When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?

Left fifth intercostal space, midclavicular line.

Third left intercostal space.

Left fourth intercostal space next to left sternal border.

Second right intercostal space.

Answer and Explanation

The Correct Answer is C

A.   The fifth intercostal space, midclavicular line, is the location for auscultating the mitral valve.
B.   The third left intercostal space is typically used for the pulmonic valve.
C.   The tricuspid valve is best auscultated at the left fourth intercostal space near the left sternal border.
D.   The second right intercostal space is used to listen to the aortic valve.

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Correct Answer is C

Explanation

A. Nicotine’s impact on REM sleep is not as direct as this option suggests. REM sleep can be reduced, but
it is not directly linked to a decreased need for REM sleep.
B. This option may be true for some individuals, but smoking typically causes disruptions throughout the night, not just in the second half.
C. Smoking has been shown to increase sleep latency (the time it takes to fall asleep) and reduce total sleep time due to nicotine’s stimulant effect and withdrawal symptoms during sleep.
D. Difficulty falling asleep and light sleep with frequent arousals are common effects of smoking due to
nicotine’s stimulant properties and withdrawal during the night.

A. Ask questions in a vague, nonspecific format. B. Share personal values to put the client at ease. C. Begin with questions that are less sensitive in nature. D. Get the most difficult questions over with first.

Correct Answer is C

Explanation

A. While this approach may seem less intrusive, it can create confusion and may prevent the client from feeling fully understood. Asking vague questions could make it more difficult to get useful information about the client's health concerns.
B. Sharing personal values is generally not appropriate in a clinical interview, as it could create boundaries that compromise the professional relationship. The nurse should maintain objectivity and empathy without sharing personal beliefs.
C. Starting with less sensitive questions allows the nurse to build rapport and trust with the client before delving into more personal or difficult topics. This approach is helpful in easing the client into more sensitive discussions.
D. Asking the most difficult questions right away can overwhelm the client, especially if they are hesitant or uncomfortable. It is better to establish a trusting relationship first and allow the client to open up at their own pace.

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When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?

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Correct Answer is C

Explanation

Correct Answer is C

Explanation

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