A 65-year-old man presents to the clinic with complaints of swelling in his lower extremities, abdominal discomfort, and weight gain over the past few weeks. On examination, you notice jugular venous distention and hepatomegaly. Which condition is most likely causing these symptoms?

Left-sided heart failure

Right-sided heart failure

Liver cirrhosis

Chronic kidney disease

Answer and Explanation

The Correct Answer is B

Rationale:

A. Typically causes pulmonary symptoms, such as dyspnea, orthopnea, and pulmonary edema, rather than peripheral edema and hepatomegaly.

B. Right-sided HF leads to systemic venous congestion, causing peripheral edema, jugular venous distention, hepatomegaly, and abdominal discomfort. Weight gain from fluid retention is also common.

C. Can cause ascites and hepatomegaly, but usually accompanied by stigmata of chronic liver disease (jaundice, spider angiomas) and not jugular venous distention due to cardiac causes.

D. May cause generalized edema and weight gain, but jugular venous distention and hepatomegaly are less specific, and lab findings (BUN, creatinine) would help distinguish.

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Correct Answer is A

Explanation

Rationale:
A. Percutaneous transluminal balloon valvuloplasty (PTBV) is a minimally invasive procedure that dilates the stenotic mitral valve without replacing it. Since no prosthetic valve is implanted, clients typically do not require lifelong anticoagulation, which is a major advantage over mechanical valve replacement.

B. While PTBV is less invasive than open surgery, it usually requires moderate sedation or general anesthesia for patient comfort and safety. Local anesthesia alone is rarely sufficient.

C. PTBV improves valve opening temporarily, but valve restenosis can occur over time, so the correction is not necessarily permanent. Valve replacement provides a more long-term solution.

D. While PTBV avoids prosthetic material and thus may reduce some infection risks, infection is generally not the primary concern with valve replacement, and the overall difference in infection risk is not a primary advantage cited for PTBV.

A. First-degree AV block is characterized by a prolonged PR interval greater than 0.20 seconds. B. First-degree AV block is a type of heart block where some atrial impulses fail to reach the ventricles. C. Patients with first-degree AV block typically present with symptoms such as syncope or dizziness. D. First-degree AV block often requires immediate treatment with a pacemaker.

Correct Answer is A

Explanation

Rationale:

A. In first-degree atrioventricular (AV) block, all atrial impulses reach the ventricles, but conduction through the AV node is delayed. This delay is reflected on the ECG as a PR interval longer than 0.20 seconds, while the QRS complex remains normal. First-degree AV block is usually asymptomatic and often does not require treatment.

B. This description fits second-degree AV block, not first-degree. In first-degree block, no impulses are blocked, only delayed.

C. First-degree AV block is generally asymptomatic, and patients rarely experience symptoms. Symptoms such as syncope are more characteristic of higher-degree AV blocks.

D. Pacemaker therapy is not indicated for first-degree AV block unless it progresses to higher-degree AV block with symptomatic bradycardia. Immediate intervention is not needed in asymptomatic patients.

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A 65-year-old man presents to the clinic with complaints of swelling in his lower extremities, abdominal discomfort, and weight gain over the past few weeks. On examination, you notice jugular venous distention and hepatomegaly. Which condition is most likely causing these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following is an advantage of percutaneous transluminal balloon valvuloplasty over valve replacement in treating mitral stenosis?

Correct Answer is A

Explanation

A 55-year-old patient with a history of hypertension is undergoing a routine ECG as part of their annual check-up. The ECG reveals a first-degree AV block. Which of the following statements about first-degree AV block is correct?

Correct Answer is A

Explanation

After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first?

A 65-year-old patient with congestive heart failure has been on diuretic therapy for the past two weeks. During a follow-up appointment, which of the following findings would indicate that the diuretic therapy is effective?

A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?

A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave?

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

Which of the following is the initial step in the management of a patient with asystole?

A nurse is reviewing laboratory results for a client who has pericarditis. Which of the following blood test results should the nurse anticipate? (Select All that Apply.)