N209 EXAM QUESTIONS WITH
CORRECT SOLUTIONS||UPDATED
2026/2027 SYLLABUS||<<NEWEST
VERSION>>
what are murmurs? - ANSWER ✓ blowing/swooshing sounds of the heart
what causes murmurs? - ANSWER ✓ an increased contractility of the heart
leading to a higher blood velocity/turbulence
what are innocent/functional murmurs and what kind of patients is this common
in? - ANSWER ✓ common in children/adolescents; normal murmur sound due to
greater blood flow
____________ murmurs can be normal or pathologic, while _______________
murmurs are always pathologic - ANSWER ✓ systolic; diastolic
what are the 6 stages of loudness of murmurs? - ANSWER ✓ I - barely audible
II - faint, but audible
III - moderately loud
IV - loud, thrill palpable
V - very loud with stethoscope lifted
VI - loudest, heard with scope off chest
what are three ways to describe the pitch of a murmur? - ANSWER ✓ high,
medium, low
what is a decrescendo murmur pattern? - ANSWER ✓ starts loud, then gets softer
what is a diamond murmur pattern? - ANSWER ✓ crescendo, then decrescendo
of sound
what are four ways to describe the quality of a murmur? - ANSWER ✓ musical,
blowing, harsh, rumbling
,what does it mean for a murmur to radiate? where can it radiate to (4)? -
ANSWER ✓ heard in other places; precordium, neck, back, axilla
what is the precordium? - ANSWER ✓ the region of the thorax immediately in
front of the heart
how can posture affect murmurs? - ANSWER ✓ may disappear or get louder with
position change
what is the order of heart auscultation? - ANSWER ✓ aortic
pulmonary
erb's point
tricuspid
mitral
how can a heart problem affect a child's development? - ANSWER ✓ may delay
it
children with heart problems will show what signs when playing or exercising? -
ANSWER ✓ can't keep up with other kids and get unusually fatigued
why do kids with heart problems squat? - ANSWER ✓ provides more relief from
fatigue than sitting upright
children with heart problems may show what signs when crying? - ANSWER ✓
cyanosis/pallor
heart rate ____________ as people get older - ANSWER ✓ decreases
what is a newborn's average heart rate? - ANSWER ✓ 140 bpm
why can heart tones be heard in different locations in older adults? (2) - ANSWER
✓ postural changes, enlarged heart
why are murmurs common in older adults? - ANSWER ✓ valves are thickened
,how is the older adult's heart different from the younger heart in size? - ANSWER
✓ slightly enlarged
raynaud's disease is a type of _________ - ANSWER ✓ PVD
raynaud's disease most commonly occurs in what sex/age? - ANSWER ✓ women,
18-30 years
what 6 things may bring on episodes in those with raynaud's disease? - ANSWER
✓ cold, inc emotions, stress, drugs, HTN, trauma
what two kinds of drugs may increase symptoms of raynaud's disease? -
ANSWER ✓ beta blockers, estrogens
the symptoms of raynaud's disease can be attributed to what? - ANSWER ✓
spasms of the arteries
what are four symptoms of raynaud's disease? - ANSWER ✓ cyanosis then rubor,
pain, burning, numbness/parathesias
what is rubor? - ANSWER ✓ a brick red color
what are parasthesias? - ANSWER ✓ feelings of "pins and needles"
how long can episodes of raynaud's disease last? - ANSWER ✓ a few minutes to
a few hours
what is a normal finding when comparing the BP of both arms while sitting?
abnormal? - ANSWER ✓ 5-10 mmHg difference
anything greater or can't auscultate
what is pulse pressure? - ANSWER ✓ measures pressure exerted by blood as it
flows in arteries
how do you calculate pulse pressure? - ANSWER ✓ subtract diastolic from
systolic
what is a normal pulse pressure? - ANSWER ✓ 30-40 mmHg
, what is a widened pulse pressure? - ANSWER ✓ above 40 mmHg
what causes widened pulse pressure? - ANSWER ✓ reduced large artery
compliance
widened pulse pressure can be found in what 5 conditions? - ANSWER ✓
systolic HTN
aortic regurgitation
patent ductus arteriosus
anemia
extreme emotions
what is a narrow pulse pressure? - ANSWER ✓ below 30 mmHg
what is pericardial effusion? - ANSWER ✓ fluid between the pericardium
narrow pulse pressure can be seen in what 5 conditions? - ANSWER ✓
tachycardia
severe aortic stenosis
pericarditis
pericardial effusions
ascites
what is a normal standing finding for systolic and diastolic BP? abnormal? -
ANSWER ✓ systolic BP less than 15 mmHg and diastolic less than 5 mmHg
higher than sitting
greater or can't auscultate
how should you measure BP when comparing sitting to standing pressures? -
ANSWER ✓ do both arms when sitting and both when standing
how do you inspect the carotid artery? - ANSWER ✓ use a penlight to view slight
pulsations
the carotid's pulse is simultaneous with what? - ANSWER ✓ S1 sounds
