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While auscultating a patient's heart sounds, a nurse detects a fourth heart sound (S4). The nurse understands that this finding possibly indicates:.

Pericarditis.

Arterial obstruction or aneurysm.

Forceful atrial contraction to overcome ventricular resistance.

An infectious valvular disorder.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Pericarditis is an inflammation of the pericardium and would not directly cause an S4 heart sound.

Choice B rationale:

Arterial obstruction or aneurysm would cause changes in blood flow, but not specifically an S4 heart sound.

Choice C rationale:

An S4 heart sound is an extra sound that is heard late in diastole just before S1. It occurs due to resistance to blood flow in an enlarged ventricle, often due to forceful atrial contraction to overcome ventricular resistance.

Choice D rationale:

An infectious valvular disorder could cause a variety of heart sounds, but not specifically an S42.

So, the correct answer is C, after analyzing all choices.

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Correct Answer is A

Explanation

Choice A rationale:

A fasting triglyceride level of 167 mg/dL is above the desirable level of less than 150 mg/dL, indicating a higher risk for CAD34.

Choice B rationale:

An HDL level of 96 mg/dL is considered good and is protective against CAD34.

Choice C rationale:

An LDL level of 104 mg/dL is near optimal/above optimal, but it’s not high enough to be a priority risk factor for CAD34.

Choice D rationale:

Total serum cholesterol of 192 mg/dL is within the desirable range of less than 200 mg/dL34.

So, the correct answer is A, after analyzing all choices.

A. Patient with dilated cardiomyopathy who has bilateral crackles at the lung bases. B. Patient with acute aortic regurgitation whose blood pressure is 86/54 mm Hg. C. Patient with infective endocarditis who has a murmur and splinter hemorrhages. D. Patient with rheumatic fever who has sharp chest pain with a deep breath.

Correct Answer is B

Explanation

Choice A rationale:

While bilateral crackles at the lung bases indicate fluid accumulation, a common symptom of dilated cardiomyopathy, it’s not as immediately life-threatening as some other conditions.

Choice B rationale:

Acute aortic regurgitation can lead to a rapid and severe drop in blood pressure, which is a medical emergency. Therefore, this patient should be assessed first.

Choice C rationale:

While a murmur and splinter hemorrhages are symptoms of infective endocarditis, they are not as immediately life-threatening as acute aortic regurgitation.

Choice D rationale:

Sharp chest pain with a deep breath could be a symptom of rheumatic fever, but it’s not as immediately life-threatening as acute aortic regurgitation.

So, the correct answer is Choice B, after analyzing all choices.

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While auscultating a patient's heart sounds, a nurse detects a fourth heart sound (S4). The nurse understands that this finding possibly indicates:.

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