A 56-year-old individual visits his primary care provider for a routine checkup.The physical examination reveals edema, an enlarged liver (hepatomegaly), and muffled heart sounds.

Which of the following findings should the nurse be most concerned about?

Choice A rationale
Education on the necessity of continuous antibiotic prophylaxis is crucial for patients who have just recovered from rheumatic fever. Rheumatic fever is an inflammatory disease that can develop as a complication of untreated or inadequately treated strep throat or scarlet fever.
Patients who have had rheumatic fever are at risk of getting it again if they have another strep infection. Continuous antibiotic prophylaxis can prevent recurrent infections and the development of rheumatic heart disease.
Choice B rationale
While anticoagulation therapy may be necessary for some patients with heart conditions, it is not typically the most important nursing action for a patient who has just recovered from rheumatic fever. Rheumatic fever can cause inflammation and damage to the heart valves, but it does not typically cause blood clots, which are the primary reason for anticoagulation therapy.
Choice C rationale
Adherence to standard infection control procedures is important for all patients, but it is not the most important nursing action for a patient who has just recovered from rheumatic fever. The primary concern for these patients is preventing recurrent strep infections, which can be achieved through continuous antibiotic prophylaxis.
Choice D rationale
While physical activity management may be part of the overall care plan for a patient who has just recovered from rheumatic fever, it is not typically the most important nursing action. The primary concern for these patients is preventing recurrent strep infections, which can be achieved through continuous antibiotic prophylaxis.

Choice A rationale
Aortic regurgitation is a condition where the aortic valve doesn’t close tightly, causing blood to leak back into the left ventricle. This condition can lead to left heart failure but is not typically associated with right heart failure.
Choice B rationale
Mitral regurgitation is a disorder in which the mitral valve on the left side of the heart does not close properly. This condition can lead to left heart failure but is not typically associated with right heart failure.
Choice C rationale
Aortic stenosis is a narrowing of the aortic valve opening. This condition can lead to left heart failure but is not typically associated with right heart failure.
Choice D rationale
Tricuspid regurgitation is a disorder in which the heart’s tricuspid valve does not close properly, causing blood to flow backward into the right atrium. This condition can lead to right heart failure, especially when associated with pulmonary hypertension.