uestion 1:
The lymphatic ducts drain into the:
a. Arterial system.
b. Venous system.
c. Arteriovenous system.
d. Capillary bed.
Explanation:
The
... [Show More] lymphatic ducts drain into the venous system.
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:
a. Tricuspid regurgitation.
b. Mitral regurgitation.
c. ventricular septal defect
d. An innocent murmur.
Explanation:
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. 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 murmur of an
uncomplicated ventricular septal defect has a high pitch and is usually heard throughout
systole. An innocent murmur is heard loudest at mid systole near the second to fourth
intercostal spaces between the left sternal border and the apex. It usually decreases or
disappears when sitting.
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?
a. Tissue perfusion greater than 3 seconds, bluish colored skin, and poor feeding
b. Abnormal heart sounds, capillary refill less than 2 seconds, and oxygen saturation
less than 95%
c. Capillary refill less than 2 seconds, tissue perfusion less than 3 seconds, and oxygen
saturation greater than 95%
d. Poor feeding, audible heart murmur, and oxygen saturation greater than 95%
Explanation:
Infants with defects resulting from decreased pulmonary blood flow have cyanosis because
of desaturated blood entering systemic circulation and/or because of the inability to get
blood to the lungs. Tetralogy of Fallot (TOF), pulmonary atresia and tricuspid atresia all fall
in this category and are considered cyanotic defects. Due to the ventricular septal defect in
TOF, the absence of the tricuspid valve or pulmonary valve in tricuspid and pulmonary
atresia, one should hear abnormal heart sounds either due to the murmur in TOF or single
heart sounds of S1 or S2 in pulmonary atresia or tricuspid atresia. Usually these infants
have activity intolerance and therefore, experience failure to thrive because of their
inability to consume enough formula to gain weight appropriately. Capillary refill is usually
prolonged due to poor oxygenation and poor perfusion secondary to the defect as well as
the O2 sats being lower than normal, sometimes even in the 80% range.
Question 4:
Right atrial pressure can be determined by:
a. Palpating the carotid pulse. Incorrect
b. Identifying the pulsations of the right jugular vein.
c. Analyzing the arterial blood gases.
d. Assessing for dependent edema. [Show Less]