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A client with aortic valve regurgitation is asking about the disease process. What would the nurse tell the client is the first sign of aortic valve regurgitation?
- A. Tachycardia
- B. Left-sided heart failure
- C. Pain
- D. Dysrhythmias
Correct Answer: A
Rationale: Tachycardia is one of the first signs of cardiac compensation. When valve damage affects the left ventricle, the client becomes aware of forceful heart contractions (palpitations). At first, palpitations occur only when lying flat or on the left side. Aortic valve regurgitation does not produce left-sided heart failure, pain, or dysrhythmias as the first symptom of disease.
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The client is complaining of severe dizziness and drowsiness. Upon assessment, the nurse finds the client has bradycardia and a bluish discoloration of the palms and fingernails. What do these signs and symptoms indicate?
- A. Cinchonism
- B. Overdosage
- C. Hypokalemia
- D. Hypertension
Correct Answer: B
Rationale: These signs and symptoms indicate overdosage of a drug. The nurse should inform the care provider immediately if these symptoms appear. These are not the signs and symptoms of cinchonism, hypokalemia, or hypertension.
The nurse is caring for a client diagnosed with mitral stenosis. Which client symptom change would most likely indicate to the nurse, a progression of this condition?
- A. Decreased systolic pressure
- B. Increased systolic pressure
- C. Widening pulse pressure
- D. Normal diastolic pressure
Correct Answer: A
Rationale: As mitral stenosis progresses, the systolic blood pressure will decrease due to the reduction of the cardiac output. Widening pulse pressure with normal diastolic pressure is associated more with aortic regurgitation.
The nursing instructor is teaching the junior nursing students about aortic regurgitation. What classification of drugs is used to sustains the client with aortic regurgitation?
- A. Antihypertensives
- B. Anticoagulants
- C. Cardiac glycosides
- D. Antiarrhythmics
Correct Answer: C
Rationale: Because aortic regurgitation is mild and only slowly progressive in most people, clients are sustained with cardiac glycosides or beta-blockers and diuretics. Antihypertensives, anticoagulants, and antiarrhythmics are not the type of drugs used to treat aortic regurgitation.
A client reports a family history of aortic stenosis. Which assessment finding would the nurse identify as a likely contributing factor?
- A. High blood pressure
- B. Missing aortic cusp
- C. Unidirectional blood flow
- D. Chest pain
Correct Answer: B
Rationale: In young adults, aortic stenosis usually is a consequence of a congenital defect in which the valve has two instead of three cusps. High blood pressure and chest pain are symptoms that can be exhibited in aortic stenosis. Unidirectional blood flow is the normal flow of blood through the heart.
The nurse collects data for a client who is diagnosed with mitral stenosis with a murmur. In which position does the nurse place the client to auscultate the documented murmur?
- A. Prone
- B. Supine
- C. Left lateral
- D. Right lateral
Correct Answer: C
Rationale: Changes in heart sounds may be the earliest indication of mitral valve stenosis. S1 may be extremely loud if the cusps are fused or muffled or absent if the cusps have calcified and are immobile. A murmur, described as sounding like a rumbling underground train, can be heard at the heart's apex, especially when the client assumes a left lateral position. The other positions are not supported by evidence-based practice guidelines as appropriate positions in which to place the client to monitor a murmur.