Deck 15: Heart

Question 1

Your patient, who abuses intravenous (IV) drugs, has a sudden onset of fever and symptoms of congestive heart failure. Inspection of the skin reveals nontender erythematic lesions to the palms. These findings are consistent with the development of:

A) rheumatic fever.
B) cor pulmonale.
C) pericarditis.
D) endocarditis.

Answer 1

endocarditis.

Question 2

Chest pain with an organic cause in a child is most likely the result of:

A) cardiac disease.
B) asthma.
C) esophageal reflux.
D) arthritis.

Answer 2

asthma.

Question 3

In the adult, the apical impulse should be most visible when the patient is in what position?

A) Supine
B) Upright
C) Lithotomy
D) Right lateral recumbent

Answer 3

Upright

Question 4

Which of the following information belongs in the past medical history section related to heart and blood vessel assessment?

A) Adolescent inguinal hernia
B) Childhood mumps
C) History of bee stings
D) Previous unexplained fever

Question 5

If the apical impulse is more vigorous than expected, it is called a:

A) lift.
B) thrill.
C) bruit.
D) murmur.

Question 6

An apical PMI palpated beyond the fifth intercostal space may indicate:

A) decreased cardiac output.
B) obesity.
C) left ventricular hypertrophy.
D) hyperventilation.

Question 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.

Question 8

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.

Question 9

You are listening to a patient's heart sounds in the aortic and pulmonic areas. The sound becomes asynchronous during inspiration. The prevalent heart sound in this area is most likely:

A) S₁.
B) S₂.
C) S₃.
D) S₄.

Question 10

To hear diastolic heart sounds, you should ask patients to:

A) lie on their back.
B) lie on their left side.
C) lie on their right side.
D) sit up and lean forward.

Question 11

Mr. O, age 50 years, comes for his annual health assessment, which is provided by his employer. During your initial history-taking 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.

Question 12

A patient you are seeing in the emergency department for chest pain is believed to be having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of "heart trouble." The most important follow-up 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?"

Question 13

Your patient has been diagnosed with pericarditis. Which are signs and symptoms, or a precipitating factor? (Select all that apply.)

A) Sharp pain
B) Pain relieved by sitting up
C) Pain relieved by resting
D) Friction rub heard to right of sternum
E) History of kidney failure
F) Result of viral infection
G) Result of medications such as procainamide

Question 14

The most helpful finding in determining left-sided heart failure is:

A) dyspnea.
B) orthopnea.
C) jugular vein distention.
D) an S3 heart sound.

Question 15

A condition that is likely to present with dizziness and syncope is:

A) bacterial endocarditis.
B) hypertension.
C) sick sinus syndrome.
D) pericarditis.

Question 16

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.

Question 17

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