Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is collecting data from a client who has mitral valve regurgitation. In which of the following areas should the nurse place the stethoscope to auscultate a murmur? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
A. -
is not the correct answer because the tricuspid area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The tricuspid area is located at the fifth intercostal space at the lower left sternal border, and is the site where blood flows from the right atrium to the right ventricle during systole.
B. -
The correct answer is choice B, the mitral area. When auscultating for a murmur in a client with mitral valve regurgitation, the nurse should place the stethoscope at the mitral area, which is the fifth intercostal space at the left midclavicular line. This is because the mitral valve is located at this spot and is the site where blood flows from the left atrium to the left ventricle during systole.
C. -
is not the correct answer because the aortic area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The aortic area is found at the second intercostal space at the right sternal border, and is the site where blood flows from the left ventricle to the aorta during systole. ChoiceD4 is not the correct answer because the pulmonic area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The pulmonic area is located at the second intercostal space at the left sternal border, and is the site where blood flows from the right ventricle to the pulmonary artery during systole.
D. -
The correct answer is choice B, the mitral area. When auscultating for a murmur in a client with mitral valve regurgitation, the nurse should place the stethoscope at the mitral area, which is the fifth intercostal space at the left midclavicular line. This is because the mitral valve is located at this spot and is the site where blood flows from the left atrium to the left ventricle during systole.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Adult Med Surg 2020 with NGN Proctored Exam. Take the full exam now
Full Explanation
is not the correct answer because the tricuspid area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The tricuspid area is located at the fifth intercostal space at the lower left sternal border, and is the site where blood flows from the right atrium to the right ventricle during systole.<\/p>"},"B":{"choice":"-","reason":"
The correct answer is choice B, the mitral area. When auscultating for a murmur in a client with mitral valve regurgitation, the nurse should place the stethoscope at the mitral area, which is the fifth intercostal space at the left midclavicular line. This is because the mitral valve is located at this spot and is the site where blood flows from the left atrium to the left ventricle during systole.<\/p>"},"C":{"choice":"-","reason":"
is not the correct answer because the aortic area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The aortic area is found at the second intercostal space at the right sternal border, and is the site where blood flows from the left ventricle to the aorta during systole.
\r\nChoiceD4 is not the correct answer because the pulmonic area is not the location where a nurse should auscultate for a murmur related to mitral valve regurgitation. The pulmonic area is located at the second intercostal space at the
\r\n
\r\nleft sternal border, and is the site where blood flows from the right ventricle to the pulmonary artery during systole.<\/p>"},"D":{"choice":"-","reason":"
The correct answer is choice B, the mitral area. When auscultating for a murmur in a client with mitral valve regurgitation, the nurse should place the stethoscope at the mitral area, which is the fifth intercostal space at the left midclavicular line. This is because the mitral valve is located at this spot and is the site where blood flows from the left atrium to the left ventricle during systole.<\/p>"}}
Similar Questions
A nurse is preparing to administer ceftriaxone using the z-track technique to a client who has gonorrhea. After the nurse performs hand hygiene and reconstitutes the medication, identify the sequence the nurse should use to administer the medication. (Move the steps, placing them in the order of performance. Use all the steps.)
A. Use the nondominant hand to pull the skin and subcutaneous tissue 2.5 cm (1 in) laterally.
B. Remove the needle and release the tissue.
C. Aspirate by pulling back on the plunger and inject the medication.
Full Explanation
A nurse is collecting data from a client who has suspected appendicitis. What finding should the nurse prioritize to report to the provider?
A. Loss of appetite
Option A - Loss of appetite is a common symptom of appendicitis.
B. WBC count 15,000/mm
Option B - A WBC count of 15,000/mm is an expected finding in appendicitis.
C. Rigid, board-like abdomen
peritonitis, a complication that requires immediate medical attention. Option A is incorrect because loss of appetite is a common symptom of appendicitis. Option B is incorrect because a WBC count of 15,000/mm is an expected finding in appendicitis due to the inflammatory response. Option D is incorrect because a temperature of 37.8°C (100°F) is a mild fever and can be expected in appendicitis.
D. Temperature 37.8°C (100°F)
Option D - A temperature of 37.8°C (100°F) is a mild fever and can be expected in appendicitis
A nurse is assisting in the care of a client who had an ischemic stroke. Which of the following observations by the nurse indicates a need for an occupational therapy referral?
A. The client becomes exhausted while brushing her teeth.
The correct answer is choice A, "The client becomes exhausted while brushing her teeth." This indicates a need for an occupational therapy referral to help the client with daily activities that require more energy.
B. The client coughs while drinking from a straw.
is incorrect because coughing while drinking indicates a need for a speech therapy referral.
C. The client is unable to bear her full weight while walking.
is incorrect because inability to bear full weight while walking indicates a need for physical therapy.
D. The client is having difficulty reading large print.
is incorrect because difficulty reading large print indicates a need for visual aids or referral to an ophthalmologist