NM 703- Exam 1 Blueprint ACTUAL EXAM
QUESTIONS WITH COMPLETE SOLUTION GUIDE (A+
GRADED 100% VERIFIED) LATEST VERSION 2025!!
Clinical presentations of gastrointestinal, respiratory, musculoskeletal &
psychiatric causes of chest pain - (ANSWER)a. GI- Acid regurgitation, cough,
difficult/painful swallowing, belching, -symptoms related to eating, usually worse
after a large meal or lying down after a meal, might report some heartburn or
acid reflux into the throat, sore or bitter tase in the mouth, molar enamel erosion,
usually a more "sub-sternal" chest pain, potential risk factors such as obesity,
pregnancy, etc.
b. Respiratory- cough, dyspnea, localized, positional, sharp and stabbing pain
(pleuritic)
c. Musculoskeletal- Nagging chest pain with position changes, coughing and deep
breathing
d. Psychiatric- related to depression, panic d/o, or anxiety in younger women with
or without a mental health history
Physical examination components of gastrointestinal, respiratory, musculoskeletal
& psychiatric causes of chest pain - (ANSWER)a. GI- Tenderness in the epigastric
area or the right or left upper quadrants causing irritation to the diaphragm
b. Respiratory- Lymphadenopathy in neck (cervical chains or supraclavicular fossa)
indicates volume overload. Tracheal deviation likely pneumothorax.
If costochondritis pain upon palpation or raising arms, deep breathing, coughing,
pain when palpating 3rd or 5th rib, sharp and localized pain
,Dullness to percussion over posterior chest could be pleural effusion or
pneumonia, may also have asymmetric breath sounds, pleural friction rub,
wheezing, crackles, absent or decreased breath sounds
c. Musculoskeletal- range of motion of upper body and palpation of chest causes
chest pain
d. Psychiatric- related to depression, panic d/o, or anxiety in younger women with
or without a mental health history
What is hemodynamic stability / instability? - (ANSWER)a. Hemodynamic
stability- Patient is conscious, clear and lucid, capillary refill is brisk < 2 sec,
extremities are warm and pink, peripheral pulse has good volume, HR is normal
for rate and age, normal BP and pulse pressure for age, normal RR for age, normal
urine output
b. Hemodynamic instability-
i. HR <40/min or >140/min
ii. RR <8 or >36/min
iii. O2 <85%
iv. BP <80 or >200mm Hg systolic or > 110mm Hg diastolic
Steps of assessment of a patient presenting with chest pain, i.e. assess for red flag
indicators first and rule out life-threatening conditions before gathering further
data. - (ANSWER)a. Rule out red flag indicators (see below)
b. Assess for life threatening conditions (present as acute rather than chronic)
, i. MI- sudden onset of pain unrelieved by nitro or rest, n/v, diaphoresis, dyspnea,
dizziness, non-localized pain lasting > 20 minutes that radiates to jaw, shoulders,
neck, arms
ii. Aortic dissection- sudden tearing pain located in the anterior or posterior chest,
may radiate to arms, legs abdomen or back
iii. Pulmonary embolism- Able to point to area of pain over lung, dyspnea,
apprehension "I'm going to die", hemoptysis, gripping or stabbing pain of
moderate to severe intensity that may increase with deep breathing, may radiate
to neck or shoulder, bed rest and orthopedic surgery are risk factors
c. Determine if any risk factors for CAD/CVD? (smoker, HTN, diet high in saturated
fats, etc.)
d. Determine if anything that places them at higher risk of blood clots? (sedentary
lifestyle, CAD, pregnancy, contraceptive use, cancer)
e. Determine if family history of chest pain
f. Assess for chronic diseases
Red flag indicators of emergency conditions and actions if identified. - (ANSWER)-
Non localized pain
-Lasting > 20 minutes
-Associated with
a. Diaphoresis
b. Dyspnea
c. N & V
d. Dizziness
e. Radiation
QUESTIONS WITH COMPLETE SOLUTION GUIDE (A+
GRADED 100% VERIFIED) LATEST VERSION 2025!!
Clinical presentations of gastrointestinal, respiratory, musculoskeletal &
psychiatric causes of chest pain - (ANSWER)a. GI- Acid regurgitation, cough,
difficult/painful swallowing, belching, -symptoms related to eating, usually worse
after a large meal or lying down after a meal, might report some heartburn or
acid reflux into the throat, sore or bitter tase in the mouth, molar enamel erosion,
usually a more "sub-sternal" chest pain, potential risk factors such as obesity,
pregnancy, etc.
b. Respiratory- cough, dyspnea, localized, positional, sharp and stabbing pain
(pleuritic)
c. Musculoskeletal- Nagging chest pain with position changes, coughing and deep
breathing
d. Psychiatric- related to depression, panic d/o, or anxiety in younger women with
or without a mental health history
Physical examination components of gastrointestinal, respiratory, musculoskeletal
& psychiatric causes of chest pain - (ANSWER)a. GI- Tenderness in the epigastric
area or the right or left upper quadrants causing irritation to the diaphragm
b. Respiratory- Lymphadenopathy in neck (cervical chains or supraclavicular fossa)
indicates volume overload. Tracheal deviation likely pneumothorax.
If costochondritis pain upon palpation or raising arms, deep breathing, coughing,
pain when palpating 3rd or 5th rib, sharp and localized pain
,Dullness to percussion over posterior chest could be pleural effusion or
pneumonia, may also have asymmetric breath sounds, pleural friction rub,
wheezing, crackles, absent or decreased breath sounds
c. Musculoskeletal- range of motion of upper body and palpation of chest causes
chest pain
d. Psychiatric- related to depression, panic d/o, or anxiety in younger women with
or without a mental health history
What is hemodynamic stability / instability? - (ANSWER)a. Hemodynamic
stability- Patient is conscious, clear and lucid, capillary refill is brisk < 2 sec,
extremities are warm and pink, peripheral pulse has good volume, HR is normal
for rate and age, normal BP and pulse pressure for age, normal RR for age, normal
urine output
b. Hemodynamic instability-
i. HR <40/min or >140/min
ii. RR <8 or >36/min
iii. O2 <85%
iv. BP <80 or >200mm Hg systolic or > 110mm Hg diastolic
Steps of assessment of a patient presenting with chest pain, i.e. assess for red flag
indicators first and rule out life-threatening conditions before gathering further
data. - (ANSWER)a. Rule out red flag indicators (see below)
b. Assess for life threatening conditions (present as acute rather than chronic)
, i. MI- sudden onset of pain unrelieved by nitro or rest, n/v, diaphoresis, dyspnea,
dizziness, non-localized pain lasting > 20 minutes that radiates to jaw, shoulders,
neck, arms
ii. Aortic dissection- sudden tearing pain located in the anterior or posterior chest,
may radiate to arms, legs abdomen or back
iii. Pulmonary embolism- Able to point to area of pain over lung, dyspnea,
apprehension "I'm going to die", hemoptysis, gripping or stabbing pain of
moderate to severe intensity that may increase with deep breathing, may radiate
to neck or shoulder, bed rest and orthopedic surgery are risk factors
c. Determine if any risk factors for CAD/CVD? (smoker, HTN, diet high in saturated
fats, etc.)
d. Determine if anything that places them at higher risk of blood clots? (sedentary
lifestyle, CAD, pregnancy, contraceptive use, cancer)
e. Determine if family history of chest pain
f. Assess for chronic diseases
Red flag indicators of emergency conditions and actions if identified. - (ANSWER)-
Non localized pain
-Lasting > 20 minutes
-Associated with
a. Diaphoresis
b. Dyspnea
c. N & V
d. Dizziness
e. Radiation
