Nokea
The acronym PMI stands for what? Which means what?
- A. Point of maximum impulse, strongest heart beat
- B. Pulse measurement index, pulse strength
- C. Primary medical inspection, initial assessment
- D. Point of mitral intensity, mitral valve sound
Correct Answer: A
Rationale: PMI stands for 'point of maximum impulse,' the location where the heart's apex beat is strongest, typically at the 5th intercostal space.
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You know that when assessing the pulse there is more than one characteristic you should assess. Which of the following best identifies the characteristics you must assess?
- A. Rate, rhythm, and strength
- B. Rate, volume, and strength
- C. Regularity and number of beats per minute
- D. Site of PMI, rate, and strength
Correct Answer: A
Rationale: Pulse assessment includes rate (beats per minute), Rhythm (regular or irregular), and strength (force of the pulse).
You are caring for a patient with mitral valve stenosis. You plan to assess the mitral valve during your initial assessment. Where will you be best able to auscultate the mitral valve?
- A. The right base of the heart
- B. The left base of the heart
- C. The apex of the left ventricle
- D. The left lateral sternal border
Correct Answer: C
Rationale: The mitral valve is best heard at the apex of the left ventricle, typically in the 5th intercostal space, midclavicular line.
The off-going nurse reported to you that one of your patients had been having an irregular pulse for several hours. You plan to assess this patient's heart rate carefully during your initial patient rounds at the beginning of your shift. Which of the following would be the most accurate way to do this?
- A. Palpate a radial pulse in both wrists for 30 seconds
- B. Auscultate the apical pulse for 60 seconds
- C. Take a second nurse with you to palpate the radial pulse at the same time that you auscultate the apical pulse for 60 seconds
- D. Palpate the PMI for a full minute
Correct Answer: B
Rationale: Auscultating the apical pulse for 60 seconds provides the most accurate heart rate, especially for irregular rhythms.
Select the symptom(s) from this list of assessment findings.
- A. Flushing
- B. Fever of 102.8°F
- C. Nausea
- D. Vomiting
- E. Light-headedness
- F. Cramping
- G. Guarding
Correct Answer: C,D,E,F
Rationale: Symptoms are subjective complaints reported by the patient (nausea, vomiting, light-headedness, cramping), while others are objective findings.
At which of the following locations can you best hear the sound of the aortic valve?
- A. Just to the left of the sternum in the 3rd intercostal space
- B. To the left of the sternum in the 5th intercostal space in the midclavicular line
- C. Just to the right of the sternum in the 2nd intercostal space
- D. Just to the right of the sternum in the 4th intercostal space
Correct Answer: C
Rationale: The aortic valve is best heard at the right 2nd intercostal space near the sternum.