When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?

Left fifth intercostal space, midclavicular line.

Third left intercostal space.

Left fourth intercostal space next to left sternal border.

Second right intercostal space.

Answer and Explanation

The Correct Answer is C

A.   The fifth intercostal space, midclavicular line, is the location for auscultating the mitral valve.
B.   The third left intercostal space is typically used for the pulmonic valve.
C.   The tricuspid valve is best auscultated at the left fourth intercostal space near the left sternal border.
D.   The second right intercostal space is used to listen to the aortic valve.

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Correct Answer is A

Explanation

A. A decrease in hematocrit from 36% to 32% suggests ongoing blood loss and that the client’s GI bleeding has not yet resolved. Hematocrit is a key indicator of the client’s blood volume and oxygen- carrying capacity.
B. Hemoglobin A1C reflects long-term blood sugar control, not current blood loss. A change in A1C is not indicative of GI bleeding resolution.
C. An increase in prothrombin time (PT) from 12 to 18 seconds indicates clotting abnormalities, which may occur with liver dysfunction or anticoagulant therapy, but it doesn't directly relate to GI bleeding resolution.
D. A positive to negative change in the guaiac test (fecal occult blood test) would indicate that the blood in the stool is no longer present, suggesting resolution of bleeding, which doesn’t match the question’s context.

A. Examine client's sclera for icterus. B. Review recent serum bilirubin levels. C. Observe the client's urine for dark orange color. D. Assess conjunctival sacs of lower lids for pallor.

Correct Answer is A

Explanation

A. Icterus, or yellowing of the sclera, is a key sign of jaundice, which occurs when there is an excess of bilirubin in the blood.
B. Serum bilirubin levels are important for diagnosis but are not an immediate physical assessment.
C. Dark urine can suggest liver or bile duct issues but is not definitive for jaundice.
D. Pallor of the conjunctiva indicates anemia, not jaundice.

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When assessing heart sounds of a client with rheumatic valvular heart disease, where should the nurse place the stethoscope to auscultate the tricuspid valve?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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