A nurse is examining a client with diastolic dysfunction. Upon auscultation using the bell of the stethoscope the nurse hears a late diastolic heart sound at the 5th intercostal space, left midclavicular line. Based on these findings and the clients history, the nurse would recognize this extra heart sound is most likely what?

Answer and Explanation

The Correct Answer is B

A. S1: S1 is the first heart sound, heard at the beginning of systole, and is not related to diastolic dysfunction.

B. S4: This is the correct answer. An S4 sound is heard late in diastole, often due to increased resistance to filling during diastole, which is typical in diastolic dysfunction.

C. S3: An S3 is a low-pitched sound heard early in diastole, typically associated with systolic dysfunction or heart failure with reduced ejection fraction.

D. S2: S2 is the second heart sound, heard during the end of systole and is not associated with diastolic dysfunction.

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Correct Answer is D

Explanation

A. Potassium chloride is used to treat hypokalemia, not as a warfarin antidote.

B. Vitamin E does not counteract warfarin’s effects and may increase bleeding risk.

C. Protamine sulfate is the antidote for heparin, not warfarin.

D. Vitamin K is the appropriate antidote for excessive warfarin, as it promotes the synthesis of clotting factors inhibited by warfarin.

A. "In hot weather, I sweat so much that I drink six glasses of water each day." B. "I take sodium bicarbonate after every meal to prevent heartburn." C. "I don't drink milk because it gives me gas and diarrhea." D. "I have been taking digoxin every day for the last 15 years."

Correct Answer is B

Explanation

A. Drinking water in hot weather is important to prevent dehydration. This is not a risk factor for metabolic alkalosis unless the client is excessively losing electrolytes through sweating and not replacing them.

B. Sodium bicarbonate is an alkaline substance, and regular use, especially after meals, can contribute to metabolic alkalosis. The client should be instructed on the potential risks of using sodium bicarbonate too frequently.

C. Avoiding milk due to gastrointestinal symptoms does not directly contribute to metabolic alkalosis.

D. Digoxin does not directly affect acid-base balance, but it requires monitoring due to potential interactions with other medications or electrolyte imbalances.

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Naxlex Comprehensive Predictor Exams

A client who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the client may have been taken too much warfarin. The nurse anticipates that client will receive which antidote?

Correct Answer is D

Explanation

After providing discharge teaching, a nurse assesses the client's understanding regarding increased risk for metabolic alkalosis. Which statement indicates that the client needs additional teaching?

Correct Answer is B

Explanation

Which information about continuous bladder irrigation will the nurse teach to a client who is being admitted for a transurethral resection of the prostate (TURP)?

What would be the priority intervention for the care of the client who is pulseless and has the following rhythm on the monitor?

An emergency department nurse triages clients who present with chest discomfort. Which client would the nurse plan to assess first?

A nurse reviews a client's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

Which assessment finding in a 36-year-old client is most indicative for further evaluation?

The new graduate nurse is assessing a client with an unrepaired abdominal aortic aneurysm. What assessment technique requires further education by the supervising nurse?

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

A nurse is reviewing the chart of a new client in the family medicine clinic and notes that the client is identified as "George Smith." The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?