A nurse is caring for a client with a heart murmur due to mitral valve disease. Where would the nurse hear the murmur the loudest?

Fourth intercostal space, right sternal border

Second intercostal space, right sternal border

Fifth intercostal space, left midclavicular line

Third intercostal space, left midclavicular line .

Answer and Explanation

The Correct Answer is C

A heart murmur due to mitral valve disease is typically heard loudest over the mitral area, which is located at the fifth intercostal space in the left midclavicular line.

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Correct Answer is B

Explanation

Choice A rationale

While understanding the recommended diabetic diet is important for managing type 1 diabetes, it is not the immediate priority for a client who has received no instruction on diabetes management. Without insulin, a person with type 1 diabetes can develop life- threatening diabetic ketoacidosis, regardless of their diet.

Choice B rationale

Administration of insulin is the immediate priority for a client newly diagnosed with type 1 diabetes. In type 1 diabetes, the body does not produce insulin, a hormone that regulates blood sugar levels. Without insulin, blood sugar levels can become dangerously high, leading to diabetic ketoacidosis, a serious condition that requires emergency medical treatment.

Choice C rationale

While exercise is an important part of managing diabetes, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management. Exercise can help regulate blood sugar levels, but without insulin, exercise alone is not sufficient to prevent diabetic ketoacidosis.

Choice D rationale

Urine testing for ketones is an important part of managing type 1 diabetes, especially during illness or stress, when ketone levels can rise quickly. However, it is not the immediate priority for a client newly diagnosed with type 1 diabetes who has received no instruction on diabetes management.

A. People with Type 1 diabetes have little or none of their own insulin that can be released. B. People with Type 1 diabetes would need so much of an oral antihyperglycemic agent that it would cost too much. C. People with Type 1 diabetes have resistance to their endogenous insulin. D. People with Type 1 diabetes would have more episodes of hypoglycemia with oral antihyperglycemic agents.

Correct Answer is A

Explanation

Choice A rationale

People with Type 1 diabetes have little or no insulin that can be released. This is because their pancreatic β-cells, which produce insulin, are destroyed by an autoimmune process. Without insulin, glucose cannot be taken up into cells to be used for energy. Oral antihyperglycemic agents work by increasing the release of insulin or increasing the body’s sensitivity to insulin, so they are not effective in Type 1 diabetes where there is an absolute insulin deficiency.

Choice B rationale

The cost of oral antihyperglycemic agents is not the primary reason they are not used in Type 1 diabetes. The main issue is the lack of insulin production, which these medications cannot address.

Choice C rationale

People with Type 1 diabetes do not typically have resistance to their endogenous insulin. Insulin resistance is more commonly associated with Type 2 diabetes.

Choice D rationale

While hypoglycemia can occur with the use of some antihyperglycemic agents, this is not the primary reason these medications are not used in Type 1 diabetes. The main issue is the absolute deficiency of insulin.

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A nurse is caring for a client with a heart murmur due to mitral valve disease. Where would the nurse hear the murmur the loudest?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client newly diagnosed with Type 1 diabetes is to be discharged in the morning and has received no instruction on diabetes. What should be the nurse’s teaching priority?

Correct Answer is B

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is explaining to a patient why oral antihyperglycemic agents are not effective in Type 1 diabetes. What is the reason?

Correct Answer is A

Explanation

Choice B rationale

Choice C rationale

Choice D rationale

The nurse is educating a client who has been newly prescribed acarbose in addition to repaglinide for the treatment of Type 2 diabetes. Which statement made by the client indicates that the teaching has been effective?

The nurse is aware that a client taking an antibiotic that causes diarrhea should be taught about:

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A patient receives 20 units of Isophane Insulin Suspension (NPH) Insulin at 07:30. At what time are signs of hypoglycemia most likely to occur?

A patient diagnosed with deep vein thrombosis asks the nurse, “How does this blood thinner heparin work?” Which response is most accurate?

A newly admitted client has been prescribed trimethoprim-sulfamethoxazole. The nurse understands that this medication is contraindicated based on which lab result?