2004 Exam 1

Front 1

The first heart sound of S1 is produced by?

A. closure of the semilunar valves.

B. closure of the AV valves.

C. opening of the semilunar valves.

D. opening of the AV valves

Back 1

B. closure of the AV valves

Front 2

what guideline may be used to identify which heart sound is S1?

A. S1 is louder than S2 at the base of the heart.

B. S1 coincides with the A wave of the jugular venous pulse wave.

C. S1 coincides with the carotid artery pulse.

D. S1 coincides with the Q wave of the QRS electrocardiogram complex.

Back 2

C. S1 coincides with the carotid artery pulse

Front 3

Which of the following cardiac alterations occurs during pregnancy?

A. An increase in cardiac output and blood pressure

B. An increase in cardiac volume and a decrease in blood pressure

C. An increased heart rate and increased blood pressure

D. An increased stroke volume and decreased cardiac output

Back 3

B. an increase in cardiac volume and a decrease in blood pressure

Front 4

Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs?

A. Roll toward the left side

B. Roll toward the right side

C. Trendelenburg position

D. Recumbent position

Back 4

A. roll toward left side

Front 5

The ability of the heart to contract independently of any signals or stimulation is due to:

A. depolarization.

B. automaticity.

C. conduction.

D. repolarization

Back 5

B. automaticity

Front 6

When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates:

A. the presence of congenital heart disease.

B. a normal sound because of the thinner chest wall of the newborn.

C. an expected sound caused by nonclosure of the ductus arteriosus.

D. pathology only when accompanied by an increased heart rate.

Back 6

C. an expected sound caused by nonclosure of the ductus arteriosus

Front 7

A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:

A. decreased velocity of blood flow through the carotid artery.

B. turbulent blood flow through the carotid artery.

C. rapid blood flow through the carotid artery. D. increased viscosity of blood

Back 7

B. turbulent blood flow through the carotid artery

Front 8

The jugular venous pressure is an indirect reflection of the:

A. heart’s efficiency as a pump.

B. cardiac cycle.

C. conduction effectiveness.

D. synchronization of mechanical activity.

Back 8

A. heart's efficiency as a pump

Front 9

The semilunar valves separate the:

A. atria from the ventricles.

B. right atria from the left atria.

C. ventricles from the arteries.

D. atria from the veins.

Back 9

C. ventricles from the arteries

Front 10

One of the leg’s deep veins is the:

A. great saphenous.

B. small saphenous.

C. tibial.

D. popliteal.

Back 10

D. popliteal

Front 11

Arteriosclerosis refers to:

A. a variation from the heart’s normal rhythm.

B. a sac formed by dilation in the arterial wall.

C. thickening and loss of elasticity of the arterial walls.

D. deposition of fatty plaques along the intima of the arteries

Back 11

C. thickening and loss of elasticity of the arterial walls.

Front 12

Palpable inguinal lymph nodes are:

A. normal if small (less than 1 cm), movable, and nontender.

B. abnormal in adults but common in children and infants.

C. normal if fixed and tender.

D. abnormal and indicate the presence of malignant disease.

Back 12

A. normal if small, moveable, and nontender.

Front 13

In pulsus paradoxus:

A. the rhythm is irregular; every other beat is premature.

B. there is a deficiency of arterial blood to a body part.

C. the rhythm is regular, but the force of the pulse varies with alternating beats.

D. beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration.

Back 13

D. beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration

Front 14

A water-hammer or Corrigan pulse is associated with:

A. hyperkinetic states.

B. decreased cardiac output.

C. aortic valve regurgitation.

D. conduction disturbance.

Back 14

C. aortic valve regurgitation

Front 15

The cervical nodes drain the:

A. upper arm and breast.

B. hand and lower arm.

C. external genitalia.

D. head and neck.

Back 15

D. head and neck

Front 16

In young children, the thymus gland:

A. produces T lymphocytes.

B. is small and begins to atrophy.

C. is not important in immune function.

D. produces B lymphocytes.

Back 16

A. produces T lymphocytes

Front 17

Claudication is caused by:

A. venous insufficiency.

B. arterial insufficiency.

C. varicose veins.

D. stasis ulcerations.

Back 17

B. arterial insufficiency

Front 18

A patient has severe bilateral lower extremity edema. The most likely cause is:

A. an infection of the right great toe.

B. Raynaud phenomenon.

C. heart failure.

D. an aortic aneurysm.

Back 18

C. heart failure

Front 19

physical appearance in the general survey has to do with assessment of what?

