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NUR524 Exam 2 Questions And 100% Correct Answers

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NUR524 Exam 2 Questions And 100% Correct Answers...

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  • September 30, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • NUR524
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NUR524 Exam 2 Questions And 100%
Correct Answers

Normal PMI? In cardiomegaly? - Answer Midclavicular 5th intercostal space

In Cardiomegaly displaced to the left



What should you tell your patient to do when assessing for carotid bruits? - Answer Hold
breath



S1 - Answer Closure of AV valves when ventricular pressure exceeds atrial pressures at
beginning of systole

Corresponds with pulse

Best heard at apex



S2 - Answer Closure of semilunar valves

Normally split because Aortic valve closes before Pulmonic valve

Closure pressure on left is 80mmHg compared to 10 on right

Normal for split to widen during inspiration d/t increased RV filling from negative
intrathoracic pressure



S3 - Answer Transition from rapid to slow ventricular filling in early diastole. May be
normal in children

Best heard with bell

Can be caused by poor systolic dysfunction or poor myocardial contracility such as CHF



S4-Answer Abnormal late diastolic sound caused by forcible atrial contraction in the
presence of decreased ventricular compliance

,Best heard with bell (Higher pitch than S3)

Caused by diastolic dysfunction or poor myocardial relaxation (Compliance) such as in
recurrent MI, uncontrolled HTN



Pathologic Wide Split S2-Answer Best heard in pulmonic region

RV volume overload such as ASD, and is usually fixed with no difference in inspiration or
expiration

RV outflow obstruction such as pulmonary stenosis

Delayed RV depolarization such as complete RBBB



Pathologic Narrow Split S2 - Answer Pulmonary HTN as valve closes earlier d/t high
pulmonary resistance

Mild-moderate aortic stenosis as closure of valve is delayed



Pathologic Single S2 - Answer May occur if one SL valve is missing (Pulmonary/Aortic
atresia or truncus arteriosus)

If both valves close simulatenously as in Pulmonary HTN with equal pulmonary and
aortic pressures OR in double outlet single ventricle OR in large VSD with equal
ventricular pressures



Paradoxical split S2 - Answer Caused by pulmonary valve closure before aortic valve
closure; Greater with expiration

Occurs in severe aortic stenosis



What are the most common types of degenerative valvular heart disease - Answer Aortic
stenosis and mitral regurgitation



Grades of Intensity of murmurs - Answer Grade 1: Faintly audible with stethoscope,
special attention to hear

grade 2: Soft but easily detectable

Grade 3: Easily detected, but not loud

,Grade 4: Loud with associated thrill palpable

Grade 5: Very loud

Grade 6: Without use of stethoscope



What determines the Frequency of a murmur - Answer Rates of blood flow

Lower and slower flow -> Lower frequency

Higher and faster flow -> Higher frequency



Contour of murmur - Answer Configuration of murmur concerning its audibility

Crescendo, decrescendo, flat, or crescendo-decrescendo



Duration of murmurs - Answer Duration of systole or diastole

Mid-systolic, holo-diastolic, pan-systolic



Timing of murmurs - Answer Systolic murmurs start with or shortly after S1 and
terminate before or at S2

The diastolic murmurs start with or shortly after S2 and terminate before or at S1



What do murmurs in the aortic auscultation area indicate - Answer Pathology of the atria
ventricular or left ventricular outflow tracts

Aortic stenosis, aortic regurgitation, hypertrophic cardiomyopathy



What do murmurs in the pulmonic area indicate - Answer Tend to be quiet

Pathology of the pulmonic valve such as a PDA.

Further supported if intensity varies with respiration



What does murmurs in Erb's point indicate

, Answer Murmurs in this location are sometimes louder if the patient leans forward



Diastolic murmurs of R atrium and many pulmonic and aortic murmurs



What does murmurs in the tricuspid area indicate



Answer Systolic murmurs indicate pulmonic stenosis or tricuspid regurgitation

Diastolic murmurs indicate tricuspid stenosis or pulmonic regurgitation



What do murmurs in the mitral/apex area indicate - Answer Systolic murmurs indicate
mitral regurg, aortic outflow obstruction, or VSD.

Diastolic murmurs indicate mitral stenosis or aortic regurgitation; Mitral stenosis is
ONLY heard at apex and is accompanied by opening snap sound



Aortic Stenosis murmur - Answer a systolic ejection-type, harsh
crescendo-decrescendo murmur

Heard best RSB 2nd intercostal space

Delayed carotid upstroke, narrowed pulse pressure, systolic thrill

ECG findings: LAE, Left axis deviation, LVH



Pulmonary stenosis murmur - Answer Ejection systolic murmur with variable intensity;
Harsh crescendo-decrescendo

3rd and 4th LIS down left sternal border

Heard best at 2nd ICS LSB; S1 and split S2

Increased with valsalva

ECG: Right axis deviation, increased P-wave amplitude

XR: Dilated pulmonary trunk or a main pulmonary artery (Congenital)



Mitral Valve Regurgitation murmur - Answer Pansystolic blowing

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