Discussion: Systolic or Diastolic Assignment
Module 4 midterm Question 1 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 Question 2 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 cough fever and chills Question 3 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? Insect bite Urticaria or hives Psoriasis Purpura Question 4 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 Question 5 You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely? Arterial insufficiency Neuropathic ulcer Venous insufficiency Trauma Question 6 You notice a strong pulse and then a weak pulse. The pattern continues. Which of the following is most likely? Emphysema Asthma exacerbation Severe left heart failure Cardiac tamponade Question 7 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 Question 8 Sudden, painful unilateral loss of vision may be caused by which of the following conditions? Vitreous hemorrhage Central retinal artery occlusion Macular degeneration Optic neuritis Question 9 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 Question 10 Which valve lesion typically produces a murmur of equal intensity throughout systole? Aortic stenosis Mitral insufficiency Pulmonic stenosis Aortic insufficiency Question 11 You are performing a thorough cardiac examination. Which of the following chambers of the heart can you assess by palpation? Left atrium Right atrium Right ventricle Sinus node Question 12 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? Hypothyroidism Aortic stenosis, with pressure overload of the left ventricle Mitral stenosis, with volume overload of the left atrium Cardiomyopathy Question 13 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 Question 14 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? Palpable Soft, rapid, undulating quality Pulsation eliminated by light pressure on the vessel Level of pulsation changes with changes in position Question 15 Which area of the fundus is the central focal point for incoming images? The fovea The macula The optic disk The physiologic cup Question 16 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 Diffuse atherosclerosis Vasculitis as seen in systemic lupus erythematosus Question 17 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? Bronchovesicular Vesicular Bronchial Tracheal Question 18 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” Question 19 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 Question 20 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 Question 21 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 Question 22 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 Question 23 A patient presents for evaluation of a sharp aching chest pain which increases with breathing. Which anatomic area would you localize the symptoms to? Musculoskeletal Reproductive Endocrine Urinary Question 24 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 Question 25 Which of the following conditions would produce a hyperresonant percussion note? Large pneumothorax Lobar pneumonia Pleural effusion Empyema Question 26 The components of the health history include all of the following except which one? Review of systems Thorax and lungs Present illness Personal and social items Question 27 A patient comes to the emergency room for evaluation of shortness of breath. To which anatomical region would you assign symptoms? Reproductive Urinary Cardiac Hematologic Question 28 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? Hemianopsia Fatigue Oppositional defiant disorder Depression Question 29 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. Question 30 Which of the following is a “red flag” regarding patients presenting with headache? Unilateral headache Pain over the sinuses Age over 50 Phonophobia and photophobia
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