Test Bank for Evidence Based Physical Examination Best
Practices for Health and Well Being Assessment 1st Edition
9780826164537 | All Chapters with Answers and Rationals
Where should you stand when inspecting a pt in the CV exam? - ANSWER: Right side
What do you use tangential light for? - ANSWER: Apical impulse
What can an epigastric impulse indicate (may be WNL)? - ANSWER: Abdominal aortic aneurysm
What imaging can be performed to evaluate for AAA? (2) - ANSWER: US
Echo
What do you palpate for with your finger pads? - ANSWER: Pulsations
What do you palpate for with your MCPs? - ANSWER: Thrills
What murmurs are thrills associated with? (3) - ANSWER: AS
PDA
VSD
Locations for palpation (4) - ANSWER: Aortic area
Pulmonic area
Right ventricular
Left ventricular
What causes the apical impulse? - ANSWER: During contraction, the heart folds in on itself and twists
and hits the chest wall
Location of apical impulse - ANSWER: 5th ICS, MCL, 7-9 cm from MSl
Causes of increased amplitude (3) - ANSWER: Anxiety
Hyperthyroidism
Severe anemia
Cardiac hypertrophy - ANSWER: Increased thickness of wall
PE findings for cardiac hypertrophy (2) - ANSWER: Stronger impulse in the right location
Increased amplitude
Cardiac dilation - ANSWER: Expansion of the chamber size
PE findings for cardiac dilation - ANSWER: Impulse located more laterally and may be weaker
What does pregnancy cause in the heart? - ANSWER: Elevated apical impulse
What does COPD cause in the heart and why? - ANSWER: Vertical heart because it is tethered to the
diaphragm by central tendon
Auscultation sites (5) - ANSWER: Aortic
Pulmonic
Erb's point
Tricuspid
Mitral
, Events in what side of the heart occur first? - ANSWER: Left
What type of pitches can you hear with the diaphragm? - ANSWER: High pitch
What type of pitches can you hear with the bell? - ANSWER: Low pitch
What specific pitches can you hear with the diaphragm better? (7) - ANSWER: S1
S2
AR
MR
PFR
OS
AS
What specific pitches can you hear with the bell better? - ANSWER: S3
S4
MS
Positions to use to increase auscultation (4) - ANSWER: Leg lifting
Straining valsalva
Left lateral decubitus
Sit up and lean forward with exhale using diaphragm
What murmurs does leg lifting increase? - ANSWER: All murmurs except mitral valve prolapse and
hypertrophic obstructive cardiomyopathy
What volume does leg lifting increase? - ANSWER: Left ventricular volume due to increased venous
return
What volume does straining valsalva decrease? - ANSWER: Decreases left ventricular volume due to
decreased venous return
What murmurs does straining valsalva decrease? - ANSWER: All murmurs except MVP and HOCM
What sounds does left lateral decubitus increase? (4) - ANSWER: S3
S4
MS
MR
What murmurs does sitting up and leaning forward using a diaphragm increase?(2) - ANSWER: Aortic
Pulmonic
What valves close and sounds do ventricular contraction cause? - ANSWER: Mitral and tricuspid close,
creates S1
Blood flows through which arteries during ventricular contraction - ANSWER: Aorta and pulmonary
arteries
What pulse is S1 timed with? - ANSWER: Carotid
Where is S1 heard loudest? - ANSWER: Apex
What valves close during S2? - ANSWER: Aortic and pulmonic
Where does the blood travel during S2? - ANSWER: Atrium to the ventricles
Practices for Health and Well Being Assessment 1st Edition
9780826164537 | All Chapters with Answers and Rationals
Where should you stand when inspecting a pt in the CV exam? - ANSWER: Right side
What do you use tangential light for? - ANSWER: Apical impulse
What can an epigastric impulse indicate (may be WNL)? - ANSWER: Abdominal aortic aneurysm
What imaging can be performed to evaluate for AAA? (2) - ANSWER: US
Echo
What do you palpate for with your finger pads? - ANSWER: Pulsations
What do you palpate for with your MCPs? - ANSWER: Thrills
What murmurs are thrills associated with? (3) - ANSWER: AS
PDA
VSD
Locations for palpation (4) - ANSWER: Aortic area
Pulmonic area
Right ventricular
Left ventricular
What causes the apical impulse? - ANSWER: During contraction, the heart folds in on itself and twists
and hits the chest wall
Location of apical impulse - ANSWER: 5th ICS, MCL, 7-9 cm from MSl
Causes of increased amplitude (3) - ANSWER: Anxiety
Hyperthyroidism
Severe anemia
Cardiac hypertrophy - ANSWER: Increased thickness of wall
PE findings for cardiac hypertrophy (2) - ANSWER: Stronger impulse in the right location
Increased amplitude
Cardiac dilation - ANSWER: Expansion of the chamber size
PE findings for cardiac dilation - ANSWER: Impulse located more laterally and may be weaker
What does pregnancy cause in the heart? - ANSWER: Elevated apical impulse
What does COPD cause in the heart and why? - ANSWER: Vertical heart because it is tethered to the
diaphragm by central tendon
Auscultation sites (5) - ANSWER: Aortic
Pulmonic
Erb's point
Tricuspid
Mitral
, Events in what side of the heart occur first? - ANSWER: Left
What type of pitches can you hear with the diaphragm? - ANSWER: High pitch
What type of pitches can you hear with the bell? - ANSWER: Low pitch
What specific pitches can you hear with the diaphragm better? (7) - ANSWER: S1
S2
AR
MR
PFR
OS
AS
What specific pitches can you hear with the bell better? - ANSWER: S3
S4
MS
Positions to use to increase auscultation (4) - ANSWER: Leg lifting
Straining valsalva
Left lateral decubitus
Sit up and lean forward with exhale using diaphragm
What murmurs does leg lifting increase? - ANSWER: All murmurs except mitral valve prolapse and
hypertrophic obstructive cardiomyopathy
What volume does leg lifting increase? - ANSWER: Left ventricular volume due to increased venous
return
What volume does straining valsalva decrease? - ANSWER: Decreases left ventricular volume due to
decreased venous return
What murmurs does straining valsalva decrease? - ANSWER: All murmurs except MVP and HOCM
What sounds does left lateral decubitus increase? (4) - ANSWER: S3
S4
MS
MR
What murmurs does sitting up and leaning forward using a diaphragm increase?(2) - ANSWER: Aortic
Pulmonic
What valves close and sounds do ventricular contraction cause? - ANSWER: Mitral and tricuspid close,
creates S1
Blood flows through which arteries during ventricular contraction - ANSWER: Aorta and pulmonary
arteries
What pulse is S1 timed with? - ANSWER: Carotid
Where is S1 heard loudest? - ANSWER: Apex
What valves close during S2? - ANSWER: Aortic and pulmonic
Where does the blood travel during S2? - ANSWER: Atrium to the ventricles
