In which client does the nurse consider the presence of an S3 heart sound to be normal?

In a client with an indwelling pacemaker

In a client who is in elementary school

In a client who is an older adult

In a client who is diagnosed with heart failure

Answer and Explanation

The Correct Answer is B

A. In a client with an indwelling pacemaker: An S3 heart sound is not typically associated with pacemaker use and may suggest underlying heart dysfunction. In adults, it often indicates volume overload or decreased ventricular compliance.
B. In a client who is in elementary school: An S3 sound can be a normal finding in children and young adults due to their compliant ventricles and strong cardiac output. It often disappears with age and is considered "physiologic S3." It is usually soft, low-pitched, and heard best at the apex of the heart.
C. In a client who is an older adult: In older adults, an S3 sound is usually abnormal and may be an early indicator of heart failure or ventricular dysfunction. It suggests poor ventricular compliance and fluid overload.
D. In a client who is diagnosed with heart failure: An S3 sound is commonly heard in heart failure but is not considered normal. It reflects increased filling pressures and reduced ventricular function, making it a key sign of worsening cardiac status.

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Correct Answer is B

Explanation

A. "There are fibrous cysts in the lungs.": While lung damage and scarring (fibrosis) occur in cystic fibrosis, the primary issue is the abnormal mucus, not the presence of pre-existing fibrous cysts. Cystic fibrosis does not involve actual fibrous cysts in the lungs but rather thick, sticky mucus that clogs airways and promotes infection.
B. "The mucus-secreting glands are abnormal.": Cystic fibrosis is a genetic disorder that affects exocrine glands, leading to abnormally thick and sticky mucus. This affects the lungs, pancreas, and other organs, making this statement accurate.
C. "Allergic reactions cause inflammation in the lungs.": Cystic fibrosis is not caused by allergies or immune responses. Lung damage results from mucus accumulation and chronic infections, not allergic inflammation.
D. "Early treatment can stop the progression of the disease.": Early treatment can slow progression and improve quality of life but cannot stop the disease. Cystic fibrosis remains a lifelong, progressive condition despite medical advances.

A. Multivitamins B. Laxatives C. Cold and allergy medications D. Antiulcer medications

Correct Answer is C

Explanation

A. Multivitamins: Most multivitamins do not interact significantly with MAOIs unless they contain high levels of tyramine, which is rare. They are generally safe but should still be reviewed by the healthcare provider.
B. Laxatives: Laxatives are not known to have direct interactions with MAOIs. However, excessive use could alter electrolyte balance, which might complicate overall medication management but not specifically with MAOIs.
C. Cold and allergy medications: Many over-the-counter cold and allergy drugs contain sympathomimetic agents like pseudoephedrine, which can cause hypertensive crises. This is because these decongestatnts increase norepinephrine levels while MAOIs prevent the breakdown of norepinephrine. This combination is dangerous and must be strictly avoided.
D. Antiulcer medications: Most antiulcer drugs, such as proton pump inhibitors and H2 blockers, do not significantly interact with MAOIs. They should still be reviewed, but they are not commonly contraindicated.

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In which client does the nurse consider the presence of an S3 heart sound to be normal?

Nursing Test Bank

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Explanation

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Correct Answer is C

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