When auscultating a client's heart sounds, the nurse hears a louder S2 when listening at the 2nd intercostal space right sternal border. The nurse determines that this finding is consistent with the closure of which heart valves?

Pulmonic and tricuspid

Mitral and aortic

Aortic and pulmonic

Tricuspid and mitral

Answer and Explanation

The Correct Answer is C

A. Pulmonic and tricuspid: The tricuspid valve's closure is not primarily audible at the 2nd intercostal space right sternal border; it is better heard at the lower left sternal border.

B. Mitral and aortic: The mitral valve is best heard at the apex of the heart, not the 2nd intercostal space right sternal border.

C. Aortic and pulmonic: The 2nd intercostal space right sternal border is the area where the aortic and pulmonic valves are auscultated. The louder S2 here indicates the closure of these valves, with the aortic valve being the primary source of sound in this area.

D. Tricuspid and mitral: These valves are best heard at other locations, with the tricuspid valve near the lower left sternal border and the mitral valve at the apex.

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Correct Answer is B

Explanation

A. Chest pain: This symptom is important but does not specifically correlate with difficulty sleeping unless upright.

B. Orthopnea: Difficulty breathing while lying flat (orthopnea) is typically associated with heart failure and would require further investigation to understand its impact on the client's sleep.

C. Edema: While edema can be a sign of cardiovascular problems, it does not directly explain the difficulty in sleeping unless in an upright position.

D. Palpitations: Palpitations might affect sleep but are less directly linked to the need to sleep upright compared to orthopnea.

A. Pitting edema B. Capillary refill C. Skin temperature D. Peripheral pulses

Correct Answer is A

Explanation

A. Pitting edema: Pressing on the skin and observing how it rebounds (if it leaves an indentation) is used to assess for pitting edema, which indicates fluid retention in the tissues.

B. Capillary refill: This test involves pressing on the nail beds and observing the time it takes for color to return, not pressing on the arm.

C. Skin temperature: This is assessed by palpating the skin, not by pressing with the thumb.

D. Peripheral pulses: This involves palpating pulse points to assess their presence and strength, not pressing on the arm to check for edema.

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When auscultating a client's heart sounds, the nurse hears a louder S2 when listening at the 2nd intercostal space right sternal border. The nurse determines that this finding is consistent with the closure of which heart valves?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While completing the cardiovascular system health history, a client reports difficulty falling asleep unless she is in an upright position. Which of the following potential problems should the nurse further investigate?

Correct Answer is B

Explanation

While performing an assessment, the nurse presses the client's arm with the tip of her thumb, holds for a few seconds, and releases. The nurse observes the client as shown. What is the nurse assessing?

Correct Answer is A

Explanation

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