The nurse auscultates a S4 heart sound during the morning assessment of a client. Which additional assessment data would correlate with this finding?

Crackles heard at the lung bases

Dorsalis pedis pulses +1

A pericardial friction rub

Heart rate 50 beats per minute

Answer and Explanation

The Correct Answer is A

A. Crackles heard at the lung bases: An S4 heart sound often indicates left ventricular hypertrophy or decreased compliance of the left ventricle, commonly seen in conditions like heart failure. Crackles in the lungs can suggest pulmonary congestion related to heart failure, making this the most relevant correlation.

B. Dorsalis pedis pulses +1: A weak pulse may indicate peripheral vascular issues, but it doesn't directly correlate with an S4 heart sound.

C. A pericardial friction rub: This is associated with pericarditis and not directly related to the S4 heart sound.

D. Heart rate 50 beats per minute: While bradycardia may be present in various cardiac conditions, it does not specifically correlate with the S4 sound, which is more about ventricular filling pressures.

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

Explanation

A. Temperature elevation of 100.4°F: While a slight fever can indicate infection or inflammation, it is not an immediate concern related to aspirin use. It requires monitoring but is not as critical as other findings.

B. Hemoglobin decrease from 128 g/dL to 5.5 g/dL: This significant drop in hemoglobin indicates severe anemia, which is a major concern and may suggest gastrointestinal bleeding, a known risk of long-term aspirin use.

C. Serum potassium increase from 3.5 mEq/L to 4.5 mEq/L: This level is still within the normal range and does not indicate a significant clinical issue. Normal potassium levels do not raise immediate concern.

D. Gastrointestinal discomfort prior to eating breakfast: While gastrointestinal discomfort can be a side effect of aspirin, it is not immediately alarming unless associated with more severe symptoms like bleeding or ulceration.

E. Several areas of ecchymosis on upper and lower extremities: This finding is concerning as it may indicate bleeding issues due to thrombocytopenia or increased bleeding tendency associated with aspirin therapy.

A. increase calcium in the diet. B. monitor weight on a weekly basis. C. obtain blood pressure checks twice a year. D. have yearly eye examinations.

Correct Answer is B

Explanation

A. Increase calcium in the diet: While calcium is important, it's not the most critical aspect in managing hypertension compared to weight management.

B. Monitor weight on a weekly basis: Weight management is crucial for clients with hypertension, as fluctuations can indicate changes in fluid retention or overall health. Regular monitoring can help in managing blood pressure.

C. Obtain blood pressure checks twice a year: This is insufficient for monitoring hypertension; more frequent checks are generally recommended.

D. Have yearly eye examinations: While important for overall health, it’s not as directly related to the management of hypertension as monitoring weight.

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The nurse auscultates a S4 heart sound during the morning assessment of a client. Which additional assessment data would correlate with this finding?

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Explanation

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