To assess the apical pulse, the nurse should place the stethoscope on the:
a. third intercostal space to the right of the midclavicular line.
b. fifth intercostal space to the left of the midclavicular line.
c. sixth intercostal space at the midclavicular line.
d. seventh intercostal space to the left of the midclavicular line.
ANS: B
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After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client's understanding. Which action demonstrates that the client correctly understands the teaching?
a. The client lays on his or her side with his or her knees bent. b. The client places his or her hands on his or her abdomen. c. The client lays in a prone position with his or her legs straight. d. The client places his or her hands above his or her head.
Upon initial assessment of a spinal cord injured patient, the nurse will observe which of the following below the level of injury?
A) rigidity of the extremities B) deep tendon reflexes C) flaccid paralysis D) inward rotation of the extremities
Analysis has shown that a client's right atrial pressure is 30 mm Hg. What is the most likely conclusion that the client's care team will draw from this piece of data?
A) The result is likely normal and gravity dependent given the lack of valves in thoracic and central veins. B) The pressure is insufficient to provide adequate stroke volume and cardiac output. C) The pressure is excessive given that the right atrium should be at atmospheric pressure. D) Pressure pulsations are likely to be undetectable given the low atrial pressure.
Which condition is associated with oversecretion of renin?
a. Alzheimer's disease b. Hypertension c. Diabetes mellitus d. Diabetes insipidus