The nurse is performing a focused cardiovascular assessment on a 70-year-old client. What finding would be considered abnormal? No palpable vibration felt over the precordium (chest wall)
S1 and S2 heard with diaphragm of stethoscope
A blowing sound heard over the mitral area with the bell of the stethoscope
Apical pulse palpated at 5th intercostal space, midclavicular line
Absent sound over carotid arteries with bell of the stethoscope
The Correct Answer is B
A. S1 and S2 heard with the diaphragm of the stethoscope is a normal finding, as these are the expected heart sounds.
B. A blowing sound heard over the mitral area with the bell of the stethoscope suggests a possible murmur, which could indicate valvular abnormalities and is considered abnormal.
C. Apical pulse palpated at the 5th intercostal space, midclavicular line is normal and expected in adults.
D. Absence of sound over carotid arteries with the bell of the stethoscope indicates no bruits and is considered normal.
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Correct Answer is E
Explanation
A. Cutaneous pain refers to pain from the skin and subcutaneous tissues, which is not described here.
B. Parasympathetic pain is not a recognized category of pain.
C. Visceral pain arises from internal organs and does not typically present as sharp, tingling, or numb.
D. Deep somatic pain is related to muscles, joints, and bones and typically does not have the sharp, tingling quality described.
E. Neuropathic pain is characterized by sharp, tingling sensations and numbness, often resulting from nerve damage, which fits the client's description.
Correct Answer is C
Explanation
A. Poor hair growth is more associated with arterial insufficiency.
B. A weak pulse may suggest arterial, not venous, insufficiency.
C. Edema is a common finding in venous insufficiency due to fluid pooling in the extremities.
D. Muscle atrophy is not typically associated with venous insufficiency.
E. Pale color is more indicative of arterial insufficiency, while venous insufficiency may present with darkened or reddish skin.