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 D

Explanation

Choice A reason: Decreased hair is most likely a hereditary condition and nail changes are related to fungus is not the statement that describes the cause of this finding. This statement is not based on evidence and does not explain the relationship between peripheral vascular disease and the observed changes in the legs and feet.

Choice B reason: A blood clot may be forming and the client needs immediate intervention is not the statement that describes the cause of this finding. This statement is an alarmist and inaccurate interpretation of the finding. A blood clot would cause more acute and severe symptoms, such as pain, swelling, redness, and warmth in the affected area.

Choice C reason: Decreased oxygen to the tissues causes changes in hair growth and nail texture is the statement that describes the cause of this finding. This statement is based on the pathophysiology of peripheral vascular disease, which is a chronic condition that reduces the blood flow to the extremities due to atherosclerosis or inflammation of the blood vessels. The reduced blood flow leads to tissue ischemia and necrosis, which can manifest as hair loss, thickening and yellowing of the nails, skin ulcers, and gangrene.

Choice D reason: Depending on the client's age, the findings may be normal is not the statement that describes the cause of this finding. This statement is a vague and dismissive response that does not address the underlying problem of peripheral vascular disease. The findings are not normal for any age group and require further assessment and intervention.

A. Be aware that pregnancy with sickle cell disease increases the risk of crisis B. Avoid travel to cities where the oxygen level is lower C. Strenuous exercise prevents the development of sickle cell crisis D. Avoid flying on commercial airlines E. Avoid drinking water on hot days.

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Pregnancy can increase the frequency and severity of sickle cell crises⁵⁶. Regular prenatal care is especially important for women with sickle cell disease⁵⁶. Therefore, it's crucial for a young female adult with sickle cell anemia to be aware that pregnancy increases the risk of crisis.

Choice B reason: Low oxygen levels can trigger a sickle cell crisis³. Therefore, avoiding travel to cities where the oxygen level is lower can help prevent crises.

Choice C reason: While regular, moderate exercise can be beneficial, strenuous exercise can lead to dehydration and fatigue, which can trigger a sickle cell crisis⁹[^10^]¹¹. Therefore, the statement that strenuous exercise prevents the development of sickle cell crisis is not accurate.

Choice D reason: Commercial airlines have controlled cabin pressure and oxygen levels, so flying is generally safe for individuals with sickle cell disease¹²³. However, it's always best to discuss travel plans with a healthcare provider³. Therefore, avoiding flying on commercial airlines is not necessarily a requirement.

Choice E reason: Dehydration can increase the risk of a sickle cell crisis, so it's important to drink plenty of fluids, especially in hot weather³.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse, who is assessing a client with peripheral vascular disease, notes that the client has no hair on the legs and has thick toenails. Which statement describes the cause of this finding?

Correct Answer is D

Explanation

The nurse should instruct a young female adult with sickle cell anemia to do which of the following? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

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