The Nurse Is Admitting a Client Diagnosed with Congestive Heart

question 25

Multiple Choice

The nurse is admitting a client diagnosed with congestive heart failure.Although the client is sitting in a semi-Fowler position, the nurse is unable to auscultate distinct heart tones.Which action should the nurse perform first?

• A)Document that the heart tones are muffled.
• B)Count the radial pulse and document it as the heart rate.
• C)Assist the client to lean forward and toward the left side.
• D)Report the findings to the admitting physician.

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Break-even Point

The level of production or sales at which total costs equal total revenue, resulting in no net loss or gain.