CORRECT SOLUTIONS||UPDATED
2026/2027 SYLLABUS||<<NEWEST
VERSION>>
what are murmurs? - ANSWER ✓ blowing/swooshing sounds of the heart
what causes murmurs? - ANSWER ✓ an increased contractility of the heart
leading to a higher blood velocity/turbulence
what are innocent/functional murmurs and what kind of patients is this common
in? - ANSWER ✓ common in children/adolescents; normal murmur sound due to
greater blood flow
____________ murmurs can be normal or pathologic, while _______________
murmurs are always pathologic - ANSWER ✓ systolic; diastolic
what are the 6 stages of loudness of murmurs? - ANSWER ✓ I - barely audible
II - faint, but audible
III - moderately loud
IV - loud, thrill palpable
V - very loud with stethoscope lifted
VI - loudest, heard with scope off chest
what are three ways to describe the pitch of a murmur? - ANSWER ✓ high,
medium, low
what is a decrescendo murmur pattern? - ANSWER ✓ starts loud, then gets softer
what is a diamond murmur pattern? - ANSWER ✓ crescendo, then decrescendo
of sound
what are four ways to describe the quality of a murmur? - ANSWER ✓ musical,
blowing, harsh, rumbling
,what does it mean for a murmur to radiate? where can it radiate to (4)? -
ANSWER ✓ heard in other places; precordium, neck, back, axilla
what is the precordium? - ANSWER ✓ the region of the thorax immediately in
front of the heart
how can posture affect murmurs? - ANSWER ✓ may disappear or get louder with
position change
what is the order of heart auscultation? - ANSWER ✓ aortic
pulmonary
erb's point
tricuspid
mitral
how can a heart problem affect a child's development? - ANSWER ✓ may delay
it
children with heart problems will show what signs when playing or exercising? -
ANSWER ✓ can't keep up with other kids and get unusually fatigued
why do kids with heart problems squat? - ANSWER ✓ provides more relief from
fatigue than sitting upright
children with heart problems may show what signs when crying? - ANSWER ✓
cyanosis/pallor
heart rate ____________ as people get older - ANSWER ✓ decreases
what is a newborn's average heart rate? - ANSWER ✓ 140 bpm
why can heart tones be heard in different locations in older adults? (2) - ANSWER
✓ postural changes, enlarged heart
why are murmurs common in older adults? - ANSWER ✓ valves are thickened
,how is the older adult's heart different from the younger heart in size? - ANSWER
✓ slightly enlarged
raynaud's disease is a type of _________ - ANSWER ✓ PVD
raynaud's disease most commonly occurs in what sex/age? - ANSWER ✓ women,
18-30 years
what 6 things may bring on episodes in those with raynaud's disease? - ANSWER
✓ cold, inc emotions, stress, drugs, HTN, trauma
what two kinds of drugs may increase symptoms of raynaud's disease? -
ANSWER ✓ beta blockers, estrogens
the symptoms of raynaud's disease can be attributed to what? - ANSWER ✓
spasms of the arteries
what are four symptoms of raynaud's disease? - ANSWER ✓ cyanosis then rubor,
pain, burning, numbness/parathesias
what is rubor? - ANSWER ✓ a brick red color
what are parasthesias? - ANSWER ✓ feelings of "pins and needles"
how long can episodes of raynaud's disease last? - ANSWER ✓ a few minutes to
a few hours
what is a normal finding when comparing the BP of both arms while sitting?
abnormal? - ANSWER ✓ 5-10 mmHg difference
anything greater or can't auscultate
what is pulse pressure? - ANSWER ✓ measures pressure exerted by blood as it
flows in arteries
how do you calculate pulse pressure? - ANSWER ✓ subtract diastolic from
systolic
what is a normal pulse pressure? - ANSWER ✓ 30-40 mmHg
, what is a widened pulse pressure? - ANSWER ✓ above 40 mmHg
what causes widened pulse pressure? - ANSWER ✓ reduced large artery
compliance
widened pulse pressure can be found in what 5 conditions? - ANSWER ✓
systolic HTN
aortic regurgitation
patent ductus arteriosus
anemia
extreme emotions
what is a narrow pulse pressure? - ANSWER ✓ below 30 mmHg
what is pericardial effusion? - ANSWER ✓ fluid between the pericardium
narrow pulse pressure can be seen in what 5 conditions? - ANSWER ✓
tachycardia
severe aortic stenosis
pericarditis
pericardial effusions
ascites
what is a normal standing finding for systolic and diastolic BP? abnormal? -
ANSWER ✓ systolic BP less than 15 mmHg and diastolic less than 5 mmHg
higher than sitting
greater or can't auscultate
how should you measure BP when comparing sitting to standing pressures? -
ANSWER ✓ do both arms when sitting and both when standing
how do you inspect the carotid artery? - ANSWER ✓ use a penlight to view slight
pulsations
the carotid's pulse is simultaneous with what? - ANSWER ✓ S1 sounds
