The nurse is planning to auscultate heart sounds. The history and physical indicates a history of Aortic Valve dysfunction. Where would the nurse auscultate to assess the Aortic Valve?
5th Intercostal Space, Midclavicular Line
2nd Intercostal Space, Left Sternal Border
2nd Intercostal Space, Right Sternal Border
3rd Intercostal Space, Left Sternal Border
The Correct Answer is C
A. 5th Intercostal Space, Midclavicular Line. This is the location for the apical pulse (PMI) at the mitral area, not the aortic valve.
B. 2nd Intercostal Space, Left Sternal Border. This is the location of the pulmonic valve, not the aortic valve.
C. 2nd Intercostal Space, Right Sternal Border. The aortic valve is best auscultated at the right second intercostal space, next to the sternum.
D. 3rd Intercostal Space, Left Sternal Border. This is the Erb’s point, which provides equal S1 and S2 sounds, but it is not the best location for auscultating aortic valve dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Examine the back before the general inspection of the skin: Skin assessment should follow a general inspection.
B. Note dry, flaky skin as an expected finding: While common in older adults, it may indicate dehydration or dermatologic conditions.
C. Use a penlight to examine the back in greater detail: Penlights are typically used for darker areas (e.g., mouth, wounds), not flaky skin.
D. Pinch up a fold of skin to check for turgor: Assesses hydration status, which is important since dehydration contributes to dry, flaky skin.
Correct Answer is ["60"]
Explanation
Convert weight from pounds to kilograms:
165lb÷2.2=75kg
Multiply by the Recommended Dietary Allowance (RDA) for protein:
75kg×0.8g/kg=60g
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