Exam View - Chapter 15 PDF

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Chapter 15: Heart Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. Mr. O, age 50 years, comes for his annual health assessment, which is provided by his employer. During

interview, Mr. O mentions that he routinely engages in light exercise. At this time, you should: a. ask if he makes his own bed daily. b. have the patient describe his exercise. c. make a note that he walks each day. d. record “light exercise” in the history. ANS: B

When Mr. O says that he engages in light exercise, have him describe his exercise. To qualify his use of type, length of time, frequency, and intensity of his activities. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 2. Which of the following information belongs in the past medical history section related to heart and blood a. Adolescent inguinal hernia b. Childhood mumps c. History of bee stings d. Previous unexplained fever ANS: D

Previous unexplained fever should be included in the past medical history of a heart and blood vessel as may be related to acute rheumatic fever, with potential heart valve damage. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 3. A patient you are seeing in the emergency department for chest pain is believed to be having a myocardi

health history interview of his family history, he relates that his father had died of “heart trouble.” The m question you should pose is which of the following? a. “Did your father have coronary bypass surgery?” b. “Did your father’s father have heart trouble also?” c. “What were your father’s usual dietary habits?” d. “What age was your father at the time of his death?” ANS: D

A family history of sudden death, particularly in young and middle-aged relatives, significantly increase occurrence. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 4. Which one of the following is a common symptom of cardiovascular disorders in the older adult? a. Fatigue b. Joint pain c. Poor night vision d. Weight gain ANS: A

Common symptoms of cardiovascular disorders in older adults include confusion, dizziness, blackouts, coughs and wheezes, hemoptysis, shortness of breath, chest pains or tightness, impotence, fatigue, and l DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 5. In the adult, the apical impulse should be most visible when the patient is in what position? a. Supine

b. c. d.

Upright Lithotomy Right lateral recumbent

ANS: B

6. If the apical impulse is more vigorous than expected, it is called a: a. lift. b. thrill. c. bruit. d. murmur. ANS: A

If the apical impulse is more vigorous than expected, it is referred to as a lift or heave. A thrill is a palpa auscultated arterial murmur. A murmur is an auscultated sound caused by turbulent blood flow into, thro DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 7. A palpable rushing vibration over the base of the heart at the second intercostal space is called a: a. heave. b. lift. c. thrill. d. thrust. ANS: C

A thrill is a fine, palpable, rushing vibration—a palpable murmur. Cardiac thrills generally indicate a dis blood flow related to some defect in the closure of one of the semilunar valves (generally aortic or pulm hypertension, or atrial septal defect. A heave or lift is a more vigorous apical impulse. A lift is another te more vigorous apical impulse. A thrust is sudden, forcible forward movement. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. An apical PMI palpated beyond the fifth intercostal space may indicate: a. decreased cardiac output. b. obesity. c. left ventricular hypertrophy. d. hyperventilation. ANS: C

An apical impulse that is more forceful and widely distributed, fills systole, or is displaced laterally and indicative of left ventricular hypertrophy. Obesity, large breasts, and muscularity can obscure the visibil DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. A lift along the left sternal border is most likely the result of: a. aortic stenosis. b. atrial septal defect. c. pulmonary hypertension. d. right ventricular hypertrophy. ANS: D

A lift along the left sternal border may be caused by right ventricular hypertrophy. A thrill indicates a di blood flow related to a defect in the closure of one of the semilunar valves, which is seen in aortic or pul hypertension, or atrial septal defect. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. To estimate heart size by percussion, you should begin tapping at the: a. anterior axillary line. b. left sternal border. c. midclavicular line. d. midsternal line. ANS: A

Estimating the size of the heart can be done by percussion. Begin tapping at the anterior axillary line, mo intercostal spaces toward the sternal border. The change from a resonant to a dull note marks the cardiac

DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation...