A nurse is examining a client with diastolic dysfunction. Upon auscultation using the bell of the stethoscope the nurse hears a late diastolic heart sound at the 5th intercostal space, left midclavicular line. Based on these findings and the clients history, the nurse would recognize this extra heart sound is most likely what?

Answer and Explanation

The Correct Answer is B

A. S1: S1 is the first heart sound, heard at the beginning of systole, and is not related to diastolic dysfunction.

B. S4: This is the correct answer. An S4 sound is heard late in diastole, often due to increased resistance to filling during diastole, which is typical in diastolic dysfunction.

C. S3: An S3 is a low-pitched sound heard early in diastole, typically associated with systolic dysfunction or heart failure with reduced ejection fraction.

D. S2: S2 is the second heart sound, heard during the end of systole and is not associated with diastolic dysfunction.

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Correct Answer is A

Explanation

A. Tight shoes may indicate fluid retention in the lower extremities, which is a common symptom of right-sided heart failure. This condition leads to the backup of blood into the systemic circulation, causing peripheral edema.

B. Sleeping with two pillows may indicate left-sided heart failure, as the client may be experiencing orthopnea (difficulty breathing when lying flat).

C. Shortness of breath is more commonly associated with left-sided heart failure.

D. Waking up coughing every night is also a sign of left-sided heart failure, where pulmonary congestion leads to nocturnal coughing.

Correct Answer is ["937.5"]

Explanation

Calculate the fluid volume to be administered in the remaining 16 hours:

Total fluid volume - Fluid administered in the first 8 hours = Remaining fluid volume

30,000 mL - (1875 mL/hr * 8 hr) = 15,000 mL

Calculate the infusion rate for the remaining 16 hours:

Remaining fluid volume / Remaining time = Infusion rate

15,000 mL / 16 hr = 937.5 mL/hr

Therefore, the nurse should infuse the IV fluids at a rate of 937.5 mL/hr after the first 8 hours.

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Naxlex Comprehensive Predictor Exams

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right- sided heart failure?

Correct Answer is A

Explanation

Correct Answer is ["937.5"]

Explanation

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