When auscultating the anterior thorax of a pregnant woman, the nurse notices the presence of a murmur over the second, third, and fourth intercostal spaces. The murmur is continuous but can be obliterated by pressure with the stethoscope
or finger on the thorax just lateral to the murmur. The nurse interprets this finding to be:
a.
Murmur of aortic stenosis.
b.
Most likely a mammary souffle.
c.
Associated with aortic insufficiency.
d.
Indication of a patent ductus arteriosus.
ANS: B
Blood flow through the blood vessels, specifically the internal mammary artery, can often be heard over the second, third, and fourth intercostal spaces. This finding is called a mammary souffle, but it may be mistaken for a cardiac murmur. The other options are incorrect.
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During which stage of the health planning process would the community health nurse create a plan?
A) Assessment B) Analysis and design C) Implementation D) Evaluation
Why is accreditation of nursing education programs is important? (Select all that apply.)
a. It assures students that their educational program is offering quality education. b. Acceptance into graduate programs in nursing depends on graduation from an accredited program. c. It serves as stimulus for programs to initiate periodic self-examination and self-improvement. d. It has established standards to allow graduates to take licensure examinations. e. Graduating from an accredited program ensures successful completion of the licensure exam.
Planning should occur after:
A) Nursing diagnoses are prioritized. B) Nursing diagnoses are identified. C) Goals are set. D) Evaluation has occurred.
The nurse is administering medications to a patient with neuropathic pain. The patient asks why he is getting an antidepressant medication because he is not depressed. Which of the following is the best response by the nurse?
A) "All patients with pain have at least some depression." B) "Antidepressants have been shown to have pain-relieving qualities in patients with neuropathic pain." C) "Treating your depression, even if you don't think you have it, will help control your pain." D) "The doctor thinks it will help with your pain."