NP Health Assessment Midterm
Questions with Correct Answers
Low pitched sounds to use bell for - answer mitral stenosis, S3, S4
systole heard where - answerS1. Loudest at apex
valves closing in systole - answer mitral and tricuspid. the closure creates S1
valves opening in systole - answer aortic and pulmonic
diastole heard where - answerS2, loudest at base
valves closing in diastole - answeraortic and pulmonic. closure creates S2
valves opening in diastole - answermitral and tricuspid
normal S2 splitting - answercommon <50 y.o. assess sitting
S2 splitting on _ - answerinspiration, blows away with expiration
S2 split on inspiration and expiration - answerRBBB or ASD
which vein do you measure JVP - answerinternal jugular because it does not have
valves
measuring JVP - answer45 degree angle, look left, watch for flicker. how many cm from
angle of lewey?
bruit on one side of carotid - answercarotid artery occlusion, ?plaque
bilateral carotid bruit - answeraortic stenosis radiating
PMI >3 cm indicates what - answerL ventricular enlargement
PMI shifted under axilla - answerheart failure
how to identify S1 - answerpalpate carotid and auscultate at apex
pathologic murmurs - answerdiastolic, grade >3/6, abnormal split S2, louder with
standing
, systolic murmurs - answerPlease Sneak Away Slowly MR TigeR
pulmonic stenosis, aortic stenosis, mitral regurgitation, tricuspid regurgitation
diastolic murmurs - answerARMS PaRTS
aortic regurgitation, mitral stenosis, pulmonary regurgitation, tricuspid stenosis
blowing murmurs - answerdiastolic
what side murmurs are louder on inspiration - answerright
what side murmurs are louder on expiration - answerleft
uncommon murmurs are what side - answerright
murmur grades - answer1/6 very faint, not heard in all positions
2/6 soft heard in all positions
3/6 loud, no thrill
4/6 loud with palpable thrill
5/6 heard with stethoscope partially off chest
6/6 heard with stethoscope completely off chest
aortic regurgitation - answerdiastolic, S2. high pitched murmur at Erb's point. best heard
with pt leaning forward, exhale completely and stop breathing
mitral regurgitation - answerholosystolic murmur. listen at apex. high pitched rumbling,
softer with inspiration. radiates to L axilla
aortic stenosis - answersystolic, S1. high pitched. R 2 ICS, murmur radiates to carotid
arteries. squatting increases sound of murmur
mitral stenosis - answermid diastolic. S2. low rumble listen with bell at apex, laying on L
side.
mitral valve prolapse - answerclick over mitral area. usually asymptomatic but may have
atypical CP, palpitations. systolic murmur S1. high pitched, listen at apex. increases
with valsalva and standing
hypertrophic cardiomyopathy - answersystolic murmur, high pitched at 2 ICS R and or
L. increases with valsalva and standing
what murmur is heard best squatting - answeraortic stenosis
what murmur is heard best standing/ valsalva - answermitral valve prolapse or
hypertrophic CMO
S3 - answerheard in CHF, the atrium has overloaded volume
Questions with Correct Answers
Low pitched sounds to use bell for - answer mitral stenosis, S3, S4
systole heard where - answerS1. Loudest at apex
valves closing in systole - answer mitral and tricuspid. the closure creates S1
valves opening in systole - answer aortic and pulmonic
diastole heard where - answerS2, loudest at base
valves closing in diastole - answeraortic and pulmonic. closure creates S2
valves opening in diastole - answermitral and tricuspid
normal S2 splitting - answercommon <50 y.o. assess sitting
S2 splitting on _ - answerinspiration, blows away with expiration
S2 split on inspiration and expiration - answerRBBB or ASD
which vein do you measure JVP - answerinternal jugular because it does not have
valves
measuring JVP - answer45 degree angle, look left, watch for flicker. how many cm from
angle of lewey?
bruit on one side of carotid - answercarotid artery occlusion, ?plaque
bilateral carotid bruit - answeraortic stenosis radiating
PMI >3 cm indicates what - answerL ventricular enlargement
PMI shifted under axilla - answerheart failure
how to identify S1 - answerpalpate carotid and auscultate at apex
pathologic murmurs - answerdiastolic, grade >3/6, abnormal split S2, louder with
standing
, systolic murmurs - answerPlease Sneak Away Slowly MR TigeR
pulmonic stenosis, aortic stenosis, mitral regurgitation, tricuspid regurgitation
diastolic murmurs - answerARMS PaRTS
aortic regurgitation, mitral stenosis, pulmonary regurgitation, tricuspid stenosis
blowing murmurs - answerdiastolic
what side murmurs are louder on inspiration - answerright
what side murmurs are louder on expiration - answerleft
uncommon murmurs are what side - answerright
murmur grades - answer1/6 very faint, not heard in all positions
2/6 soft heard in all positions
3/6 loud, no thrill
4/6 loud with palpable thrill
5/6 heard with stethoscope partially off chest
6/6 heard with stethoscope completely off chest
aortic regurgitation - answerdiastolic, S2. high pitched murmur at Erb's point. best heard
with pt leaning forward, exhale completely and stop breathing
mitral regurgitation - answerholosystolic murmur. listen at apex. high pitched rumbling,
softer with inspiration. radiates to L axilla
aortic stenosis - answersystolic, S1. high pitched. R 2 ICS, murmur radiates to carotid
arteries. squatting increases sound of murmur
mitral stenosis - answermid diastolic. S2. low rumble listen with bell at apex, laying on L
side.
mitral valve prolapse - answerclick over mitral area. usually asymptomatic but may have
atypical CP, palpitations. systolic murmur S1. high pitched, listen at apex. increases
with valsalva and standing
hypertrophic cardiomyopathy - answersystolic murmur, high pitched at 2 ICS R and or
L. increases with valsalva and standing
what murmur is heard best squatting - answeraortic stenosis
what murmur is heard best standing/ valsalva - answermitral valve prolapse or
hypertrophic CMO
S3 - answerheard in CHF, the atrium has overloaded volume
