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NUR 614 EXAM 2024/2025 QUESTIONS AND ANSWERS GRADED A+, Exams of Nursing

NUR 614 EXAM 2024/2025 QUESTIONS AND ANSWERS GRADED A+ Where is the heart in the body? In the mediastinum, behind and left of the sternum, above the diaphragm between the lungs and the Upper portion of heart called what? Base Lower portion of heart called what? Apex What are the layers of the heart? pericardium, epicardium(outer), myocardium (heart muscle), endocardium (inner layer) What are the two atrioventricular valves? Tricuspid and mitral

Typology: Exams

2024/2025

Available from 06/23/2025

LennieDavis
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NUR 614 EXAM 2024/2025 QUESTIONS AND
ANSWERS GRADED A+
Where is the heart in the body?
In the mediastinum, behind and left of the sternum, above the diaphragm between
the lungs and the
Upper portion of heart called what?
Base
Lower portion of heart called what?
Apex
What are the layers of the heart?
pericardium, epicardium(outer), myocardium (heart muscle), endocardium (inner
layer)
What are the two atrioventricular valves?
Tricuspid and mitral
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NUR 614 EXAM 2024/2025 QUESTIONS AND

ANSWERS GRADED A+

Where is the heart in the body?

In the mediastinum, behind and left of the sternum, above the diaphragm between the lungs and the

Upper portion of heart called what?

Base

Lower portion of heart called what?

Apex

What are the layers of the heart?

pericardium, epicardium(outer), myocardium (heart muscle), endocardium (inner layer)

What are the two atrioventricular valves?

Tricuspid and mitral

What are the two semilunar valves?

Pulmonic and aortic valves

What is the electrical activation cycle?

Sa node, AV node, Bundle of HIS, Left and right bundle branches, Purkinje fibers

What does P-wave stand for?

Atrial depolarization

What does PR interval?

Atrioventricular conduction

What is QRS complex

Ventricular depolarization

What is ST segment and T wave

blood volume increases, heart works harder (HR, BP ankle edema)

special considerations for geriatrics

heart size decreases as we age

LV thickens

valve calcification

decrease in pacemaker

delayed myocardium contactility

Birth through first few months or no anxiety whats the assessment order?

inspection, palpation, auscultation,

older infant- 3 years or fearful/anxious, what's the assessment order?

inspection, auscultation, palpation

3 years- adolescent or cooperative, whats the assessment order?

inspection, palpation, and auscultation

For CV assessment what are some things we inspect for?

apical impulse, nail beds, respiration and effort, skin

expected findings for percussing precordium

-no change in tone before right sternal border

-loss of resonance close to PMI at 5th ICS

-loss of resonance may outline left border of heart at 2th to 5th ICS

V

ventricular gallop

normally quiet, if heard can indicate increased filling pressures, best heard at apex

NORMAL in children

PATHOLOGIC in >40 years of age

AD

S

atrial gallop

quiet, pathologic if hear

best heard at apex

12-14 hours after birth

Why does the interatrial foramen ovale close?

due to shifting pressures in right and left side of the heart

special consideration of aging of the ateries

arterial walls thicken and elasticity is lost, they are stiffer and less resilient

signs of venous insufficiency

changes in skin color (blue, pale), ulcers, varicosity

signs of arterial insufficiency

shiny skin on legs, skin color changes, slower growth of nails, hair loss or slower hair growth on the legs, wounds that won't heal

AD

Cap refil in NB-7 days old and in children

<2 sec

Cap refill in adults

<3secs

Cap refil in older adults

3 secs but <5 seconds

Special consideration in pediatrics of ausculation

venous hum is often heard, nonpathological if low pitched, continuous, and louder during diastole

How to check for JVD

recline patient at 45-degree angle

observe both jugular veins

measure vertical distance between midaxillary line and highest level of JVD

What is the expected finding of JVD?

