27 Dec It is a vascular noise.
Module 4 midterm
How should you determine whether a murmur is systolic or diastolic?
Palpate the carotid pulse
Palpate the radial pulse
Judge the relative length of systole and diastole by auscultation
Correlate the murmur with a bedside heart monitor
Common or concerning symptoms to inquire about in the General Survey and vital signs include all of the following except _________________.
changes in weight
fatigue and weakness
fever and chills
Mrs. Anderson presents with an itchy rash which is raised, and which appears and disappears in various locations. Each lesion lasts for many minutes. What most likely accounts for this rash?
Urticaria or hives
Steve has just seen a 5-year-old girl who wheezes when exposed to cats. The patient s family history is positive for asthma. You think the child most likely has asthma. What have you accomplished?
You have tested your hypothesis
You have developed a plan
You have established a working diagnosis
You have created a hypothesis
You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely?
You notice a strong pulse and then a weak pulse. The pattern continues. Which of the following is most likely?
Severe left heart failure
Where is the point of maximal impulse (PMI) normally located?
In the left intercostal space, 7 to 9 cm lateral to the sternum
In the 5th intercostal space, 10 to 12 cm lateral to the sternum
In the 5th intercostal space, in the anterior axillary line
In the 5th intercostal space, in the mid-axillary line
Sudden, painful unilateral loss of vision may be caused by which of the following conditions?
Central retinal artery occlusion
Which of the following lists the proper sequence of examination for the abdomen?
Auscultation, inspection, palpation, percussion
Inspection, percussion, palpation, auscultation
Inspection, auscultation, percussion, palpation
Auscultation, percussion, inspection, palpation
Which valve lesion typically produces a murmur of equal intensity throughout systole?
You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation?
You are palpating the apical impulse in a patient with heart disease and find that the amplitude is diffuse and increased. Which of the following conditions could be a potential cause of an increase in the amplitude of the impulse?
Aortic stenosis, with pressure overload of the left ventricle
Mitral stenosis, with volume overload of the left atrium
Which of the following may be missed unless the patient is placed in the left lateral decubitus position and auscultated with the bell of the stethoscope?
Mitral stenosis murmur
Opening sap of the mitral valve
S3 and S4 gallops
All the above
You are conducting a workshop on the measurement of jugular venous pulsation. As part of your instruction, you tell the students to make sure that they can distinguish between jugular venous pulsations and the carotid pulse. Which one of the following characteristics is typical of the carotid pulse?
Soft, rapid, undulating quality
Pulsation eliminated by light pressure on the vessel
Level of pulsation changes with changes in position
Which area of the fundus is the central focal point for incoming images?
The optic disk
The physiologic cup
Asymmetric blood pressure results (left versus right sides of the body) are seen in which of the following conditions?
Coronary Artery Disease
Congenital narrowing of the aorta
Vasculitis as seen in systemic lupus erythematosus
Which lung sound possesses the characteristics of being louder and higher in pitch, with a short silence between inspiration and expiration, and with expiration being longer than inspiration?
Which of the following is true of a grade 4-intensity murmur?
It is moderately loud.
It can be heard with the stethoscope off the chest
It can be heard with the stethoscope partially off the chest
It is associated with a “thrill”
What is responsible for the inspiratory splitting of S2?
Closure of aortic and then the pulmonic valves
Closure of mitral and then the tricuspid valves
Closure of aortic and then the tricuspid valves
Closure of mitral and then the pulmonic valves
Which of the following events occurs at the start of diastole?
Closure of the tricuspid valve
Opening of the pulmonic valve
Closure of the aortic valve
Production of the first heart sound S1
Which of the following is consistent with good percussion technique?
Allow all of the fingers to touch the chest while performing percussion
Maintain a stiff wrist
Leave the plexor finger on the pleximeter after each strike
Strike the pleximeter over the distal interphalangeal joint
Which of the following is consistent with the obturator sign?
Pain distant from the site used to check rebound tenderness
Right hypogastric pain with the right hip and knee flexed and the hip internally rotated
Pain with extension of the right thigh while the patient is on her left side or while pressing her knee against your hand with thigh flexion
Pain that stops inhalation in the right upper quadrant
A patient presents for evaluation of a sharp aching chest pain which increases with breathing. Which anatomic area would you localize the symptoms to?
Which of the following occurs in respiratory distress?
Speaking in sentences of 10 to 20 words
Skin between the ribs moves inward with inspiration
Neck muscles relaxed
Patient torso leans posteriorly
Which of the following conditions would produce a hyperresonant percussion note?
The components of the health history include all of the following except which one?
Review of systems
Thorax and lungs
Personal and social items
A patient comes to the emergency room for evaluation of shortness of breath. To which anatomical region would you assign symptoms?
You ask a patient to draw a clock. He fills in all the numbers on the right half of the circle. What do you suspect?
Oppositional defiant disorder
Cody is a teenager with a history of leukemia and an enlarged spleen. Today, he presents with fairly significant left-upper quadrant pain. On examination of this area, a rough grating noise is heard. What is this sound?
It is a splenic rub.
It is a type of bowel noise.
It represents borborygmi.
It is a vascular noise.
Which of the following is a “red flag” regarding patients presenting with headache?
Pain over the sinuses
Age over 50
Phonophobia and photophobia
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