The nurse auscultates a S4 heart sound during the morning assessment of a client. Which additional assessment data would correlate with this finding?

Crackles heard at the lung bases

Dorsalis pedis pulses +1

A pericardial friction rub

Heart rate 50 beats per minute

Answer and Explanation

The Correct Answer is A

A. Crackles heard at the lung bases: An S4 heart sound often indicates left ventricular hypertrophy or decreased compliance of the left ventricle, commonly seen in conditions like heart failure. Crackles in the lungs can suggest pulmonary congestion related to heart failure, making this the most relevant correlation.

B. Dorsalis pedis pulses +1: A weak pulse may indicate peripheral vascular issues, but it doesn't directly correlate with an S4 heart sound.

C. A pericardial friction rub: This is associated with pericarditis and not directly related to the S4 heart sound.

D. Heart rate 50 beats per minute: While bradycardia may be present in various cardiac conditions, it does not specifically correlate with the S4 sound, which is more about ventricular filling pressures.

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Correct Answer is C

Explanation

A) Cholesterol 200 mg/dL, HDL 50 mg/dL, triglycerides 140 mg/dL: While the total cholesterol level is at the borderline (200 mg/dL), the HDL level is within a reasonable range, and triglycerides are also normal. This set does not immediately indicate a need for dietary modifications.

B) Cholesterol 165 mg/dL, HDL 54 mg/dL, triglycerides 160 mg/dL: All values are within acceptable ranges. The total cholesterol is below 200 mg/dL, and the HDL and triglycerides are also in normal ranges, indicating that dietary modifications may not be necessary.

C) Cholesterol 200 mg/dL, HDL 35 mg/dL, triglycerides 190 mg/dL: The total cholesterol is at the upper limit, but the low HDL (35 mg/dL) is concerning, as it is below the desirable level of 40 mg/dL. Low HDL is associated with increased cardiovascular risk, indicating a strong need for dietary modifications to improve heart health.

D) Cholesterol 180 mg/dL, HDL 40 mg/dL, triglycerides 220 mg/dL: While the total cholesterol is within a normal range, the triglycerides are elevated (above 150 mg/dL), which indicates a risk factor for coronary artery disease. Dietary modifications may be warranted, but the HDL is at the lower end of normal.

A. The client is retaining fluids and will need a fluid restriction. B. The client has developed an expected side effect of the medication. C. The client is experiencing angioedema and notifies the healthcare provider. D. The client will need to have the dose of the medication reduced.

Correct Answer is C

Explanation

A. The client is retaining fluids and will need a fluid restriction: While fluid retention can occur with certain medications, the specific symptoms of tingling lips and edema suggest a different issue, making this option less relevant.

B. The client has developed an expected side effect of the medication: Tingling of the lips and lip edema are not typical expected side effects of losartan. This medication can cause side effects like dizziness or hypotension, but angioedema is a serious concern that can occur.

C. The client is experiencing angioedema and notifies the healthcare provider: This is the most appropriate interpretation of the symptoms. Angioedema is a potentially serious allergic reaction that can occur with medications such as losartan, which is an angiotensin II receptor blocker. Immediate notification of the healthcare provider is crucial for further evaluation and management.

D. The client will need to have the dose of the medication reduced: While reducing the dose might be considered in some cases of side effects, the symptoms described indicate a potentially severe reaction that requires immediate attention rather than simply adjusting the dosage.

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The nurse auscultates a S4 heart sound during the morning assessment of a client. Which additional assessment data would correlate with this finding?

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing the laboratory data of a client diagnosed with coronary artery disease. Which set of laboratory results indicates a need for client teaching regarding dietary modifications?

Correct Answer is C

Explanation

The nurse administers losartan 50 mg PO to a client. One hour after administration, the client calls the nurse and complains of tingling of the lips. Noting that the client's lips are edematous, the nurse recognizes that the client is experiencing which issue?

Correct Answer is C

Explanation

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