Discussion: systolic or diastolic murmur
Discussion: systolic or diastolic murmur
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Question 4 Question : How should you determine whether a murmur is systolic or diastolic?
Palpate the carotid pulse
Palpate the radial pulse
Judge the relative length of systole and diastole by auscultation
Correlate the murmur with a bedside heart monitor
Question 5 Question : A 78-year-old retired seamstress comes to the office for a routine check-up You obtain an electrocardiogram (ECG) because of her history of hypertension You diagnose a previous myocardial infarction and ask her if she had any symptoms related to thisWhich of the following symptoms would be more common in this patient’s age group for an AMI?
Chest pain
Syncope
Pain radiating into the left arm
Pain radiating into the jaw
Question 6 Question : On examination, you find a bounding carotid pulse on a 62-year-old patient Which murmur should you suspect?
Mitral valve prolapse
Pulmonic stenosis
Tricuspid insufficiency
Aortic insufficiency
Question 7 Question : Which of the following correlates with a sustained, high-amplitude point of maximal impulse (PMI)?
Hyperthyroidism
Anemia
Fever
Hypertension
Question 8 Question : A 68-year-old woman with hypertension and diabetes is seen by the nurse practitioner for a dry cough that worsens at night when she lies in bed She has shortness of breath, which worsens when she exerts herself The patient’s pulse rate is 90/min and regular The patient has gained 6 lbs over the past two months She is on a nitroglycerine patch and furosemide daily The explanation for her symptoms is:
Kidney failure
Congestive heart failure
Angiotensin-converting enzyme (ACE) inhibitor induced coughing
Thyroid disease
Question 9 Question : When listening to a soft murmur or bruit, which of the following may be necessary?
Asking the patient to hold their breath
Asking the patient in the next bed to turn down the TV
Checking your stethoscope for air leaks
All of the above
Question 10 Question : You notice a patient has a strong pulse and then a weak pulse This pattern continues Which of the following is likely?
Emphysema
Asthma exacerbation
Severe left heart failure
Cardiac tamponade
