FAU Health Assessment Exam 2 (Unit
6-8) Questions with Solved Solutions.
Questions to Ask During Cardiovascular ROS - Answer Ask about:
-Incidence of chest pain/pressure
(Quantify the pain "how many flights of stairs?)
(Pressure seen in 50% of acute MI)
(Interior chest pain = ripping or tearing pain radiating to back and neck is an acute Aortic
Dissection)
-Congenital defects
-Genetics
-Surgical Procedures
-Palpitations (Unpleasant awareness of heart beat)
-Shortness of breath:
Dyspnea (Uncomfortable awareness of breathing that is inappropriate to level of exertion)
Orthopnea (Dyspnea when lying down and improves when sitting up)
Paroxysmal Nocturnal Dyspnea (Sudden that awaken a pt from sleep usually 1-2 hours after
going to bed)
-Swelling or Edema
Murmurs Heard at the Cardiac Apex - Answer -Mitral valve murmurs are heard best at the
cardiac apex
-Murmurs originating from the aortic valve may be heard anywhere from the 2nd intercostal
space to the apex
Inspiratory Splitting of S2 - Answer During inspiration the filling time of the right heart
increases, thereby increasing the stroke volume and lengthening the duration of right ventricle
emptying compared to the left ventricle.
-This delays closure of the pulmonic valve, splitting S2 into its two audible components
-Difficult to hear in obese individuals or people with increased anteroposterior diameter chest
walls
-Heard best at 2nd intercostal space close to the sternum
,Percussion Sounds over Gastric Bubble - Answer Tympany- a clear hollow drum-like note
heard during percussion over gas filled organs, such as the stomach and bowels
-Tympany overlies the gastric air bubble and the splenic flexure of the colon
-Dullness is heard over areas of fluid and feces
Good Percussion Techniques - Answer When assessing the abdomen ensure to auscultate
before you percuss
-Percuss in an order like a clock starting at RUQ moving to LUQ ->LLQ->RLQ
-Compare two area to each other
-strike twice in each location
-Identify 5 Percussion notes:
1. Flatness (Soft, high pitches, short duration in the thigh)
2. Dullness (medium, medium pitch, medium duration in the liver)
3. Resonance (Loud, low pitch, long duration in healthy lung)
4. Hyperresonance (very loud, lower pitch, longer duration, usually nowhere)
5. Tympany ( loud, high pitch, usually in gastric air bubble or puffed-out cheek)
*Use Ladder back pattern on the posterior thorax*
Assessing Enlarged Liver - Answer Percuss over the liver in both the midclavicular line and at
the midsternal line
-Midclavicular line percussion should be 6-12 cm (Liver span)
longer indicates an enlarged liver
-Midsternal line percussion should be 4-8cm
Palpate it from the right side
-use left hand to support the back at the level of the 11th and 12th rib
-Right hand presses on the abdomen inferior to the border of the liver and continues to palpate
superiorly until the liver border is palpated
-Patient can take a deep breath and this can illicit pain i liver or gallbladder disease
, makes it easier to find the inferior border of the liver (the diaphragm lowering during deep
inspiration forces the liver downward
-Use a hooking technique for obese patients
both hands side by side on the right abdomen below the border of liver dullness then press
fingers up into the costal margin ask patient to take a deep breath
Crackles - Answer Adventitious Breath Sounds
-Used to be called Rales
-Short
-Discontinuous
-Nonmusical
-Heard mostly during inspiration
-Cause by the opening of collapsed distal airways and alveoli
Common Causes:
-Pulmonary edema
-CHF
-Pulmonary Fibrosis
*With bronchitis the crackles will clear with a cough*
Wheezes - Answer Adventitious Breath Sounds
-Continuous
-Musical
-High-Pitches
-Heard mostly during expiration
-Caused by airflow through a narrowed bronchi
-Swelling (Asthma)
-Secretions (Asthma)
-Spasm
-Tumor
-Foreign Body
6-8) Questions with Solved Solutions.
Questions to Ask During Cardiovascular ROS - Answer Ask about:
-Incidence of chest pain/pressure
(Quantify the pain "how many flights of stairs?)
(Pressure seen in 50% of acute MI)
(Interior chest pain = ripping or tearing pain radiating to back and neck is an acute Aortic
Dissection)
-Congenital defects
-Genetics
-Surgical Procedures
-Palpitations (Unpleasant awareness of heart beat)
-Shortness of breath:
Dyspnea (Uncomfortable awareness of breathing that is inappropriate to level of exertion)
Orthopnea (Dyspnea when lying down and improves when sitting up)
Paroxysmal Nocturnal Dyspnea (Sudden that awaken a pt from sleep usually 1-2 hours after
going to bed)
-Swelling or Edema
Murmurs Heard at the Cardiac Apex - Answer -Mitral valve murmurs are heard best at the
cardiac apex
-Murmurs originating from the aortic valve may be heard anywhere from the 2nd intercostal
space to the apex
Inspiratory Splitting of S2 - Answer During inspiration the filling time of the right heart
increases, thereby increasing the stroke volume and lengthening the duration of right ventricle
emptying compared to the left ventricle.
-This delays closure of the pulmonic valve, splitting S2 into its two audible components
-Difficult to hear in obese individuals or people with increased anteroposterior diameter chest
walls
-Heard best at 2nd intercostal space close to the sternum
,Percussion Sounds over Gastric Bubble - Answer Tympany- a clear hollow drum-like note
heard during percussion over gas filled organs, such as the stomach and bowels
-Tympany overlies the gastric air bubble and the splenic flexure of the colon
-Dullness is heard over areas of fluid and feces
Good Percussion Techniques - Answer When assessing the abdomen ensure to auscultate
before you percuss
-Percuss in an order like a clock starting at RUQ moving to LUQ ->LLQ->RLQ
-Compare two area to each other
-strike twice in each location
-Identify 5 Percussion notes:
1. Flatness (Soft, high pitches, short duration in the thigh)
2. Dullness (medium, medium pitch, medium duration in the liver)
3. Resonance (Loud, low pitch, long duration in healthy lung)
4. Hyperresonance (very loud, lower pitch, longer duration, usually nowhere)
5. Tympany ( loud, high pitch, usually in gastric air bubble or puffed-out cheek)
*Use Ladder back pattern on the posterior thorax*
Assessing Enlarged Liver - Answer Percuss over the liver in both the midclavicular line and at
the midsternal line
-Midclavicular line percussion should be 6-12 cm (Liver span)
longer indicates an enlarged liver
-Midsternal line percussion should be 4-8cm
Palpate it from the right side
-use left hand to support the back at the level of the 11th and 12th rib
-Right hand presses on the abdomen inferior to the border of the liver and continues to palpate
superiorly until the liver border is palpated
-Patient can take a deep breath and this can illicit pain i liver or gallbladder disease
, makes it easier to find the inferior border of the liver (the diaphragm lowering during deep
inspiration forces the liver downward
-Use a hooking technique for obese patients
both hands side by side on the right abdomen below the border of liver dullness then press
fingers up into the costal margin ask patient to take a deep breath
Crackles - Answer Adventitious Breath Sounds
-Used to be called Rales
-Short
-Discontinuous
-Nonmusical
-Heard mostly during inspiration
-Cause by the opening of collapsed distal airways and alveoli
Common Causes:
-Pulmonary edema
-CHF
-Pulmonary Fibrosis
*With bronchitis the crackles will clear with a cough*
Wheezes - Answer Adventitious Breath Sounds
-Continuous
-Musical
-High-Pitches
-Heard mostly during expiration
-Caused by airflow through a narrowed bronchi
-Swelling (Asthma)
-Secretions (Asthma)
-Spasm
-Tumor
-Foreign Body
