N2030 Exam 2 Partial Study Guide
Cardiac & Blood Vessels; Thorax, Lungs & Chest; ENT; Eyes
This list is not a complete list of what you should know for the exam. So be sure to study all notes and
reference the chapters and review your exam techniques. Do not just memorize definitions, but study
& read material surrounding the words or concepts so you know & understand the full meaning & can
think & reason critically as you answer questions.
******Study all your Note taking outlines for lectures; Use Canvas PowerPoints of Lectures
******Study all your validation sheets & know all your examination techniques
******Review Terminology for each of the sections & review the lab pages in Part 2 of syllabus.
******Reference & study textbook chapters to supplement your notes: Chapters 12, 13, 14, 15, & 16
CARDIAC & BLOOD VESSELS
1.
2.
3.
4.
Aneurysm – How is it found in assessment? (Might include other sections as well)
CVA – Cerebral Vascular Accident; Cardiovascular Accident; Costal Vertebral Angle
Claudication – pain due to muscle ischemia
Know the different positions on chest wall where you listen for heart sounds; which heart sounds are
best heard in those areas & why are they best heard there.
5. Know S1 & S2 – what causes them – where heard the loudest and why
6. Know S3 & S4 and Splitting S1 & S2 – What causes them
7. Jugular Vein Distention with pulsation not felt – caused by Right Sided Heart Failure
8. Know grading of Heart murmurs and what you would hear from grade I, II, III, etc.
9. Apical Impulse (same as PMI – Point of Maximal Impulse) – where located and what causes it
10. Heave with displacement of apical pulse – Left Ventricular Enlargement
11. Lift & thrill on precordium of heart chest wall
12. Know Electrical Activity of Heart – SA Node, AV node, Bundle of HIS
13. Know normal heart and pulse rates
14. Know where & how to assess for bruits, venous hums & what they mean
15. Understand cardiac output, what it means, how to calculate & changes that take place with aging &
why these are problems for the elderly
16. Know all the pulses, where located, how to assess for rate, rhythm, & amplitude
17. Know normal Blood Pressure ranges
18. Holman’s sign p. 344
19. Phlebitis, embolism, thrombus, thrombophlebitis, thromboembolism
THORAX, LUNGS, CHEST
20. Sputum color related to different diseases i.e. bronchitis, pneumonia, etc.
21. Know the respiratory and cardiovascular signs and symptoms you might see in a person who is using
cocaine (in the reading in your book). This is in addition to what you would see with ENT examination.
22. Know the definitions & locations of normal breath sounds: Vesicular, Bronchovesicular, Bronchial
23. Know definitions & characteristics of how to identify adventitious lung sounds – wheezes, rales,
rhronchi, crackles, friction rub
24. Diaphragmatic excursion
25. Thoracic expansion
(OVER)
26. COPD – Emphysema/chronic bronchitis – long term decrease of oxygen – Barrel chest
– change in AP & Transverse diameter ratio
27. Costal Angle >90 degrees: what causes this? AP:Tv raio gets closer in size as COPD develops
28. Definition of different breathing patterns: dyspnea, orthopnea, bradypnea, platypnea; tachypnea;
apnea, paroxysmal nocturnal dyspnea, hyperpnea, Cheyne-Stokes, kussmaul, biot, ataxic
29. Know what these are & what causes them to occur: chest retractions, purse lip breathing, nasal flaring,
clubbing, capillary refilling
30. Know Pneumothorax, atelectasis, pleural effusion, bronchitis, pneumonia, tuberculosis, asthma
31. Know normal patterns of respirations & normal respiration ranges for adults
32. Vocal resonance (all types) & tactile fremitus – how to do the assessment & how to interpret the
meaning of your findings for each
33. Know skin changes caused by poor circulation – arterial vs. venous
34. Crepitus of joint; but also of escaped air from respiratory system at base of neck
ENT
35. Genetic/chromosome abnormalities of ENT
36. Rinne Test – how to do test and interpret results
37. Weber Test – how to do test and interpret results
38. Drug use effects on ENT
39. Proper techniques for examining ears
40. Romberg Test
41. Proper documentation of exam findings of all systems
42. Abnormal exam findings of ENT, i.e. Candidiasis, Leukoplakia, tonsillitis, pharyngitis, gingival
atrophy/recession vs. hypertrophy, acute otitis media, otitis externa, tympanic member bulging or
retraction or perforation, etc. etc.
43. Eustachian Tubes – infants vs children vs adults
44. Know otorrhea, vertigo, dizziness, tinnitus, Epistaxis & how to assess
45. Tympanic membrane landmarks & what changes occur with certain ear problems
46. Know names & numbers of all CRANIAL NERVES with their functions & what would be abnormal exam
findings for all systems covered on this exam
47. Kiesselbach complex
48. Transillumination of sinuses – purpose & how to do it
49. Know causes & characteristics of different types of discharges from the nose
50. How to evaluate & record tonsil size
EYES
51. Know how to assess lacrimal gland, ptosis, nystagmus, exophthalmos, facial paralysis
52. Know how to assess for consensual light reflex vs direct light reflex
53. Know assessment & meaning of eye exam results with: accommodation, confrontation, extraocular
movements (6 cardinal fields of gaze), PERRLA, corneal light reflex, cover-uncover test, strabismus,
nystagmus, miosis vs mydriasis, anisocoria, Argyll Robertson pupil
54. How to perform acuity test for distant & near vision & how to interpret results of test
55. Know the correct technique for performance of the ophthalmoscopic exam & know all the structures
you should see & what is normal or abnormal finding of the retina, optic disc, i.e. papilledema, a-v
nicking, size of arteries vs veins, method to locate & identify places or lesions on the retina, etc.
56. Know conjunctivitis, subconjunctival hemorrhage, blepharitis, hordeolum, chalazion, allergies,
cataracts, corneal circus senilis, entropian vs ectropian, senile hyaline plaque, pterygium,
57. Know the effects of pregnancy on wearing of contact lenses in the eyes and what would be a good
solution to this problem (in the reading in your book)
58. When caring for a hospitalized patient, what is the most important and most frequent eye examination
a nurse would do to test the neurological system functioning of the patient (critical thinking - What was
that set of letters I gave you in class and what did they stand for?)
59. Watch for KEY words: “quick”, “best”, “most”, “least likely”, etc.
For any health problem in the back of the chapters, it is important that you learn the following
First: What is the problem and what is going on in the body
Second: What History might the person have when you are asking questions (what would be some good
questions for you to ask?)
Third. What is the correct technique for the physical exam in assessing for it?
Fourth: Think IPPA (as it is applicable). What might be inspected? What might be found when palpated? What
might be found when percussed? What might be found with auscultation? Think Normal vs. Abnormal