Patient Data

Exhibits

Nurse analyzes the findings.

Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

Document the roaring and crackles

Wet the chest hair before auscultating

Keep the examination room warm, and warm the stethoscope

Reach under a gown to listen and take care that no clothing rubs on the stethoscope

Ensure the room is as quiet as possible

Answer and Explanation

Correct Answer : B,C,D,E

A.   Documenting the roaring and crackles is important to note any abnormal findings. However, this does not directly mitigate artifacts, which may interfere with the accuracy of the sounds heard through auscultation.
B.   Wetting the chest hair is a useful technique to reduce the sound interference caused by chest hair rubbing against the stethoscope. This helps eliminate some of the unwanted sounds and improves the clarity of auscultation.
C.   Ensuring the room is warm and the stethoscope is warmed before use is important because cold stethoscopes can cause discomfort to the client and may lead to muscle tensing, making it harder to hear clear heart and lung sounds.
D.   Reaching under the gown ensures that no clothing creates friction on the stethoscope, which can produce unwanted sounds during auscultation. This helps in obtaining clear and accurate heart or lung sounds.
E.   A quiet environment is crucial for auscultation, as background noise can obscure important sounds. Ensuring that the room is free from distractions and noise will significantly improve the quality of auscultation.

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Correct Answer is B

Explanation

A. If the apical impulse is more vigorous than expected, it may indicate an abnormal finding, such as hyperdynamic circulation or heart failure. The nurse should not simply record this without further investigation.
B. It is important to investigate whether the client has a history of heart disease, as conditions like left ventricular hypertrophy, heart failure, or valvular heart disease could cause changes in the apical impulse. This provides context for understanding the findings.
C. Obtaining the client’s blood pressure is important in assessing cardiovascular health, but the most immediate response to a more vigorous apical impulse would be to explore the potential cause, including heart disease, rather than simply measuring blood pressure.
D. Comparing the apical pulse to the carotid pulse may help assess if the increased pulse force is generalized or localized, and whether it might be a sign of circulatory changes. This would help clarify whether the finding is normal or indicative of pathology.

A. Increase in sexual desire. B. Cessation of menstruation. C. Excessive vaginal moisture. D. Drenching night sweats.

Correct Answer is D

Explanation

A. This is unlikely to be associated with perimenopause. Often, perimenopause is linked to hormonal fluctuations that can lead to decreased libido rather than an increase.
B. While cessation of menstruation may indicate menopause, it is not typically seen during the perimenopausal phase, which is the time leading up to menopause. Perimenopause is characterized by irregular periods, not complete cessation.
C. Perimenopausal symptoms typically involve a decrease in vaginal moisture due to reduced estrogen levels. Excessive vaginal moisture would not be indicative of perimenopause and might suggest an infection or other conditions.
D. This is a classic symptom of perimenopause. Hormonal fluctuations during this time can lead to hot flashes and night sweats, which are commonly experienced as part of the transition toward menopause.

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Patient Data Exhibits Nurse analyzes the findings. Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During the precordium assessment, the nurse palpates the apical impulse of a client on the 5th intercostal space left mid-clavicular line. The pulse is more vigorous than expected. Which action should the nurse take in response to this finding?

Correct Answer is B

Explanation

The nurse is obtaining a health history for a client during an annual physical examination. When evaluating the client for menopausal symptoms, which finding indicates the client is perimenopausal?

Correct Answer is D

Explanation

While auscultating for bowel sounds in an adult client, the nurse notes a series of gurgles that last about 3 seconds and occur every 5 to 10 seconds in all quadrants. How should the nurse document this finding?

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Patient Data

Exhibits

Nurse analyzes the findings.

Which can the nurse do to mitigate artifacts when performing auscultation? Select all that apply.