1Disorders with Diastolic murmurs
Aortic regurgitation
• Pulmonic regurgitation
• Mitral valve stenosis
• Tricuspid valve stenosis
2Disorders with Systolic murmurs
• Mitral valve regurgitation
• Tricuspid valve regurgitation
• Aortic stenosis
• Pulmonic stenosis
• Ventral septal defect (VSD)
• Mitral valve prolapse (MVP)
3What is the best location to hear an S3 murmur?
Apex
4What is the best location to hear an S4 murmur?
Apex
5The NP student shows understanding of S3 murmurs when he states:
- They are common in healthy children
- Pathologic when heard in individuals 40 years and above
- Also known as ventricular gallop
6True or False: Early systolic murmurs begin at S1 and end before S2?
True
7Which chief complaint by a 4-year-old would prompt you to performing a focused heart assessment?
tires easily during play
8What is the recommended physical exam sequence for a 2-year-old with stranger anxiety?
Inspection, auscultation, palpation
9True or False: The bell of the stethoscope is ideal for hearing carotid artery bruits?
True
10True or False: Carotid venous hums in a 5-year-old is suggestive of a circulatory problem that requires immediate attention
false
11When performing a capillary refill on a 70-year-old woman, the NP student expects which normal finding?
cap refill between 3-5 sec.
12True or False: The incidence of thoracic aortic aneurysms is more than that of abdominal aortic aneurysms
false
13During auscultation of the heart, you hear a low pitched, early diastolic extra heart sound. You know this heart sound to be?
S3
14You know s3 heart sound to be indicative of?
Pathologic, likely indicative of heart failure
15What in the patient’s PMH (tobacco use, HLD, and atrial fibrillation) is the likely cause of the diagnosis (Acute arterial thromboembolism )?
Atrial fibrillation
Tobacco use
HLD
16During your assessment. Which response by the patient would suggest Atrial fibrillation is the likely cause of the problem?
A. “I ran out of my blood thinner 2 weeks ago”
17Diastolic murmur heard when?
between s2 and s1
18You know s4 heart sound to be indicative of?
Pathologic, likely hypertensive heart disease
19A 45-year-old man with PMH of tobacco use, HLD, and atrial fibrillation presents with sudden onset of right leg pain. During inspection, you notice his leg below the calf to be blue. Which problem are you MOST concerned about?
Acute arterial thromboembolism