The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

Second intercostal space, right of sternum.

Third intercostal space, left of sternum.

Second intercostal space, left of sternum.

Fourth intercostal space, left mid-clavicular line.

Answer and Explanation

The Correct Answer is C

Choice A reason: The second intercostal space, right of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, right of sternum, is the location where the aortic valve can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice B reason: The third intercostal space, left of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The third intercostal space, left of sternum, is the location where the pulmonary valve, which separates the right ventricle and the pulmonary artery, can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice C reason: The second intercostal space, left of sternum, is the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, left of sternum, is the location where the aortic murmur will be most audible, as it is the closest to the aorta, the largest artery in the body. ³

Choice D reason: The fourth intercostal space, left mid-clavicular line, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The fourth intercostal space, left mid-clavicular line, is the location where the tricuspid valve, which separates the right atrium and the right ventricle, can be best heard, but not the location where the aortic murmur will be most audible. ³

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Correct Answer is B

Explanation

Choice A reason: Providing education to the client about the procedure is not the action that the nurse should implement first. This action is important, but not urgent. The nurse should prioritize the assessment and monitoring of the client's physical status and potential complications.

Choice B reason: Assessing vital signs and catheter insertion site is the action that the nurse should implement first. This action is essential to evaluate the client's hemodynamic stability and to detect any signs of bleeding, hematoma, infection, or vascular injury at the site of catheter insertion. The nurse should also check the peripheral pulses and sensation of the affected extremity.

Choice C reason: Administering fluids to provide hydration is not the action that the nurse should implement first. This action may be indicated to prevent contrast-induced nephropathy or dehydration, but it is not the priority. The nurse should first assess the client's fluid status and renal function before administering fluids.

Choice D reason: Administering the prescribed dose of aspirin and metoprolol is not the action that the nurse should implement first. This action may be indicated to prevent thrombosis or ischemia, but it is not the priority. The nurse should first assess the client's cardiac status and contraindications before administering these medications.

A. Exertional dyspnea resolved B. Heart rate 50 beats/minute C. Heart rhythm regular D. Blood pressure 120/90

Correct Answer is A

Explanation

Choice A reason: Exertional dyspnea is a common symptom of unstable angina, which is caused by reduced blood flow to the heart muscle. Carvedilol is a beta-blocker that reduces the workload of the heart and improves its oxygen supply. Therefore, resolving exertional dyspnea indicates that the medication has been effective.

Choice B reason: A heart rate of 50 beats/minute is not a desired outcome of carvedilol therapy. It may indicate that the dose is too high or that the client has a conduction problem. A normal resting heart rate for adults is between 60 and 100 beats/minute.

Choice C reason: A regular heart rhythm is not a specific indicator of carvedilol effectiveness. Carvedilol can prevent or treat some arrhythmias, but it is not the primary goal of therapy for unstable angina. A regular heart rhythm may also be influenced by other factors such as electrolytes, hydration, and stress.

Choice D reason: A blood pressure of 120/90 is not a sign of carvedilol effectiveness. Carvedilol can lower blood pressure, but it is not the main purpose of treatment for unstable angina. A blood pressure of 120/90 is considered prehypertension, which may increase the risk of cardiovascular complications.

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The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

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