thrills.
Question:
Which lymph nodes receive lymphatic fluid from the stomach, duodenum, liver, gallbladder, and pancreas?
Superior mesenteric lymph nodes
Inferior mesenteric lymph nodes
Hepatic lymph nodes
Gastric lymph nodes
Question:
When auscultating the heart of a 55-year-old patient, a loud murmur with a thrill is audible in the right second intercostal space that radiates to the carotid arteries. Also noted is a crescendo-decrescendo pitch audible at the apex. The murmur is heard best with the patient sitting and leaning forward. This finding is consistent with:
pulmonicstenosis.
tricuspidregurgitation.
mitral regurgitation.
aortic stenosis.
Question:
When auscultating heart sounds arising from the aortic valve in an adult patient, place the stethoscope:
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-clavicular line.
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
Question:
A patient describes chest pain as persistent, sharp, and knife-like. These symptoms are more characteristic of:
myocardial infarction.
costochondritis.
pericarditis.
dissecting aortic aneurysm.
Question:
A third heart sound (S3) is audible in a forty-five-year old. This S3 sound may be:
normal for this age group.
a sign of valvular heart disease.
a sign of heart disease.
associated with a jugular venous hum.
Question:
Enlarged or tender lymph nodes are most often associated with:
a malignant mass.
infection in its nearby drainage area.
a normal finding in children.
a benign tumor.
Question:
A widened pulse pressure greater than or equal to 60 in an older patient is a risk factor for cardiovascular disease, stroke, and:
emboli.
systolichypertension.
renal disease.
orthostatic hypertension.
Question:
Characteristic symptoms of chronic venous insufficiency may include which one of the following?
Intermittent claudication
Petechiae leading to brown pigmentation noted over the feet
Feet cool to touch
Feet appear pale on elevation and dusky red on dependency
Question:
Widened pulse pressure (PP) is defined as systolic blood pressure (SBP):
dropping 20 mm Hg within 3 minutes of standing.
minus diastolic blood pressure.
dropping 10 mm Hg within 5 minutes of sitting.
minus apical heart rate.
Question:
Characteristic symptoms of chronic arterial insufficiency may include which one of the following?
Persistent leg pain
Petechiae leading to brown pigmentation noted over the feet
Feet warm to touch
Feet appear pale on elevation and dusky red on dependency
Question:
Pain or cramping of the legs that occurs during exertion and is relieved by rest is termed:
neurogenicclaudication.
intermittent claudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease.
Question:
In older adults, the presence of heart sound S3 suggests:
hypertension.
heart failure.
an aortic aneurysm.
aortic stenosis.
Question:
To auscultate the tricuspid valve heart sounds in an adult patient, place the stethoscope:
between the 2nd and 3rd intercostal spaces at the right upper sternal border.
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-clavicular line.
located between the 2nd and 3rd intercostal spaces at the left sternal border.
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
Question:
When auscultating the heart of a 50-year-old patient, a soft murmur is audible in the left second and third intercostal spaces and radiates to the left shoulder and neck. Also noted is a crescendo-decrescendo pitch to the murmur. This finding could be consistent with:
pulmonic stenosis.
tricuspidregurgitation.
mitralregurgitation.
aortic stenosis.
Question:
The hemodynamic changes resulting from structural defects in children can lead to heart failure. The most common reason for these changes is related to:
volume and pressure overload resulting in increased cardiac output.
volume and pressure overload resulting in decreased cardiac output.
increased heart rate increasing cardiac output.
decreased blood volume.
Question:
The posterior auricular lymph nodes drain lymphatic fluid from the:
palpebral conjunctiva and the skin adjacent to the ear within the temporal region.
eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek.
mouth, throat, and face.
posterior part of the temporoparietal region.
Question:
While examining the heart, a pansystolic, blowing murmur is audible over the left sternal border with radiation to the right of the sternum. The intensity increased with inspiration. This finding is characteristic of:
tricuspid regurgitation.
mitralregurgitation.
a ventricular septal defect.
an innocent murmur.
Question:
The axillary lymph nodes drain lymphatic fluid from all of the following areas except the:
breasts.
upper part of the abdominal wall.
upper part of the back.
anterior chest wall.
Question:
A patient complains of pain in the arch of the foot sometimes relieved by rest. Occasionally, he experiences intermittent pain in the toes, especially at rest. Exercise aggravates the pain in the arch. History reveals he smokes approximately a half pack of cigarettes per day. These symptoms may be consistent with:
intermittentclaudication.
Raynaud'sdisease.
deep venous thrombosis.
thromboangiitis obliterans.
Question:
The occipital lymph node is located:
at the angle of the mandible.
in front of the ear.
at the base of the skull posteriorly.
superficial to the mastoid process.
Question:
A patient presents with chest pain that radiates to the left side of the neck and down the left arm when he chops wood. This type of pain could be suggestive of:
an early onset myocardial infarction.
angina pectoris.
costochondritis.
a dissecting aneurysm.
Question:
A twelve-month-old has a history of heart failure related to his congenital heart defect. He is receiving aldactone (Spironolactone), enalapril (Vasotec), furosemide (Lasix), and acetaminophen (Tylenol). The infant's potassium level is 3.1 meq/l. Which medication is most likely decreasing his potassium level?
Aldactone (Spironolactone)
Furosemide (Lasix)
Enalapril (Vasotec)
Acetaminophen (Tylenol)
Question:
The anterior cervical lymph node chain is located anterior and:
midway between the angle and the tip of the mandible.
superficial to the mastoid process.
superficial to the sternomastoid muscle.
at the angle of the mandible.
Question:
The tonsillar, submandibular, and submental nodes drain the lymphatic fluid from portions of the:
palpebral conjunctiva and the skin adjacent to the ear within the temporal region.
eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek.
mouth, throat, and face.
posterior part of the temporoparietal region.
Question:
A condition that usually presents with numbness or tingling in the distal portions of one or more fingers aggravated by cold or emotional stress may be associated with:
neurogenicclaudication.
intermittentclaudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease.
Question:
The sacral lymph nodes receive lymphatic fluid from all the following except the:
prostate.
urinary bladder.
gluteal region.
rectum.
Question:
Children presenting with congenital heart defects that result in right to left shunting would most likely exhibit which of the following symptoms?
Cyanosis, decreased cardiac output, and desaturated systemic blood flow
Increased cardiac output, cyanosis, and poor tissue perfusion
Ventricular volume overload, cyanosis, and increased cardiac output
Increased pulmonary blood flow, cyanosis, and good tissue perfusion
Question:
An otherwise healthy two-year-old presents with a heart rate that varies with inspiration and expiration. Which statement is true?
The child has ingested too much caffeine.
A cardiology referral is prudent.
This is a normal exam.
There is a need for an echocardiogram.
Question:
Heart sounds produced by turbulence due to a temporary increase in blood flow in predisposing conditions, such as hyperthyroidism, is considered:
an innocent murmur.
a pathologic murmur.
a physiologic murmur.
a normal finding.
Question:
The four classic structural defects of Tetralogy of Fallot include:
tricuspid atresia, atrial septal defect, pulmonary stenosis, and left ventricular hypertrophy.
a ventricular septal defect, an overriding aorta, pulmonary stenosis, and right ventricular hypertrophy.
dextroposition of the aorta, ventricular septal defect, aortic stenosis, and patent ductus stenosis.
an atrial septal defect, ventricular septal defect, pulmonary atresia, and the aorta arising from the right ventricle.
Question:
A child presents with fever of 102.5 °F for the past five days. Kawasaki disease is suspected if which of the following groups of symptoms is present?
Strawberry tongue, pounding pulse, elevated blood pressure, and chronic hemolytic anemia
Cervical lymphadenopathy, bilateral non-purulent conjunctivitis, periungual desquamation, and polymorphous rash
Retinopathy, petechiae, strawberry tongue, and jaundice Recent
Group A beta hemolytic streptococcus pharyngitis, erythema marginatum, non-purulent conjunctivitis, and joint pain
Question:
A finding suggestive of an inflamed lymph node would be one that is:
hard and fixed.
tender and movable.
shotty and movable.
non-tender and fixed.
