The nurse is listening to the heart sounds of a client. The nurse recognizes that the S2:

Indicates the beginning of diastole

Coincides with the carotid artery pulse

is louder than an S1

Is caused by the closure of the semilunar valves

Answer and Explanation

The Correct Answer is D

A. Indicates the beginning of diastole: This statement is not accurate. S2, the second heart sound, indicates the end of systole and the beginning of diastole. It is specifically associated with the closure of the aortic and pulmonary valves.

B. Coincides with the carotid artery pulse: This statement is not accurate. S2 is associated with the closure of the aortic and pulmonary valves in the heart, not with the carotid artery pulse.

C. Is louder than an S1: This statement is not accurate. S1, the first heart sound, is usually louder than S2. S1 is associated with the closure of the mitral and tricuspid valves and marks the beginning of systole.

D. Is caused by the closure of the semilunar valves: This statement is accurate. S2 is caused by the closure of the aortic and pulmonary valves, which are the semilunar valves in the heart. It marks the end of systole and the beginning of diastole.

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Correct Answer is D

Explanation

A. Clear and equal breath sounds bilaterally

Explanation: Clear and equal breath sounds bilaterally indicate normal lung sounds, suggesting proper air exchange in both lungs. This is a normal finding and does not require immediate reporting.

B. Oxygen saturation of 98% on room air

Explanation: An oxygen saturation level of 98% on room air indicates adequate oxygenation of the blood. This is a normal and healthy oxygen saturation level and does not require immediate reporting.

C. Cough producing clear, thin sputum

Explanation: A cough producing clear, thin sputum is indicative of a non-infected or non-inflammatory condition in the respiratory system. Clear and thin sputum is often normal, especially in the absence of other symptoms. It does not require immediate reporting unless the client has other concerning symptoms.

D. Visible use of accessory muscles during inhalation

Explanation: Visible use of accessory muscles, such as neck or intercostal muscles, during inhalation suggests that the client is working hard to breathe. This could indicate respiratory distress, potentially due to conditions like asthma, COPD (Chronic Obstructive Pulmonary Disease), or other severe lung problems. It's a concerning sign and should be reported to the healthcare practitioner promptly for further evaluation and intervention.

A. When bronchial breath sounds are auscultated in the trachea. B. When the client is experiencing excessive sneezing from a tree pollen allergy. C. When the client is resting in bed and not experiencing respiratory issues. D. When the bronchial tree is is obstructed by secretions.

Correct Answer is D

Explanation

A. When bronchial breath sounds are auscultated in the trachea.

Auscultating bronchial breath sounds in the trachea is a normal finding, as the trachea is close to the upper airway, and this is where bronchial sounds are normally heard. However, if these sounds are heard in the peripheral lung fields, it can indicate an abnormal condition.

B. When the client is experiencing excessive sneezing from a tree pollen allergy.

Excessive sneezing due to allergies would not typically result in increased breath sounds. Allergies may cause nasal congestion, but they don't directly lead to increased breath sounds.

C. When the client is resting in bed and not experiencing respiratory issues.

If a client is at rest and not experiencing any respiratory issues, breath sounds should typically be normal. There would be no reason to expect increased breath sounds in this scenario.

D. When the bronchial tree is obstructed by secretions.

Increased breath sounds, such as wheezing or rhonchi, can be auscultated when there is an obstruction in the bronchial tree due to secretions, narrowing of the airways, or other causes. These sounds are typically abnormal and indicate an issue with air movement through the airways.

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The nurse is listening to the heart sounds of a client. The nurse recognizes that the S2:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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