AD

What are some characteristics of a murmur in pediatrics that indicate structural heart disease?

normally holosystolic, diastolic, grade 3+, associated with systolic click, increased intensity when standing and harsh quality

Ventricle Septal Defect

opening between L and R ventricles

arterial pulse is small and JVD not affected

Holosystolic murmur in pediatric patients

loud, coarse, high pitched

Tetralogy of Fallot

Four defects: VSD, pulmonic stenosis, dextroposition of the aorta, R ventricular hypertrophy

Systolic ejection murmur

3rd intercostal space, can radiate to L neck, S

Patent ductus arteriosus

when the heart's foramen ovale and ductus arteriosus do not close, common in < weeks

large PDA

"machine like murmur" very harsh and 1-2 intercostal space/lower sternal border

Atrial Septal Defect (ASD)

congenital defect in septum between L and R atria

Rheumatic fever

fever, inflamed swollen joints, erythema marginatum, chorea, small painless nodules under the skin, CP, palpitations, fatigue, SOB, murmurs of mitral regurg and aortic insufficiency, cardiomegaly, pericarditis friction rub, signs of CHF

Kawasaki Disease

costovertebral angle

GI assessment- on the back

What does McBurney's point indicate?

appendicitis

How long is it ok for a child's stomach to protrude?

until 5 years old

Pyloric stenosis what and where is is noted in pediatrics?

olive shaped mass, RUQ

projectile vomiting, eager feeding after, failure to gain weight, peristalsis wave (L to R), need for ultrasound and surgical consult

Intussusception

sausage shaped mass, RUQ

Hischsprung

midline, suprapubic mass

most common cause of lower intestinal obstruction in newborns

megacolon

failure to pass meconium in 24-48 hours, absence of peristalsis, constipation, distension, bilious vomiting, diarrhea

older infant/child: constipation

Constipation

soft mass is LLQ

Meconium Ileus

failure to pass meconium in the first 24 hours, can be first sign of CF, vomiting, abdominal distension, if with volvulus (can be present in shock), hyperosmolar enemas under fluoroscopic guidance,

Biliary Atresia

postnatal-usually viral

Embryonic-genetic mutation

clay colored stools, dark urine

may have failure to gain weight

Jaundice

firm, fixed, nontender, irregular, nodular, crosses midline, imaging: calcified mass with hemorrhaging

Wilms Tumor

painless mass in abdomen often found while bathing child

abd pain, vomiting, hematuria

firm nontender, deep, does not cross midline, may be bilateral, HTN may be present

spurling test

tests cervical spine, identify if nerve root is being compressed. Passively extend and rotate patients neck to affected side, apply axial pressure, pain radiating to arm on same side of test is positive, dont preform in acute trauma

extension-rotation test

used to eliminate facet joint etiology, move patient into cervical extension, then laterally flex, and rotate to same side, considered positive if maneuver increases pain or causes numbness or tingling on side of neck being tested

Straight leg raise

test identified lumbar radiculopathy, patient lies supine, lift one leg at a time to 90 degrees, test positive if pain between 30 and 70 degrees of hip flexion that radiates below the knee

Valsalva maneuver

test identifies pain coming from cervical canal, patient sitting, take deep breath and bear down, localized or radioulnar pain is postive test

Shoulder tests

Hawkins-kennedy test

Neer test

Empty can test

drop arm test

external rotation resistance test

Hawkins Kennedy test

test identify shoulder impingement, while holding elbow at 90 degrees with one hand and wrist in other flex shoulder to 90 degrees then internally rotate, pain and apprehension is positive

test identify lateral epicondylitis or tennis elbow, with elbow stabilized and hand pronated and in a fist, have patient extend their wrist against resistance, pain over lateral epicondyle is considered postive

Golder elbow test

identify medial epicondylitis, with elbow stabilized, have patient supinate their hand and close their fist. next have patient flex their wrist against resistance, pain over epicondyle is considered positive test

Varus stress test

test identify injury to radial(lateral) collateral ligament of the elbow, with wrist stabilized, apply a varus force to medial side of elbow while flexed to 20 or 30 degrees, pain or excess motion compared to contralateral side is positive

valgus stress test

test identify ulnar (medial) collateral ligament injury of the elbow, with elbow flexed to 20 or 30 degrees and wrist stabilized, apply valgus force to lateral elbow, pain or excess motion compared to contralateral side is positive

Tinel's sign

test identify compression of the ulnar nerve. with elbow relaxed and the wrist supported, tap the ulnar nerve as it courses through the ulnar notch. tingling or pain along ulnar distribution is postive

Phalen's test

test for hands and wrist, can detect carpal tunnel syndrome , have patient sit with dorsum of their hand touching in maximal wrist flexion for one minute, numbness or tingling in median nerve distribution is postive

Hip tests

FABER test, log roll, thomas test, trendelenburg test

FABER test

test identifies hip, stands for flexion, abduction, and external rotation

Log roll

test looks at hip but particularly symptomatic arthritis, with patient supine, hold the ankle or knee and passively internally and externally rotate leg, pain in groin is positive test