A nurse is auscultating a client's heart sounds and hears a third heart sound (S3). Which finding is consistent with the presence of an S3 sound in a client with congestive heart failure?

High-pitched, scratchy sound heard during inhalation

Extra heart sound heard immediately after S1 and S2

Prolonged, whooshing sound heard during systole

Irregular heart rhythm with varying intensity

Answer and Explanation

The Correct Answer is B

A) This choice is incorrect because a high-pitched, scratchy sound heard during inhalation is called a pleural friction rub and is associated with pleuritis or inflammation of the pleura, not congestive heart failure.

B) This choice is correct. An S3 heart sound is an extra heart sound heard immediately after S1 and S2, often described as a "ventricular gallop." It is associated with congestive heart failure and indicates increased fluid volume and strain on the ventricles.

C) This choice is incorrect because a prolonged, whooshing sound heard during systole is a heart murmur, which can be caused by various conditions, but it is not specific to the presence of an S3 sound.

D) This choice is incorrect because an irregular heart rhythm with varying intensity is characteristic of cardiac arrhythmias or irregular heartbeats and is not specific to the presence of an S3 sound.

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Correct Answer is B

Explanation

A) This choice is incorrect because taking the nitrate medication with food is not necessary. Nitrate medications are usually taken sublingually or by mouth and are not associated with significant stomach upset.

B) This choice is correct. Nitrate medications, such as nitroglycerin, can cause a dangerous drop in blood pressure when used concurrently with erectile dysfunction medications, specifically phosphodiesterase type 5 inhibitors (PDE5 inhibitors) like sildenafil (Viagra) or tadalafil (Cialis). Clients should be warned against using these medications together to prevent hypotension and potential cardiovascular complications.

C) This choice is incorrect because grapefruit juice is not typically associated with nitrate medications. Grapefruit juice can interact with certain medications, but it is not a known interaction with nitrates.

D) This choice is incorrect because increasing the nitrate dose without healthcare provider guidance can be dangerous. Clients should be instructed to take nitrate medications as prescribed and seek immediate medical attention if chest pain is not relieved within a specific timeframe, as directed by their healthcare provider.

Questions

A. Electrolyte imbalances. B. Left-sided heart failure. C. Decreased afterload. D. Microvascular damage.

Correct Answer is D

Explanation

A) This choice is incorrect because while electrolyte imbalances can have cardiovascular implications, they are not directly associated with diabetes mellitus or congestive heart failure.

B) This choice is incorrect because left-sided heart failure is not directly related to uncontrolled diabetes mellitus. However, diabetes can exacerbate heart failure if not well-controlled due to its impact on blood vessels and the heart.

C) This choice is incorrect because decreased afterload is not directly related to uncontrolled diabetes mellitus. Afterload refers to the resistance the heart has to overcome to eject blood into the circulation.

D) This choice is correct. Uncontrolled diabetes mellitus can lead to microvascular damage, particularly in the small blood vessels of the heart. This damage can contribute to heart muscle dysfunction and congestive heart failure. Diabetes is a significant risk factor for developing heart failure.

Questions

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A nurse is auscultating a client's heart sounds and hears a third heart sound (S3). Which finding is consistent with the presence of an S3 sound in a client with congestive heart failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with congestive heart failure is prescribed a nitrate medication. The nurse should instruct the client to:

Correct Answer is B

Explanation

A nurse is reviewing a client's medical history and notes a diagnosis of uncontrolled diabetes mellitus. The nurse recognizes this as a significant risk factor for congestive heart failure due to its association with:

Correct Answer is D

Explanation

A client with suspected congestive heart failure undergoes a chest X-ray. The nurse should anticipate which finding that may be indicative of CHF?

A nurse is caring for a client with congestive heart failure who is prescribed a loop diuretic. The nurse should monitor the client for which potential electrolyte imbalance associated with this medication?

A client with suspected congestive heart failure undergoes an echocardiogram. The nurse should expect which parameter to be measured during the echocardiogram to assess the client's heart function?

A nurse is reviewing the diagnostic tests for a client suspected of having congestive heart failure. Which test is considered the gold standard for diagnosing CHF?

A nurse is providing education to a client with congestive heart failure about managing fluid intake. The nurse should instruct the client to:

A client with congestive heart failure reports waking up at night with sudden breathlessness and feeling the need to sit upright to breathe comfortably. The nurse should document this symptom as:

A nurse is providing education to a client with congestive heart failure regarding dietary management. Which instruction is essential for the nurse to include?

A client with congestive heart failure is prescribed furosemide, a loop diuretic. The nurse should monitor the client for which potential adverse effect of this medication?