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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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Blood glucose elevation is a concern for statins, but it is not a primary reason for questioning the order.

B. A history of high cholesterol is common and would not trigger concern regarding lovastatin.

C. Lovastatin can cause liver toxicity, so elevated liver enzymes are a contraindication or cause for concern when prescribing this medication. The nurse should verify this before starting the medication.

D. A history of peptic ulcers is unrelated to the use of lovastatin and would not be a concern in this case.

A. "I need to inform my allergist that I cannot take my normal antihistamine." B. "There should be no problem with drinking wine with dinner each night." C. "My routine of drinking a quart (liter) of water first thing in the morning needs to change." D. "I am so glad that I weaned myself off of coffee about a year ago."

Correct Answer is B

Explanation

A. Certain antihistamines can worsen urinary retention in BPH, so informing the allergist is a good practice.

B. Alcohol, including wine, can worsen the symptoms of BPH by increasing urinary retention and bladder discomfort. The client needs further teaching regarding the effects of alcohol on BPH symptoms.

C. It is advisable to avoid large volumes of fluids in the morning, as this can exacerbate BPH symptoms.

D. Caffeine can irritate the bladder and worsen BPH symptoms, so weaning off coffee is a helpful measure.

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Naxlex Comprehensive Predictor Exams

After reviewing the client's chart upon admission to the unit, the nurse consults the healthcare provider about a new order for lovastatin (Mevacor). What triggered the nurse's action?

Correct Answer is C

Explanation

The nurse is teaching a client diagnosed with benign prostatic hyperplasia (BPH). What statement indicates the client needs further information?

Correct Answer is B

Explanation

The nurse will anticipate that a 61-year-old client who has an enlarged prostate detected by digital rectal exam (DRE) and an elevated prostate specific antigen (PSA) level will need teaching about

A client who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!" The nurse will document this assessment finding as

The post anesthesia care unit (PACU) charge nurse notes vital signs on four postoperative clients. Which client would the nurse assess first?

After starting the treatment for type 2 diabetes mellitus 6 months earlier, a client is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the clients adherence to the antidiabetic therapy over the past few months?

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

After the nurse has taught the client with a newly diagnosed sexually transmitted infection about expedited partner therapy, which client statement indicates that teaching has been effective?

The nurse is caring for a client who has frequent gastric pain and dyspepsia. Which procedure would the nurse expect the health care provider to order to make an accurate diagnosis?

During the administration of finasteride (Proscar), the nurse must remember which important precaution?