The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

Second intercostal space, right of sternum.

Third intercostal space, left of sternum.

Second intercostal space, left of sternum.

Fourth intercostal space, left mid-clavicular line.

Answer and Explanation

The Correct Answer is C

Choice A reason: The second intercostal space, right of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, right of sternum, is the location where the aortic valve can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice B reason: The third intercostal space, left of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The third intercostal space, left of sternum, is the location where the pulmonary valve, which separates the right ventricle and the pulmonary artery, can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice C reason: The second intercostal space, left of sternum, is the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, left of sternum, is the location where the aortic murmur will be most audible, as it is the closest to the aorta, the largest artery in the body. ³

Choice D reason: The fourth intercostal space, left mid-clavicular line, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The fourth intercostal space, left mid-clavicular line, is the location where the tricuspid valve, which separates the right atrium and the right ventricle, can be best heard, but not the location where the aortic murmur will be most audible. ³

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Correct Answer is C

Explanation

Choice A reason: Having a urinary output of greater than 30 mL per hour for 24 hours is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of fluid volume excess or renal impairment, which are not the case for this client.

Choice B reason: Discussing which lifestyle modifications will be necessary to maintain health is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of knowledge deficit or risk for recurrence, which are not the priority for this client.

Choice C reason: Expressing no complaints of chest discomfort or shortness of breath is the most appropriate outcome for the problem of impaired tissue perfusion. This outcome indicates that the client's cardiac output and oxygen delivery are adequate and that the interventions are effective.

Choice D reason: Having clear breath sounds bilaterally upon auscultation is not the most appropriate outcome for the problem of impaired tissue perfusion. This outcome is more relevant for the problem of impaired gas exchange or pulmonary congestion, which are not the case for this client.

A. Cholesterol 200 mg/dL; HDL 35 mg/dL; triglycerides 190 mg/dL B. Cholesterol 120 mg/dL; HDL 50 mg/dL; triglycerides 140 mg/dL C. Cholesterol 180 mg/dL; HDL 40 mg/dL; triglycerides 220 mg/dL D. Cholesterol 165 mg/dL; HDL 54 mg/dL; triglycerides 160 mg/dL

Correct Answer is C

Explanation

Choice A reason: This option is not correct because the cholesterol level is within the normal range of less than 200 mg/dL¹, the HDL level is slightly low but not too far from the recommended level of over 40 mg/dL for men and over 50 mg/dL for women¹, and the triglyceride level is also within the normal range of less than 150 mg/dL¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.

Choice B reason: This option is not correct because the cholesterol level is low, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.

Choice C reason: This option is correct because the cholesterol level is high, the HDL level is low, and the triglyceride level is high. These are all unfavorable results that reflect a high risk of coronary artery disease¹. High cholesterol and triglycerides can lead to plaque buildup in the arteries, which can cause atherosclerosis and reduce blood flow to the heart². Low HDL can also increase the risk of heart disease because it does not help remove LDL (bad cholesterol) from the arteries². Therefore, this set of laboratory results indicates a need for dietary modifications, such as reducing saturated and trans fats, increasing fiber, and limiting alcohol³.

Choice D reason: This option is not correct because the cholesterol level is normal, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications..

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The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

The nurse is reviewing the laboratory data of a client diagnosed with coronary artery disease. Which set of laboratory results indicates a need for client teaching regarding dietary modifications?

Correct Answer is C

Explanation

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