Health Assessment Exam 3 test bank questions and answers 100% verified.

Health Assessment Exam 3 test bank questions and g g g g g g g




answers 100% verified.
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While auscultating the heart at the third intercostal space, left sternal border, the nurse
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notes a high-pitched, scratchy sound that increases with exhalation with the client
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leaning forward. The nurse would document which of the following?
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A) Pericardial friction rub
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B) Midsystolic click
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C) Summation gallop
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D) Aortic ejection click - ANSWER A) Pericardial friction rub
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During chest auscultation, the nurse hears a quiet murmur immediately upon placing
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the stethoscope on the client's chest. The nurse interprets this as which grade?
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A) I g



B) II g



C) III g



D) IV - ANSWER B) II
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After teaching a group of students about blood flow through the heart, the instructor
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determines that the teaching was successful when the students state that after being
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received by the atria, the blood goes to which of the following?
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A) Chordae tendineae
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B) Ventricles
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C) Semilunar valves
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D) Precordium - ANSWER B) Ventricles
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A group of students is reviewing the structures of the heart, noting that the thickest
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layer of the heart is made up of contractile muscle cells. The students are correct in
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identifying it as which of the following?
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A) Myocardium
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B) Epicardium
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C) Endocardium
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D) Pericardium - ANSWER A) Myocardium
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A nursing student is reviewing the electrical conduction of the heart. The student is
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correct in identifying the sinoatrial node of the heart as which of the following?
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A) Bundle of His
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B) Purkinje fibers
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C) Pacemaker
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D) Conduction system - ANSWER C) Pacemaker
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The nurse is assessing a client's first heart sound. The nurse interprets this finding as
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indicating which heart action?
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A) Isometric contraction
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B) Closure of the semilunar valves
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,C) Beginning of diastole
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D) Closure of the atrioventricular valves - ANSWER d
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A nurse assesses a client's jugular venous pulse to gather information about which of
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the following?
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A) Left arterial pressure.
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B) Left ventricular diastolic filling.
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C) Right ventricular pressure.
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D) Hemodynamics of the right side of the heart. - ANSWER d
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On examination, the nurse would expect what finding if a client is in right-sided failure?
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A) Increased jugular venous pressure
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B) Decreased right-sided volume
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C) Decreased central venous pressure
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D) Decreased stroke volume - ANSWER a
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A client presents with chest pain described as a pressure and squeezing sensation
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that is steady and severe. The nurse would suspect which system as the most likely
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source?
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A) Cardiac
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B) Gastrointestinal
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C) Musculoskeletal
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D) Pulmonary - ANSWER a
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A client complains of palpitations and a feeling of anxiety. Which of the following would
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be most appropriate for the nurse to keep in mind?
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A) This is a normal response by the heart's conduction system.
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B) This is the body's response to an increase in cardiac output.
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C) The heart is attempting to increase cardiac output.
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D) The heart is responding to increased renal perfusion. - ANSWER c
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Which of the following would the nurse suspect when a client with a cardiac condition
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complains of not sleeping well and having to get up frequently at night to urinate?
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A) This indicates the heart is working efficiently.
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B) Increased urination at rest may indicate heart failure.
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C) The client has decreased performance levels of activities of daily living.
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D) The client most likely sleeps without a pillow at night. - ANSWER b
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When auscultating the left carotid artery, the nurse notes a swishing sound. The nurse
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interprets this finding as suggesting which of the following?
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A) Decreased cardiac output
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B) Increased central venous pressure
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C) A narrowed vessel
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D) Right ventricular failure - ANSWER b
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Which technique would be most appropriate to use when examining the jugular venous
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pulse?
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A) Perform the exam with the client in a supine position.
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B) Have the client look straight ahead with chin slightly lifted.
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C) Have the client sit up at a 90-degree angle.
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, D) Inspect the suprasternal notch or around the clavicles. - ANSWER d
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The nurse is preparing to assess a client's apical impulse. The nurse would palpate at
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which location?
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A) Second intercostal space, left sternal border
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B) Third intercostal space, left axillary line
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C) Fourth intercostal space, left sternal border
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D) Fifth intercostal space, left midclavicular line - ANSWER d
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A nurse is preparing a presentation for a local community group about coronary artery
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disease and culture. Which information would the nurse include?
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A) Caucasians take higher lifestyle risks than African Americans.
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B) Hypertension is more prevalent in African Americans.
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C) Hypertension is seen more in white women than in African-American women.
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D) Hispanic Americans have a higher rate of coronary artery disease than white
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Americans. - ANSWER b
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A nurse auscultates a client's heart sounds and notes an accentuated first heart sound.
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The nurse would suspect which of the following?
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A) Hypothyroidism
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B) Feverg



C) Mitral stenosis
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D) Heart murmur - ANSWER c
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Which characteristic of the first heart sound would the nurse expect to hear in a client
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with mitral insufficiency?
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A) Splitg



B) Diminished
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C) Accentuated
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D) Varying - ANSWER b
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A nurse suspects that a client may have a pericardial friction rub. To ensure that the
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nurse hears this, the nurse would place the client in which position?
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A) Supine with head of bed elevated 30 degrees
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B) Leaning forward while in a sitting position
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C) Flat, left lateral
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D) Sitting upright in a straight back chair - ANSWER b
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A nurse is demonstrating the technique for auscultating heart sounds. Which of the
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following would be most important for the nurse to emphasize?
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A) Start at the apex.
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B) Listen over each of the heart chambers.
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C) Use both the bell and diaphragm.
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D) Cover the entire precordium. - ANSWER d
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After teaching a group of students about the traditional areas of auscultation of heart
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sounds, the instructor determines that the teaching was successful when the students
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identify which of the following as Erb's point?
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A) Fifth intercostal space near the left midclavicular line
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B) Third to fifth intercostal space at the left sternal border
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