Exam 20: Heart and Neck Vessels

Which sequence does the electrical stimulus of the cardiac cycle follow?

During cardiac auscultation,the nurse hears a sound occurring immediately after S₂ at the second left intercostal space.What would the nurse do to further assess this sound?

While counting the apical pulse in a 16-year-old patient,the nurse notes an irregular rhythm.His rate speeds up on inspiration and slows on expiration.What would the nurse do next?

The nurse is performing cardiac assessment on a 65-year-old patient 3 days after the patient had a myocardial infarction.Heart sounds are normal when she is supine,but while the patient is sitting and leaning forward,the nurse hears a high-pitched,scratchy sound at the apex with the diaphragm of the stethoscope.The sound disappears on inspiration.The nurse suspects:

A 45-year-old man is in the clinic for "a routine physical." During history-taking,the patient states he has been having difficulty sleeping."I'll be sleeping great,and then I wake up and feel like I can't get my breath." The nurse's best response to this would be:

A 30-year-old woman with a history of mitral valve problems states that lately she has been "very tired." She has started waking up at night and feels like her "heart is pounding." During assessment,the nurse identifies a thrill and lift at the fifth left intercostal space midclavicular line.In the same area,the nurse also identifies a blowing,swishing sound right after S₁.These findings would be most consistent with:

In assessing a patient's major risk factors for heart disease,which of the following would the nurse want to include in the history?

While auscultating for heart sounds,which sequence would the nurse use?

When listening to heart sounds,the nurse is aware that the valve closures that can be heard best at the base of the heart are:

The nurse is assessing a patient suspected to have cardiomyopathy and is evaluating the hepatojugular reflux.If heart failure is present,what would the nurse find while pushing on the right upper quadrant of the patient's abdomen,just below the rib cage?

During assessment of a healthy adult,where would the nurse palpate for the apical impulse?

Which of the following describes the closure of the valves in a normal cardiac cycle?

During inspection of the precordium of an adult patient,the nurse notices the chest moving in a forceful manner along the fourth-to-fifth left intercostal space at the midclavicular line.This finding most likely suggests:

In percussing the left cardiac border,the nurse would expect to hear dullness at the:

Assessment of a 70-year-old patient with swelling in his ankles reveals jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees.The nurse is aware that this indicates:

The vital signs of a 70-year-old patient with a history of hypertension are BP 180/100 mm Hg and HR 90 bpm.The nurse hears an extra heart sound at the apex immediately before S₁.The sound is heard only with the bell while patient is in the left lateral position.With these findings and the patient's history,the nurse knows that this extra heart sound is most likely:

Which of the following would the nurse expect to find during cardiac assessment of a 4-year-old child?

During assessment of a patient,the nurse notes that the apical impulse is displaced laterally and is palpable over a wide area.This indicates:

During cardiovascular assessment,the nurse is aware that S₄ is:

During precordial assessment of a woman who is 8 months pregnant,the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line.This would indicate: