NURS 507 Exam 2: Study Guide Questions
(201 Terms) with Verified Solutions 2023-
2024.
Cardiovascular assessment includes: - Correct Answer: 1. Cardiac
vascular system
2. Peripheral vascular system
Cardia is performed with a __ exam. - Correct Answer: pulmonary exam
Peripheral vascular is done when ____. - Correct Answer: Examining the
extremities.
Chest Pain requires you to use... - Correct Answer: OPQRSTU pain scale
Cardiac Assessment (7) - Correct Answer: 1. Chest pain (at rest, with
exertion)
2. Dyspnea (at rest, with exertion)
3. Orthopnea (SOB when lying down)
4. Paroxysmal noctural dyspnea (PND)
5. Peripheral edema
6. Past cardiac history

7. Cardiac risk factors
Cardiac risk factors - Correct Answer: diabetes (#1 risk factor for CAD
and sudden cardiac death)
family history
smoking
obesity
First step: Inspect (4 steps) - Correct Answer: a. Lie px at 30 degrees
b. Look for pulsation (apical impulse b/t fourth and fifth rib) this is most
easily seen in children or thinner adults
c. Observe for a "heave" or a lift"
d. Inspect vessels of the neck

Never palpate __ carotid arteries at ___. - Correct Answer: Never
palpate both carotid arteries at the same time.
Second Step: Palpate (feel) (7 steps) - Correct Answer: a. palpate carotid
arteries one at a time
b. apical impulse (point of maximal impulse)
c. heaves/lifts
d. thrills
e. left lateral decubitus position may be useful
f. should occupy only one interspace (4th or 5th) midclavical line of just
medial
g. may not be palpable in various circumstances
Cardiac Ascultation mnemonic - Correct Answer: "All Patients Eagerly
Take Meds"
"All physicians enjoy taking money"
A-Aortic area

P- pulmonic area
E- Erb's point
T- tricuspid area
M- mitral apex
How many heart tones are there? - Correct Answer: Five heart tones
Aortic area - Correct Answer: second intercostal space along right
sternal border
Pulmonic area - Correct Answer: second intercostals space at left
sternal border
Erb's point - Correct Answer: third intercostal space at left sternal
border
Tricuspid area - Correct Answer: fifth intercostal space along the left
sternal border

mitral area - Correct Answer: fifth intercostal space, midclavical line.
This is where the PMI is found. Known as th point of maximal impulse.
note: with enlarged hearts mitral area may present at anterior axillary
line
Auscultation of Heart (2 types) - Correct Answer: 1. S1 and S2 heart
sounds (use diaphragm at areas of A, P, E, T, M) and listen for "lub"
"dub" or S1, S2 sound
2. Apical pulse (left of sternum, b/t 4th and 6th ICS at MCL. 30 sec if
regular, 60 sec if irregular)
S1 - Correct Answer: closure of mitral, tricuspid valves.
beginning of systole

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Carotid arteries (ascultate) - Correct Answer: listen with bell over each
artery for bruits (noise due to turbulence that sounds like a cat purring).
Murmurs - Correct Answer: for now, only try to describe whern they
occur.
Normal Cardiac Assessment - Correct Answer: No chest pain/pressure
or SOB
No pulsations, heaves, or lifts
Apical impulse in 4th of 5th ICS at MCL
No thrill
Rate 60-100 bpm (athletes might be 40-60)
Normal S1 and S2

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No extra heart sounds
Cardiac documentation - Correct Answer: "no heaves or lifts. Apical
impulse palpated at 5th ICS at left MCL. Regular rate and rhythm.
Normal S1 and S2. No S3 and S4, murmurs, clicks or rubs."
Age related cardiac considerations - Correct Answer: Rate faster in
children and can quicken or slow in the respiratory cycle
S3 and innocent murmurs common in kids
"venous hum" common in children due to turbulent blood flow in
jugular venous sys.
Systolic murmurs common in older adults due to aortic sclerosis
Cardiac Assessment "pearls" - Correct Answer: - take your time

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- concentrate on one heart sound at time
- don't press too hard on stethoscope
- feel peripheral pulse while osculating in order to verify which sound is
s1
- to differntiate b/t pleural friction rub and pericardial friction rub, have
px. hold their breath. If you hear something, then it is a pericardial rub.
If not, then pleural.
Peripheral Vascular Asssessment (4) - Correct Answer: 1. leg
pain/cramping
2. leg swelling
3. changes in the skin
4. non-healing sores
PVA: Arterial System (inspect) - Correct Answer: skin shows signs of
insufficiency

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2- normal
3-full (sometimes seen in pregnant women)
4- bounding
Assess peripheral vasculature - Correct Answer: nail bed color, shape,
configuration
look for cyanosis and clubbing
Capillary refill test - Correct Answer: should be less than 3 seconds after
blanching
1. pressure applied to nail bed until it turns white
2. blood returned to tissue
PVA: venous - Correct Answer: inspect, palpate
-skin for insufficiency
- variscosities

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Edema is graded: 0-4 (+)
EDEMA Scale - Correct Answer: Assess by placing thumb over dorm of
the foot or tibia for 5 seconds
0- no edema
1+: barely discernible depression
2+: a deeper depression (<5mm) w/ normal foot an leg contours
3+: deep depression (5-10mm) with foot and leg swelling
4+: more than 1cm with severe foot and leg swelling
Vernous Stasis - Correct Answer: Scalling, redness, skin taunt and shiny,
possible ulcerations.
"venous stasis ulcers"

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What does the lymphatic system do? - Correct Answer: part of
circulatory that transports excess interstitial fluid back into the
bloodstream.
it actively filters microorganisms and prevents unwanted substances
from re-entering the bloodstream.
What is the third vascular system? - Correct Answer: The Lymphatic
system
What are you looking for? - Correct Answer: thousands of nodes that
are part of hematological and immune system
inflammation of the nodes can be indicative of infection
Unilateral lymph node enlargement is indicative of what? - Correct
Answer: neoplasm (cancer)

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PV Documentation - Correct Answer: "No clubbing, cyanosis, or edema.
No varicosities. Capillary refill less than 3 seconds. Pulses 2+ and
symmetric. No thrills or bruits."
Age- related PV considerations - Correct Answer: kids w/ congenital
heart disease may inhibit cyanosis or clubbing in toes/fingers
older adults more apt. to have changes associated with arterial and or
venous insufficiency
older adults have have weaker pulses and bruits due to atherosclerotic
disease
Peripheral Assessment "Pearls" - Correct Answer: always look of
symmetry
check for edema over BONY PROMINENCES (ex. medial malleolus)

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2023-2024 NURS507 Cardiovascular Study Guide With Answers (201 Solved Questions)

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