NSG 6320 AGNP BOARD EXAM QUESTIONS (latest)
Cardiovascular Assessment (107 Questions and Answers)
– South university Savannah
1.Question:
The
... [Show More] preauricular nodes drain lymphatic fluid from the:
palpebral conjunctiva and the skin adjacent to the ear within the temporal
region. Correct
eyelids, the conjunctiva, and the skin and mucous membrane of the nose and cheek.
mouth, throat, and face.
posterior part of the temporoparietal region.
Explanation:
The preauricular nodes drain lymphatic fluid from the palpebral conjunctiva as well as
the skin adjacent to the ear within the temporal region. Tonsillar, submandibular, and
submental nodes (anterior and superficial cervical lymph nodes) drain lymphatic fluid
from portions of the mouth , throat, and face. The facial lymph nodes (infraorbital or
maxillary, buccinator, and supramandibular) drain lymphatic fluid from the eyelids, the
conjunctiva, and the skin and mucous membranes of the nose and cheek. The posterior
auricular lymph nodes drain lymphatic fluid from the posterior part of the
temporoparietal region.
2.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. Correct
pulmonary stenosis.
a normal PMI location.
Explanation:Displacement of the PMI lateral to the midclavicular line or greater than 10 cm lateral to
the midsternal line suggests left ventricular hypertrophy (LVH).
3.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:
pulmonic stenosis.
tricuspid regurgitation.
mitral regurgitation.
aortic stenosis. Correct
Explanation:
With aortic stenosis, the murmur is audible loudest in the right second intercostal space
and radiates to the carotid arteries, down the left sternal border, or the apex. There is a
crescendo-decrescendo pitch audible at the apex. The murmur is heard best with the
patient sitting and leaning forward. The murmur audible with pulmonic stenosis
produces a soft intensity with a crescendo-decrescendo pitch. It is loudest at the second
or third intercostal spaces and radiates to the left shoulder and neck. With tricuspid
regurgitation, the murmur is audible loudest at the left sternal border with radiation to
the right sternal border, xiphoid area, or to the left midclavicular line. It produces a
blowing sound and is pansystolic. The intensity may increase with inspiration. Mitral
regurgitation produces a pansystolic, harsh murmur heard loudest at the apex with
radiation toward the left axilla. The intensity of the murmur can be soft, or if there is an
atrial thrill, it can be loud.
4. Question:
A disease that may present as indigestion, but is precipitated by exertion and relieved by
rest is most likely:
gastroesophageal reflux.
inflammatory bowel disease.
angina. Correct
aortic stenosis.
Explanation:A disease that may present as indigestion, but is precipitated by exertion and relieved by
rest is most likely angina.
Question:
Causes of orthostatic hypotension in older adults may include all of the following except:
diabetes.
cardiovascular disorders.
medications.
impaired visual acuity. Correct
Explanation:
Orthostatic hypotension occurs in 20% of older adults and in up to 50% of frail nursing
home residents, especially when they first arise in the morning. Causes include
medications, autonomic disorders, diabetes, prolonged bed rest, volume depletion,
amyloidosis, and cardiovascular disorders. Impaired visual acuity is not a cause of
orthostatic hypotension but can be a resulting symptom.
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 midclavicular 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. Correct
between the 3rd, 4th, 5th, and 6th intercostal spaces at the left lower sternal border.
Explanation:
Auscultation should proceed in a logical manner over 4 general areas on the anterior
chest, beginning with the patient in the supine position and using the diaphragm of the
stethoscope. The mitral listening point is near the apex of the heart between the 5th and
6th intercostal spaces in the mid-clavicular line. The aortic listening point is between
the 2nd and 3rd intercostal spaces at the right upper sternal border (RUSB). The
pulmonic listening point is located between the 2nd and 3rd intercostal spaces at the left
sternal border (LUSB). The tricuspid listening point is between the 3rd, 4th, 5th, and
6th intercostal spaces at the left lower sternal border (LLSB).
Question:A sudden, tearing, sharp pain that begins in the chest and radiates to the back or into
the neck is usually associated with:
angina pectoris.
a myocardial infarction.
an aortic dissection. Correct
pericarditis.
Explanation:
Assessing chest pain can be very difficult but a thorough patient history and physical
exam can help the clinician determine a likely cause. A sudden sharp pain that radiates
to the back or into the neck is usually associated with aortic dissection. Exertional pain
can be angina pectoris. Symptoms most often seen with myocardial infarction include a
retrosternal type pain that often radiates up to the neck, shoulder, and jaw and down to
the ulnar aspect of the left arm. Pain associated with pericarditis may radiate to the tip
of the shoulder and to the neck and presents with a sharp knifelike pain. Any pain in the
chest is cardiac until proven otherwise.
Question:
A 68-year-old man with uncontrolled hypertension presents with sudden, intense left
lower abdominal pain that radiates to the back. The pain is associated with a tearing
sensation. These findings are MOST likely associated with:
cholecystitis.
an abdominal aortic aneurysm (AAA). Correct
perforated gastroesophageal (GI) ulcer.
nephrolithiasis.
Explanation:
Sudden, intense left lower abdominal pain that radiates to the back with a “tearing”
sensation are symptoms of abdominal aortic aneurysm (AAA). For the diagnosis of a
possible rupturing AAA, outpatient CT scan, abdominal ultrasound, and angiography
testing are NOT recommended. The patient should be referred to the emergency
department for acute assessment and treatment.
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:neurogenic claudication.
intermittent claudication.
atherosclerotic peripheral vascular disease.
Raynaud's disease. Correct
Explanation:
Raynaud's disease may present with numbness or tingling in the distal portions of one
or more fingers aggravated by cold or emotional stress. Pain or cramping in the legs that
occurs with exertion and is relieved by rest is termed intermittent claudication.
Atherosclerotic peripheral artery disease presents with symptomatic limb ischemia with
exertion. Pain with walking or prolonged standing, radiating from the spinal area into
the buttocks, thighs, lower legs, or feet, may be seen in neurogenic claudication.
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) Correct
Enalapril (Vasotec)
Acetaminophen (Tylenol)
Explanation:
Loop diuretics can produce decreased potassium levels. Lasix is a loop diuretic.
Potassium levels considered WNL by most labs range between 3.5 and 5.3 meq/l; so 3.1
meq/l is considered low and may need to be adjusted. The other medications are not
known for excessive potassium losses. [Show Less]