A nurse is reinforcing teaching with an older adult client who has been newly diagnosed with a heart murmur. Which of the following statements should the nurse make?
"A heart murmur is a high-pitched sound due to a narrow valve."
"A heart murmur is an extra sound your heart makes due to blood entering an inflexible chamber."
"This means that there is some inflammation around your heart."
"This indicates turbulent (chaotic, random fluctuations) blood flow through a valve."
The Correct Answer is D
A. "A heart murmur is a high-pitched sound due to a narrow valve." While some murmurs may be caused by a narrow valve (stenosis), not all murmurs are high-pitched. Murmurs vary in pitch depending on the cause, so this is not a comprehensive explanation.
B. "A heart murmur is an extra sound your heart makes due to blood entering an inflexible chamber." This describes an S3 or S4 sound rather than a murmur. A heart murmur is typically related to turbulent blood flow through valves, not just an inflexible heart chamber.
C. "This means that there is some inflammation around your heart." This statement incorrectly links a murmur to pericarditis or myocarditis, which involve inflammation. A murmur is associated with abnormal blood flow, not inflammation.
D. "This indicates turbulent (chaotic, random fluctuations) blood flow through a valve." A heart murmur is caused by turbulent blood flow, which can occur when blood moves through a valve that is narrow or has regurgitation. This is the correct explanation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Liver: Liver is high in cholesterol and should be avoided by clients on a low-cholesterol diet. This is not a suitable choice for the client.
B. Beans: Beans are a high-fiber, plant-based protein source that is low in cholesterol. This is a good choice for a low-cholesterol diet.
C. Eggs: Eggs contain cholesterol, particularly in the yolk. While one egg a day may be acceptable for some individuals, this is generally a food that should be limited on a low-cholesterol diet.
D. Milk: Depending on the fat content, milk can be high in cholesterol. Clients should opt for skim or low-fat milk to reduce cholesterol intake. Full-fat milk is not ideal for a low-cholesterol diet.
Correct Answer is D
Explanation
A. "A heart murmur is a high-pitched sound due to a narrow valve." While some murmurs may be caused by a narrow valve (stenosis), not all murmurs are high-pitched. Murmurs vary in pitch depending on the cause, so this is not a comprehensive explanation.
B. "A heart murmur is an extra sound your heart makes due to blood entering an inflexible chamber." This describes an S3 or S4 sound rather than a murmur. A heart murmur is typically related to turbulent blood flow through valves, not just an inflexible heart chamber.
C. "This means that there is some inflammation around your heart." This statement incorrectly links a murmur to pericarditis or myocarditis, which involve inflammation. A murmur is associated with abnormal blood flow, not inflammation.
D. "This indicates turbulent (chaotic, random fluctuations) blood flow through a valve." A heart murmur is caused by turbulent blood flow, which can occur when blood moves through a valve that is narrow or has regurgitation. This is the correct explanation.
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