Question:
The posterior auricular lymph node is located:
at the angle of the mandible.
in front of the ear.
at the base of the skull posteriorly.
superficial to the mastoid process.
Question:
Enlargement of which lymph nodes would be suggestive of metastasis from a thoracic or abdominal malignancy?
Tonsillar
Anterior cervical chain
Submandibular
Supraclavicular
Question:
The superior and inferior mesenteric lymph nodes drain lymphatic fluid from the:
stomach.
pancreas.
liver.
small and large intestines.
Question:
A male patient states that he has difficulty breathing when he is lying down but when he sits up, it improves. This is a classic description of:
eupnea.
dyspnea.
orthopnea.
paroxysmal nocturnal dyspnea.
Question:
Assessment findings in a newborn at birth include: irregular respirations without crying, heart rate of 105 beats/minute, grimaces with reflex stimulation, kicking of both feet, and moving of both arms. The body and face are pink and hands and feet are cyanotic. What is the APGAR score?
57
9
1
0
Question:
A patient complains of increased pain in the calf muscles and buttocks especially after walking or riding his bicycle. He states that the pain stops after he sits still for about 2-3 minutes. This condition may be associated with:
intermittent claudication.
Raynaud'sdisease.
deep venous thrombosis.
superficial thrombophlebitis.
Question:
A condition that presents with symptomatic limb ischemia upon exertion is termed:
neurogenicclaudication.
intermittentclaudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease.
Question:
Absent or diminished pulses in the wrist could be indicative of:
varicosities.
right-sided heart failure.
venousinsufficiency.
arterial occlusive disease.
Question:
In older adults, the presence of heart sound S4 suggests:
hypertension.
heart failure.
an aortic aneurysm.
aortic stenosis.
Question:
A patient describes chest pain as pressing, squeezing, and tight lasting between 1 and 3 minutes. These symptoms are more characteristic of:
myocardial infarction.
costochondritis.
pericarditis.
dissecting aortic aneurysm.
Question:
When auscultating the heart, a scratchy, continuous murmur is audible during atrial systole and ventricular systole and diastole. This finding may be indicative of a:
pericardial friction rub.
venoushum.
patent ductus arteriosus.
ventricular septal defect.
Question:
The anterior mediastinal lymph nodes drain lymphatic fluid from the:
anterior chest wall.
upper part of the abdominal wall.
thymus, thyroid gland and the anterior part of the pericardium.
breasts.
Question:
To assess the murmur of aortic insufficiency, position the patient:
supine.
sitting leaning forward.
supine with head elevated 30 degrees and turned partly to the left side.
standing.
Question:
A pediatric patient presents with erythema marginatum, chorea, and a heart murmur. These symptoms are consistent with:
Kawasaki Disease.
rheumatic heart disease.
infectious endocarditis.
sickle cell disease.
Question:
When auscultating the heart; S1 sound, is located at the apex of the heart and signifies:
closure of the pulmonic and aortic valves.
closure of the mitral and tricuspid valves.
both ventricles filling rapidly.
an increased resistance to ventricular filling.
Question:
A patient with cirrhosis develops portal hypertension as indicated by the presence of:
splenomegaly.
bleedinggums.
jaundice.
muscle wasting.
Question:
Pain with walking or prolonged standing, radiating from the spinal area into the buttocks, thighs, lower legs, or feet, may be seen with:
neurogenic claudication.
intermittentclaudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease.
Question:
Why would a newborn with patent ductus arteriosus receive a prostaglandin inhibitor (indomethacin)?
To maintain Ductus Arteriosus patency
To reduce fluid overload on the pulmonary circulation
To improve oxygenation of systemic circulation
To improve contractility of the left ventricle
Question:
When assessing a 3-year-old African American child, the most likely cause of black, dusky mucous membranes is related to:
jaundice.
pallor.
erythema.
cyanosis. [Show Less]