Nokea
You are performing a cardiac examination on a patient with shortness of breath and palpitations. You listen to the heart with the patient sitting upright, then have him change to a supine position, and finally have him turn onto his left side in the left lateral decubitus position. Which of the following valvular defects is best heard in this position?
- A. Aortic
- B. Pulmonic
- C. Mitral
- D. Tricuspid
Correct Answer: C
Rationale: The correct answer is C: Mitral valve defect. This is because the mitral valve is best heard in the left lateral decubitus position. In this position, the heart rotates, bringing the mitral valve closer to the chest wall, making it easier to auscultate any abnormalities such as murmurs. Aortic (A), pulmonic (B), and tricuspid (D) valve defects are not typically better heard in the left lateral decubitus position, so they are incorrect choices.
You may also like to solve these questions
The assessment of a 72-year-old male causes the NP to have concerns that the pt. is a suicide risk. Risk factors for suicide in the elderly do NOT include
- A. Chronic pain
- B. Comorbid physical illness
- C. Family history of suicide
- D. Retirement
Correct Answer: D
Rationale: The correct answer is D: Retirement. Retirement is not a known risk factor for suicide in the elderly. Here's the rationale:
1. Chronic pain (choice A) and comorbid physical illness (choice B) are risk factors as they can contribute to feelings of hopelessness and despair.
2. Family history of suicide (choice C) is a significant risk factor due to the genetic and environmental influences.
3. Retirement (choice D) does not directly increase the risk of suicide. In fact, many individuals find purpose and fulfillment in retirement.
Which is a true statement about varicose veins?
- A. They are due to congenital valve deformities
- B. They are usually diagnosed on clinical presentation
- C. They are not affected by pregnancy
- D. They are more symptomatic during ovulation
Correct Answer: B
Rationale: The correct answer is B because varicose veins are usually diagnosed based on clinical presentation, such as visible, bulging veins and symptoms like pain or swelling. This is because varicose veins are often easily visible and cause noticeable symptoms.
A: Varicose veins are not typically due to congenital valve deformities but rather develop over time due to weakened vein walls and valves.
C: Varicose veins can be affected by pregnancy due to hormonal changes and increased pressure on the veins.
D: Varicose veins may not necessarily be more symptomatic during ovulation; symptoms can vary based on individual factors.
An 84-year-old male with prostatic hypertrophy is at increased risk of:
- A. Constipation
- B. Fecal incontinence
- C. Urinary tract infections
- D. Prostate cancer
Correct Answer: C
Rationale: The correct answer is C: Urinary tract infections. Prostatic hypertrophy can cause obstruction of the urinary tract, leading to urinary retention and stasis, which increases the risk of urinary tract infections. Constipation (choice A) and fecal incontinence (choice B) are more related to issues with the gastrointestinal system rather than prostatic hypertrophy. Prostate cancer (choice D) is a separate condition that is not directly linked to prostatic hypertrophy. Therefore, the increased risk for an 84-year-old male with prostatic hypertrophy is urinary tract infections due to urinary obstruction.
What is the most common cause of erectile dysfunction in older men?
- A. Psychological stress
- B. Adverse drug reaction
- C. Atherosclerosis
- D. Autonomic neuropathy
Correct Answer: C
Rationale: The correct answer is C: Atherosclerosis. Atherosclerosis is the most common cause of erectile dysfunction in older men as it leads to reduced blood flow to the penis, affecting the ability to achieve and maintain an erection. Psychological stress (A) can contribute to erectile dysfunction but is not the primary cause. Adverse drug reactions (B) can also lead to erectile dysfunction, but it is not as common as atherosclerosis. Autonomic neuropathy (D) can affect nerve impulses in the penis but is not as prevalent as atherosclerosis in causing erectile dysfunction in older men.
The earliest clinical manifestation of diabetic nephropathy is:
- A. An elevation in blood urea nitrogen (BUN)
- B. An elevation in blood urea nitrogen (BUN) and creatinine (CR)
- C. A decreased glomerular filtration rate
- D. Microalbuminuria
Correct Answer: D
Rationale: The correct answer is D: Microalbuminuria. In diabetic nephropathy, the earliest clinical manifestation is the presence of microalbuminuria, which indicates early kidney damage. This occurs before significant changes in BUN, creatinine, or glomerular filtration rate are observed. Microalbuminuria is a key indicator for monitoring and early intervention in diabetic nephropathy.
Incorrect Options:
A: An elevation in blood urea nitrogen (BUN) - BUN levels may rise in later stages of kidney damage.
B: An elevation in blood urea nitrogen (BUN) and creatinine (CR) - These markers typically increase as kidney function declines, not in the early stages.
C: A decreased glomerular filtration rate - GFR decreases as kidney function worsens, not typically an early sign in diabetic nephropathy.