Nokea
Which symptom is most important in determining the diagnosis and nursing care for a client experiencing pulmonary hypertension?
- A. Increased stroke volume
- B. Bradycardia
- C. Frothy sputum
- D. High systolic pressure
Correct Answer: C
Rationale: Tachycardia, low systolic pressure, and decreased stroke volume are symptoms associated with pulmonary hypertension. A productive cough with pink-tinged frothy sputum can indicate progression of the disorder and need for treatment.
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The nurse is providing teaching to a post-valve replacement client. Which activit(ies) would require prophylactic antibiotic use? Select all that apply.
- A. Vision screening
- B. Dental care
- C. Echocardiogram
- D. MRI
- E. Colonoscopy
- F. Chelation therapy
Correct Answer: B,E
Rationale: Dental cleaning/care and colonoscopy are invasive procedures that can disturb the normal bacteria located in residence and place a valve replacement client at risk for infective endocarditis. Vision screening, echocardiogram, MRI, and chelation therapy are not invasive procedures and do not mobilize bacteria.
The client has been diagnosed with aortic regurgitation. Which nursing data is most significant in identifying the cause for this disorder?
- A. Obesity
- B. Tobacco use
- C. Fen-Phen
- D. Lack of exercise
Correct Answer: C
Rationale: The incidence of mitral and aortic regurgitation increased by as much as 36% in 1997, due to the use of fenfluramine with phentermine (Fen-Phen) for weight loss. Obesity, tobacco use, and lack of exercise have been identified as risk factors for heart disease but not a significant identified cause for aortic regurgitation.
What must the nurse assess for to determine adequate care for a client with aortic stenosis?
- A. Increased systolic pressure
- B. Calcification of aortic valve
- C. Angina
- D. Systolic murmur
Correct Answer: C
Rationale: Angina indicates insufficient nourishment of the myocardium, which can increase the risk for mortality. The systolic blood pressure increases to force blood through the narrowed opening, and systolic murmurs can be identified in some clients, but are not the most important factors. Calcification of the aortic valve is a cause for the disorder.
What is the best technique to identify structural changes in the mitral valve?
- A. Chest radiography
- B. Cardiac catheterization
- C. Transthoracic echocardiogram
- D. Cardiac stress test
Correct Answer: C
Rationale: Standard transthoracic or transesophageal echocardiography is the best technique to identify structural changes in the mitral valve because the performance of the valve during the cardiac cycle can be evaluated. Chest radiography shows structures in the chest. Cardiac catheterization evaluates patency of arteries and measures pressures in cardiac chambers. Cardiac stress testing shows areas of the heart muscle that may become ischemic with exercise.
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.