Findings for the heart

Which heart rate would be cause for concern if measured in a 19-year-old patient who regularly participates in track and football?

100 beats/min A young, well-conditioned athlete would usually have a lower heart rate, 60 beats/min or below, because the cardiac muscle has been strengthened through exercise to pump more forcibly at a slower rate.

Select the murmur that is low pitched and accompanied by an opening snap.

Diastolic rumble

The nurse would expect the first heart sound to be heard loudest at which location?

Mitral area The first heart sound (S1) signals the closure of the aortic and pulmonic valves and is heard loudest at the mitral or apex area.

Select the sound that results from high ventricular pressure and valvular stenosis.

Murmur

The nurse determines that the point of maximal impulse (PMI) occupies a radius of approximately 1 cm. What is the concern regarding this finding?

No concern

Which finding is expected on palpation of the epigastric region of the chest?

No palpable pulsations

Select the heart sound that occurs because of a delay in right ventricular depolarization and does not vary with respirations.

Pathologic splitting of the second heart sound (S2)

Which sound is caused by the irritation of the heart's parietal and visceral layers?

Pericardial friction rub

The nurse auscultates the heart sounds of a patient and identifies a split on inspiration that disappears on expiration. What does the nurse recognize this finding as?

Physiologic splitting

Which extra heart sound is caused by early, rapid ventricular filling at the beginning of diastole?

s3

Select the findings that represent the normal closure of the aortic and pulmonic valves.

"Dubb" sound The "dubb" sound, or the second heart sound (S2), is created by the closing of the aortic and pulmonic valves, marking the beginning of diastole.

Splitting of heart sounds is common in infants at birth and should disappear in hours.

48 hours

Which heart rates fall within the normal range for a sedentary 35-year-old patient?

60-100

On percussion, what does a change from a resonant to a dull sound indicate

Cardiac borders A change from a resonant to a dull sound during percussion identifies the location of the cardiac borders, which can be used to indicate cardiac size.

When the nurse auscultates the heart, the first heart sound (S1) is typically synchronous with which pulse?

Carotid

Match the heart sound with the associated cause.

Closure of the mitral and tricuspid valves -S1 Closure of the aortic and pulmonic valves -S2 Early filling of the ventricle with blood -S3 Mitral valve prolapse during mid-to-late systole -S4

An infant presents with cyanosis and a weak pulse in the femoral arteries. The nurse finds that the infant's capillary refill time is 3.5 seconds. Which disorder does the nurse suspect?

Coarctation of the aorta

Match the murmur with its characteristics.

Faint, heard after listener "tunes in" -Grade 1 Faint, heard immediately -Grade 2 Moderately loud with a thrill -Grade 5 Very loud, may be heard with the rim of the stethoscope -Grade 6

The apex of the heart may be found in which location in healthy infants?

Fourth to fifth intercostal space medial to the midclavicular line

Which murmur grade has a thrill, with a pitch that is very loud and can be heard with a stethoscope rim touching the chest?

Grade 5

Which response describes the quality of the ejection-type systolic murmur?

Harsh

Cyanosis that appears after the first month of life is an abnormal finding and indicates which condition?

Pulmonic stenosis Tetralogy of Fallot

Which findings are normal for the apical pulse?

Regular rhythm Rate of 60-100 beats/min Full and bounding Located at the apex

The normal rhythm of the heart can be described in which way?

Regular with a steady beat

Which assessment finding is normal for a 3-day old newborn on auscultation of the heart?

Sinus arrhythmia

What finding is indicated when an infant's heart rate increases during inspiration and decreases during expiration?

Sinus arrhythmia associated with a cycle of irregular rhythms, is a normal finding in infants.

Choose the description that matches the pitch and quality, respectively, of tricuspid regurgitation.

Soft and blowing

Which finding in a 6-week-old infant is cause for concern?

Sustained tachycardia

Which condition is suggested by cyanosis of the tongue and lips in a 1-month-old patient?

Tetralogy of Fallot