(6)

Back 19

-age

-race

-gender

-level of conciousness

-skin color

-facial features

Front 20

Body structure has to do with what?

(6)

Back 20

stature

nutrition

symmetry

posture

position

body build/ contour

Front 21

mobility is concerned with (3) things.

Back 21

gait

range of motion

presence of involuntary movement

Front 22

Behavior considers?

(5)

Back 22

-facial expression

-mood and affect

-speech

-dress

-personal hygeine

Front 23

with a child, what are some clues to child abuse, mental illness, or a developmental disability or disorder?

Back 23

unexpected behavior from the adult to the child

Front 24

Developmental considerations with general survery in an aging adult?

Back 24

-be aware that posture, appearance, and mobility may change.

-by 8th decade spinal flexion can occur

-angulation of features and a redistribution of body proportions

-gait may have wider base

Front 25

developmental considerations with general survey for a child?

Back 25

observe the interactions between child and accompanying adult.

Front 26

practical marker of optimal healthy weight?

Back 26

BMI (body mass index)

Front 27

is an important independent risk factor for disease, over and above that of BMI.

Back 27

Excess abdominal fat

Front 28

most convenient route for Temp?

Most accurate route for Temp?

Back 28

1. oral

2. rectal

Front 29

senses infrared emissions of the eardrum, so it is an accurate measurement of core temperature.

Back 29

tympanic route

Front 30

uses infrared emissions from the temporal artery and provides an average of multiple readings.

Back 30

temporal artery thermomete

Front 31

When palpating a peripheral pulse, assess three qualities.

Back 31

rate, rhythym, force.

Front 32

(pulse)

In an adult at rest, the rate normally ranges from

Back 32

50-95 BPM

Front 33

force of the pulse shows the strength of

Back 33

the heart's stroke volume

Front 34

To assess respirations, count them while

Back 34

your hand is still in position to check pulse.

Front 35

normal respirations are usually documented as?

Back 35

relaxed, regular, automatic, and silent.

Front 36

the ratio of the pulse rate to respiratory rate commonly is?

Back 36

4:1

Front 37

is the force of the blood pushing against the blood vessel walls.

Back 37

blood pressure

Front 38

is the maximum pressure felt on the artery during left ventricular contraction (or systole)

Back 38

systolic pressure

Front 39

e is the elastic recoil (or resting) pressure the blood exerts constantly between contractions.

Back 39

diastolic pressure

Front 40

is the difference between the systolic and diastolic pressures and reflects the stroke volume.

Back 40

pulse pressure

Front 41

is the pressure forcing blood into the tissues, averaged over the cardiac cycle.

Back 41

mean arterial pulse

Front 42

In a young adult, several factors affect blood pressure, including

Back 42

age

gender

race

diurnal rhythm

weight

exercise

emotions, and stress.

Front 43

The blood pressure level is determined by five factors:

Back 43

1.cardiac output (CO)

2. peripheral vascular resistance (PVR)

3.volume of circulating blood

4.viscosity

5. vessel wall elasticity.

Front 44

To obtain an accurate measurement, the width of the cuff’s rubber bladder should equal __ and the length of the bladder should equal ___.

Back 44

1. 40

2. 80

Front 45

A false high BP reading can be caused by?

Back 45

A cuff that is too small

Front 46

A BP cuff that is too wide yields a

Back 46

false low reading

Front 47

The purpose of the complete health history is to

Back 47

collect subjective data from the patient

Front 48

with what type of patient would the health history includes a detailed, chronological record of the health problem

Back 48

ill patients

Front 49

For all patients, it is a screening tool for

Back 49

abnormal symptoms

health problems

concerns

Front 50

What are the 8 categories to gather data in a complete health history?

Back 50

1.biographical data

2.source of history

3.reason for seeking care

4.present health or history of present illnes

5.past health events

6.family history

7.review of systems

8.functional assessment

Front 51

when performing a symptom analysis, what are you analyzing?

(6)

Back 51

including location,

character or quality,

quantity or severity,

timing, setting,

aggravating or relieving factors,

associated factors, and patient’s perception.

Front 52

past health events

(6)

Back 52

illnesses

injuries

hospitalizations

surgeries

allergies

current prescribed and herbal medications.

Front 53

what is the purpose of the review of systems?

Back 53

to evaluate the past and present health of each body system

Front 54

When obtaining a child’s health history, use the same structure you would use for an adult but make pertinent modifications or additions, including:

Back 54

A prenatal and perinatal history including the family unit

• The description of the present problem and who is providing the information

• Any childhood illnesses or accidents

• Immunizations

• A developmental overview

• A nutritional history.

Front 55

when assessing functional abilities in a child, you must consider

Back 55

environment and his or her function or role in the environment.

Front 56

When taking an older adult’s health history, ask additional questions such as

Back 56

changes in activities of daily living that may result from the aging process or chronic illness.

Front 57

The impact or burden of a disease may be more important to an older adult than

Back 57

the actual disease diagnosis or pathology.

Front 58

Physical examination requires the sequential use of four assessment techniques:

Back 58

inspection

palpation

percussion

auscultation.

Front 59

is the use of touch to assess texture, temperature, moisture, and organ location and size.

Back 59

palpation

Front 60

are best for fine tactile discrimination.

Back 60

finger tips

Front 61

Grasping with the fingers and thumb is ideal for

Back 61

detecting position, shape, and consistency of an organ or mass.

Front 62

backs of the hands and fingers are good for determining

Back 62

temperature

Front 63

is best for assessing vibration.

Back 63

base of the fingers or ulnar surface of the hand

Front 64

detects surface characteristics and accustoms the person to being touched.

Back 64

light palpation

Front 65

assesses an organ or mass deeper in a body cavity

Back 65

deep palpation

Front 66

bimanual palpation

Back 66

requires the use of both hands to envelop or capture certain body parts or organs.

Front 67

This technique is used to assess the location, size, and density of an organ;

detect a fairly superficial abnormal mass;

or elicit a deep tendon reflex.

Back 67

percussion (tapping)

Front 68

Each percussion sound has four components.

Back 68

amplitude: intensity (loud or soft)

pitch: # vibrations per second

quality: diff. bc of distinctive overtones

duration: length of time note lingers

Front 69

commonly auscultated areas

Back 69

The heart, blood vessels, lungs, and abdomen.

Front 70

use the stethoscopes diaphragm for __ pitched sounds

Back 70

high

(breath, bowel, normal heart sounds)

Front 71

use the stethoscopes bell for ___ pitched sounds.

Back 71

low

(murmurs or gallops)

Front 72

Pace the examination to match the older adult’s pace, which may be slowed.

Back 72

for an older adult

Front 73

The thoracic cage consists of the

Back 73

sternum

12 thoracic ribs

12 thoracic vertebra

diaphragm

Front 74

separating the thoracic cavity from the abdomen.

Back 74

diaphragm

Front 75

On the posterior thorax, surface landmarks include the

Back 75

vertebra prominens

the spinous processes

the inferior border of the scapula

and the twelfth rib.

Front 76

On the anterior thorax, surface landmarks include the

Back 76

suprasternal notch;

the sternum, or breastbone;

the sternal angle, which is continuous with the second rib;

and the costal angle, where the right and left costal margins meet at the xiphoid process.

Front 77

Anteriorly, the ____ (or highest point) of the lungs lies 3 or 4 cm above the inner third of the clavicles.

Back 77

apex

Front 78

The ____ (or lower border) rests on the diaphragm at the sixth rib in the left midclavicular line.

Back 78

base

Front 79

Laterally, the lungs extend from the apex of the axilla to the ___ rib.

Back 79

7th or 8th

Front 80

The ____ protects the alveoli from small particulate matter by using mucus and cilia, which sweep particles upward for swallowing or expulsion.

