A nurse is collecting data about a client's cardiac functioning. The nurse auscultates an S3 sound. Which of the following causes should the nurse suspect?
Atrial gallop
Ventricular gallop
Closing of semilunar valves
Closing of the atrioventricular valves
The Correct Answer is B
A. Atrial gallop: An atrial gallop is associated with the S4 heart sound, which occurs before the S1 sound due to the atrial contraction.
B. Ventricular gallop: An S3 heart sound is known as a ventricular gallop and is often a sign of heart failure or fluid overload. It occurs during early diastole when the ventricle fills rapidly.
C. Closing of semilunar valves: The closing of the semilunar valves (aortic and pulmonary) produces the S2 heart sound, not the S3 sound.
D. Closing of the atrioventricular valves: The closing of the atrioventricular valves (mitral and tricuspid) produces the S1 heart sound, not the S3 sound.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. To provide analgesia: While aspirin can reduce pain, its primary use following a myocardial infarction is not for analgesia. Other medications are used for pain management in this scenario.
B. To prevent blood clotting: Aspirin is prescribed following a myocardial infarction to inhibit platelet aggregation and prevent blood clots, which can reduce the risk of future cardiac events. This is the correct rationale for aspirin use in coronary artery disease.
C. To reduce inflammation: Although aspirin has anti-inflammatory properties, the primary reason for prescribing it after a myocardial infarction is to prevent blood clots, not to reduce inflammation.
D. To prevent fever: Aspirin can reduce fever, but this is not the reason it is prescribed after a myocardial infarction.
Correct Answer is A
Explanation
A. Check pedal pulses every 15 min. Checking pedal pulses every 15 minutes is essential to monitor for adequate blood flow to the extremity and to detect any signs of arterial obstruction or complications at the catheter insertion site.
B. Keep the client in high-Fowler's position for 6 hr. The client should remain flat or in a low-Fowler's position to reduce the risk of bleeding at the femoral artery access site. High-Fowler's position is contraindicated.
C. Remind the client not to turn from side to side. Clients may be allowed to turn gently, but they should avoid putting pressure on the insertion site. Complete immobility is unnecessary.
D. Perform passive range-of-motion for the affected extremity. Passive range of motion is not appropriate in the immediate post-procedure period, as the extremity should remain still to prevent bleeding.
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