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 D

Explanation

Rationale:

A. A barrel chest is typically associated with chronic obstructive pulmonary disease (COPD) due to chronic hyperinflation of the lungs, not mitral valve stenosis.

B. Clubbing occurs in chronic hypoxia conditions such as congenital heart defects or long-term lung disease. It is not a primary feature of mitral stenosis.

C. Mitral stenosis does not typically cause bradycardia. Some clients may develop atrial fibrillation, which usually causes irregularly rapid heart rates, not slowed heart rate.

D. Mitral valve stenosis narrows the mitral valve, causing turbulent blood flow from the left atrium to the left ventricle during diastole. This produces a diastolic murmur, often heard best at the apex with the client in the left lateral position.

A. Bradycardia B. Abdominal pain C. Exertional dyspnea D. Peripheral edema

Correct Answer is C

Explanation

Rationale:
A. Chronic aortic regurgitation typically does not cause bradycardia; the heart often compensates for the increased volume load by maintaining a normal or slightly elevated heart rate to preserve cardiac output.

B. This symptom is not characteristic of aortic regurgitation. Any abdominal discomfort in cardiac patients is more likely related to comorbidities or advanced heart failure affecting liver congestion, not the valve disease itself.

C. Chronic aortic regurgitation leads to volume overload of the left ventricle, causing left ventricular dilation and eventually increased pulmonary venous pressure. This results in left-sided heart failure symptoms, such as exertional dyspnea, fatigue, and decreased exercise tolerance, which often appear gradually as the disease progresses.

D. Typically associated with right-sided heart failure, peripheral edema is not an early or primary symptom of isolated aortic regurgitation. It may appear only in advanced stages if biventricular failure develops.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has mitral valve stenosis. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

Which of the following is a common symptom of chronic aortic regurgitation?

Correct Answer is C

Explanation

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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?

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