Back 80

bronchial tree

Front 81

The respiratory system has four major functions:

Back 81

supplies oxygen to the body for energy production.

• removes carbon dioxide as a waste product of energy reactions.

• maintains homeostasis (or acid-base balance) in arterial blood

• maintains heat exchange.

Front 82

True or False?

The respiratory system develops in utero but does not function until birth.

Back 82

True

Front 83

During pregnancy, the growing uterus displaces the diaphragm. The fetus increases maternal oxygen demands, which are met by an

Back 83

increased tidal volume

Front 84

True or False?

In babies, the costal cartilages become calcified, respiratory muscle strength declines, and lung elasticity decreases, making the lungs less distensible and lessening their tendency to collapse and recoil.

Back 84

False, in elderly adults

Front 85

the cardiovascular system consists of two things?

Back 85

-heart, which is a muscular pump

-blood vessels, which provide pulmonary and systemic circulation

Front 86

The first heart sound (S1) results from

Back 86

closure of the atrioventricular valves. (AV)

Front 87

The second heart sound (S2) results from

Back 87

closure of the semilunar valves.

Front 88

is due to the vibration of ventricles that resist early, rapid filling;

Back 88

A third heart sound (S3)

Front 89

is due to the vibration of noncompliant ventricles when the atria contract and push blood into them;

Back 89

A fourth heart sound (S4)

Front 90

The heart ___ in response to an electrical current in its conduction system.

Back 90

contracts

Front 91

The cardiac impulse originates in the

Back 91

sinoatrial node (SA node)

Front 92

located in the groove between the trachea and the sternomastoid muscle. Its pulse closely coincides with ventricular systole.

Back 92

carotid artery

Front 93

give information about filling pressures and volume changes in the right side of the heart.

Back 93

jugular veins

Front 94

allows oxygenated blood from the placenta to be shunted to the left side of the heart and out to the general circulation.

Back 94

foramen ovale

Front 95

During pregnancy, blood volume increases by 30% to 40%, increasing the

Back 95

stroke volume

cardiac output

and pulse rate.

Front 96

with aging, there is an increase in ___, _____, and_____.

Back 96

-blood pressure

-dsyrhythmias

-ability to augment cardiac output is decreased

Front 97

The major risk factors for heart disease and stroke are

Back 97

high blood pressure

abnormal lipids

smoking

high cholesterol levels

abdominal obesity

and type 2 diabetes mellitus.

Front 98

vascular system consists of the vessels of the body, which transport fluid, such as

Back 98

blood or lymph

Front 99

impairs the delivery of oxygen and nutrients to the tissues and retards the elimination of carbon dioxide and waste products from cellular metabolism.

Back 99

any disease in the vascular system

Front 100

what is the function of veins?

Back 100

drain deoxygenated blood and waste products from the tissues and return blood to the heart

Front 101

Three mechanisms keep blood moving toward the heart

Back 101

contraction of skeletal muscles

pressure gradient

intraluminal valves

Front 102

capitence vessels are also known as

Back 102

veins

Front 103

Risk factors for venous stasis include

Back 103

standing or sitting too long

hypercoagulation

vein wall trauma

varicose veins

obesity

pregnancy

genetic predisposition.

Front 104

separate system that retrieves excess fluid and plasma proteins from the interstitial spaces and returns it to the bloodstreem

Back 104

lymphatic system

Front 105

three major functions of lymphatic system

Back 105

conserves fluid and plasma proteins that leak out of capillaries.

• it is a major part of the immune system that defends the body against disease.

• it absorbs lipids from the intestinal tract.

Front 106

filter fluid before it is returned to the bloodstream and remove harmful organism

Back 106

lymph node functions

Front 107

what three things aid the lymphatic system?

Back 107

The spleen, tonsils, and thymus.

Front 108

destroys old red blood cells, produces antibodies, stores red blood cells, and filters organisms from the blood.

Back 108

spleen

Front 109

what is the function of the tonsils in the lymphatic system?

Back 109

They respond to local inflammation.

Front 110

develops T lymphocytes in the immune system in children but atrophies after puberty.

Back 110

thymus

Front 111

in ____ lymph nodes are commonly palpable.

Back 111

children