A nurse is caring for a client with a heart murmur due to mitral valve disease. Where would the nurse hear the murmur the loudest?
Fourth intercostal space, right sternal border
Second intercostal space, right sternal border
Fifth intercostal space, left midclavicular line
Third intercostal space, left midclavicular line .
The Correct Answer is C
A heart murmur due to mitral valve disease is typically heard loudest over the mitral area, which is located at the fifth intercostal space in the left midclavicular line.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Soaking feet once daily in warm water is not recommended for diabetic patients. This is because prolonged soaking can lead to skin breakdown and increase the risk of foot ulcers and infections.
Choice B rationale
Utilizing a mirror to examine the soles of the feet is a recommended practice for diabetic patients. This allows them to check for any cuts, sores, blisters, or changes in the skin that they may not be able to see otherwise. Early detection of these issues can prevent serious complications such as infections and ulcers.
Choice C rationale
Cutting nails in a curved direction is not advised for diabetic patients. This can lead to ingrown toenails, which can cause sores and infections. It’s recommended to cut the nails straight across to avoid this.
Choice D rationale
Using a commercial medicine to remove a corn is not recommended for diabetic patients. These products can damage the skin and increase the risk of ulcers and infections. Any issues with corns or calluses should be addressed by a healthcare professional.
Correct Answer is A
Explanation
Choice A rationale
Diabetes mellitus can lead to several chronic complications, including retinopathy, which can cause blindness. Regular eye exams are crucial for early detection and treatment of diabetic retinopathy. Therefore, scheduling and keeping appointments for annual eye exams is an important part of managing diabetes.
Choice B rationale
While adequate fluid intake is generally important for overall health, it is not specifically effective in preventing kidney damage in patients with diabetes mellitus. Kidney damage in diabetes, also known as diabetic nephropathy, is caused by high blood sugar levels over time, not by dehydration.
Choice C rationale
Regular checks of cardiac enzymes are not a standard part of diabetes management. Cardiac enzymes are typically checked in the context of suspected heart disease or a heart attack, not as a routine measure in diabetes care.
Choice D rationale
While regular foot care is important in diabetes to prevent complications such as foot ulcers and infections, podiatry exams every 3 months are not typically necessary unless the patient has a history of foot problems or a high risk of foot complications.
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