While auscultating a client's heart sounds, the nurse hears turbulence between S1 and S2. The nurse should document this finding as which of the following?

A systolic murmur

A third heart sound (S3)

A fourth heart sound (S4)

An expected heart sound

Answer and Explanation

The Correct Answer is A

A. A systolic murmur: A murmur heard between S1 and S2 occurs during systole, which is why it is classified as a systolic murmur. Systolic murmurs are often due to valve abnormalities like aortic stenosis or mitral regurgitation.

B. A third heart sound (S3): The S3 sound occurs after S2, not between S1 and S2. It is associated with rapid ventricular filling and may indicate heart failure.

C. A fourth heart sound (S4): The S4 sound occurs before S1, not between S1 and S2. It is associated with a stiff or hypertrophic ventricle.

D. An expected heart sound: A murmur is not considered an expected heart sound; it is typically abnormal and requires further investigation.

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Correct Answer is A

Explanation

A. "I will sit on the side of the bed before I stand up." Propranolol can cause orthostatic hypotension, so the client should sit on the edge of the bed before standing to avoid dizziness or falls. This statement shows correct understanding.

B. "I should weigh myself on the same day once a week." Clients taking propranolol, especially if they have heart failure, should weigh themselves daily to monitor for fluid retention. Weekly weighing is insufficient for identifying early signs of worsening heart failure.

C. "I should expect to develop a slight cough while taking this medication." A cough is more commonly associated with ACE inhibitors (such as lisinopril) rather than beta-blockers like propranolol. This statement indicates a misunderstanding.

D. "I will not take my medicine if my heart rate is greater than 70/min." Beta-blockers like propranolol are typically withheld if the heart rate is below 60 beats per minute, not when it is greater than 70. This statement shows a misunderstanding of when to hold the medication.

A. Schedule an appointment for a prostate-specific antigen (PSA) test. B. Schedule his next appointment for 1 year from now. C. Provide information about how to reduce risk factors of hypertension. D. Provide information for a weight loss plan that includes increasing physical activity.

Correct Answer is C

Explanation

A. Schedule an appointment for a prostate-specific antigen (PSA) test. PSA screening is typically considered for men aged 50 and older, or earlier for those with higher risk factors like family history. Since the client does not mention any risk factors, this option is not a priority.

B. Schedule his next appointment for 1 year from now. While it is standard for clients without significant health issues to have annual exams, the nurse should prioritize education on risk factors related to hypertension, given the client's slightly elevated blood pressure.

C. Provide information about how to reduce risk factors of hypertension. Even though the client's blood pressure is in the elevated category, it is important to educate him about how to reduce the risk of developing hypertension, particularly since he is African-American, which is a population at higher risk for hypertension.

D. Provide information for a weight loss plan that includes increasing physical activity. The client has a normal BMI of 24, so weight loss would not be necessary. However, regular physical activity is important for overall cardiovascular health.

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While auscultating a client's heart sounds, the nurse hears turbulence between S1 and S2. The nurse should document this finding as which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has hypertension and is taking propranolol. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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