NAB Bundled Exams | Questions and Answers with Complete Solutions (Already Passed)

NAB Bundled Exams | Questions and Answers with Complete Solutions (Already Passed) what are most strokes caused by? - ansatrial fibrillation (blood sitting the atrium clots), tx for atrial fibrillation is to put a pacemaker in Pericardium - anssac around the heart cardiac output - ansThe volume of blood ejected from the left side of the heart in one minute. CO = HR x SV Importance of not palpating both carotid arteries at the same time - ansstimulate a vasovagal response which will slow down HR and then you will pass out jugular vein - ansdeoxygenated, passive blood return, does not have pressure so should not bulge out. If pressure has backed up into venous system, can have JVD (bulging) which is from CHF African Americans - anshave a higher rate of HTN and diabetes Nicotine - ansstimulant which causes vasoconstriction Pallor - ansdont have enough RBC's to carry O2 to tissues Nocturia - ansurinating at night JVD - ansJugular vein distention, sign of heart dysfunction Inspection of chest - anspulsations? heave? lift? cardiac myopathy - ansheart becoming abnormally enlarged What to say when breath sounds are clear - ansCTA - clear to auscultation Bronchophony - ansNormal: normal voice transmission heard when patient says "99", can hear sound through stethoscope but cant distinguish exactly what is being said Abnormal: you auscultate a clear "99", the words are more distinct than normal Egophany - ans-auscultate the chest while the person phonates a long "ee-ee-ee-ee" sound -normal: should hear "eee" through stethoscope -abnormal: over area of consolidation or compression the spoken "eee" sound changes to a bleating long "aaa" sound whispered pectoriloquy - ans-ask the person to whisper a phrase such as "one-two-three" as you auscultate -normal: the normal response is faint, muffled, and almost inaudible -abnormal: with only small amount of consolidation, the whispered voice is transmitted very clearly and distinctly, although still somewhat faint; it sounds as if the person is whispering right into your stethoscope, "one-two-three". Crackles - fine - ans(rales) abnormal, discontinuous, adventitious lung sounds heard on inspiration Crackles - coarse - ans(coarse rales) Loud, low-pitched, bubbling and gurgling sounds that start in early inspiration and may be present in expiration. May decrease somewhat by suctioning or coughing but will reappear shortly. Sounds like opening a velcro fastener. atelectatic crackles - ans(atelectatic rales) Fine crackles that disappear with first few breaths Pleural Friction Rub - ansA very superficial sound that is coarse and low pitched; it has a grating quality as if two pieces of leather are being rubbed together; sounds just like crackles, but close to the ear; sounds louder if you push the stethoscope harder onto the chest wall; sound is inspiratory and expiratory Cardiomegaly - ansleft ventricular hypertrophy, abnormally enlarged, hearts way of compensation and becomes less efficient which decreased CO, apex of heart should end at 5th intercostal space palpating chest for thrill - anspalpable vibration arrythmia - ansAbnormal heart rhythm atrial fibrillation - ansat risk for clots Capillary Refill Test - ansPressure is applied to the nail bed until it turns white, this indicates that the blood has been forced from the tissue (called blanching) and once the tissue has blanched, pressure is removed. While the patient holds their hand above their heart, the health care provider measures the time it takes for blood to return to the tissue. Return of blood is indicated by the nail turning back to a pink color. Should be less than 3 seconds Mongolian Spots - ansbluish purple spots of hyperpigmentation Cafe au lait spots - ansBirth marks Linear Lesion - ansa scratch, streak, line, or stripe Zosteriform lesion - anslinear arrangement along a unilateral nerve route (herpes zoster) Macule Lesion - ansflat lesion measuring less than 1 cm in diameter EX. freckles, petechiae, measles Papule Lesion - anssomething you can feel (i.e solid, elevated, circumscribed, less than 1cm diameter) caused by superficial thickening in epidermis ex: mole or wart Tumor Lesion - anslarger than a few centimeters in diameter, firm or soft, deeper into dermis ex: lipoma, hemangioma Vesicle Lesion - anselevated cavity containing free fluid, up to 1 cm (blister). Ex: herpes simplex, early varicella, herpes zoster, contact dermatitis Cyst Lesion - ansencapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin (sebaceous cyst) Pustule lesion - anspus-filled (acne) Ulcer Lesion - ansdeeper depression into dermis, irregular shape, may bleed (pressure sore) Contusion - ansbruise (blunt force) Echymosis - ansa discoloration of the skin resulting from bleeding underneath, typically caused by bruising Hematoma - anscontusion that has caused a lump of blood Port Wine Stain - ansalong cranial nerve V, dark, red, bluish or purplish. Intensifies with crying, exertion, exposure to heat/cold. Petichiae - ansblood vessels that rupture Tinea corporis - ansringworm of the body primary contact dermatitis - anslocal inflammatory reaction to an irritant in the environment or an allergy Allergic Drug Reaction - anserythematous and symmetric rash, usually generalized Herpes Simplex - ans"cold sores"; clear vesicles with red base that evolve into pustules, can also be genital