When performing a cardiovascular assessment, what would the nurse understand about an S3 heart sound? Select all that apply

Can be caused by a poorly compliant (stiff) ventricle

Can occur with congestive heart failure

Heard just after S1

Always pathologic

An expected finding in adolescents

Answer and Explanation

Correct Answer : A,B,E

A. An S3 is often associated with a stiff or poorly compliant ventricle.
B. An S3 heart sound can be an indication of congestive heart failure in adults, as it reflects increased fluid volume and pressure in the ventricles.
C. S3 is heard just after S2, not S1.
D. The S3 heart sound is not always pathologic. It is often benign in children, adolescents, and young adults, where it may occur due to a rapid filling phase of the ventricles.
E. In adolescents and younger individuals, an S3 heart sound is usually considered a normal finding.

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Correct Answer is C

Explanation

A. "Leave" is not a part of the LEARN mnemonic.
B. "Leverage" is also not included in the LEARN mnemonic.
C. "Listen" is the correct answer; it encourages active listening to understand the client’s cultural needs and perspectives.
D. While "Look" may imply observation, it is not a component of the LEARN mnemonic.
E. "Liken" is not part of the LEARN mnemonic and is not relevant here.

A. cannula prongs are curved downward to follow natural curve of nasal passages B. pressure areas of tubing along the skin of the ears are padded C. oxygen flow rate meter is set to 10 L/min D. no smoking signs and no open flame signs are posted and clearly visible E. cannula tubing is adjusted under the neck for proper fit

Correct Answer is C

Explanation

A. Curved prongs fitting the nasal passages correctly is appropriate practice for comfort and effective delivery.
B. Padding pressure areas on the skin is a best practice to prevent skin breakdown and is indicative of proper care.
C. An oxygen flow rate of 10 L/min is excessively high for a nasal cannula, which typically accommodates 1-6 L/min; this indicates a need for further education on proper flow rates.
D. Posting clear no smoking and no open flame signs is essential for safety in oxygen therapy, reflecting good practice.
E. Proper adjustment of cannula tubing under the neck is necessary to ensure a secure fit without causing discomfort.

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When performing a cardiovascular assessment, what would the nurse understand about an S3 heart sound? Select all that apply

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Naxlex Comprehensive Predictor Exams

A nurse is performing a cultural assessment using the LEARN mnemonic for communication. Which area will the nurse assess for the "L" portion of the mnemonic?

Correct Answer is C

Explanation

When the nurse manager is evaluating the care of a client receiving oxygen through a nasal cannula, which finding indicates a need for more staff education about oxygen therapy?

Correct Answer is C

Explanation

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