A client is being seen in the clinic to rule out mitral valve stenosis. Which assessment data would be an early indication of this condition?

The client's blood pressure has decreased since the last visit

The client's liver is enlarged and the abdomen is edematous

The client has jugular vein distention and 3+ pedal edema

The client complains of shortness of breath when walking

Answer and Explanation

The Correct Answer is D

A. The client's blood pressure has decreased since the last visit. Decreased blood pressure is not a typical early sign of mitral valve stenosis.

B. The client's liver is enlarged and the abdomen is edematous. These are signs of more advanced heart failure, which can result from mitral valve stenosis but are not early indicators.

C. The client has jugular vein distention and 3+ pedal edema. Jugular vein distention and pedal edema are later signs of heart failure caused by mitral valve stenosis, not early signs.

D. The client complains of shortness of breath when walking. Shortness of breath on exertion is an early sign of mitral valve stenosis as the left atrium is unable to effectively pump blood into the left ventricle, leading to pulmonary congestion and difficulty breathing.

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Correct Answer is B

Explanation

A. Aspirin 325 mg PO: Aspirin is important for preventing clot formation but should not be administered until a hemorrhagic stroke is ruled out.

B. Non-contrast computed tomography (CT) scan: This is the priority because it determines whether the stroke is ischemic or hemorrhagic, guiding further treatment.

C. Electrocardiogram (ECG): While assessing cardiac rhythm is important, it is not the immediate priority in the presence of stroke symptoms.

D. Simvastatin (Zocor) 80 mg PO: Statins are used for long-term management but are not urgent in this acute scenario.

A. Amiodarone B. Dopamine C. Adenosine D. Atropine E. Norepinephrine F. Epinephrine

Correct Answer is ["B","E","F"]

Explanation

A. Amiodarone: This is an antiarrhythmic, not a vasopressor.

B. Dopamine: Dopamine has vasopressor effects, increasing blood pressure and cardiac output.

C. Adenosine: This is used to treat supraventricular tachycardia, not for vasopressor purposes.

D. Atropine: Atropine increases heart rate by inhibiting parasympathetic activity but is not a vasopressor.

E. Norepinephrine: Norepinephrine is a potent vasopressor that increases systemic vascular resistance and blood pressure.

F. Epinephrine: Epinephrine has vasopressor and inotropic effects, making it critical during cardiac arrest.

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A client is being seen in the clinic to rule out mitral valve stenosis. Which assessment data would be an early indication of this condition?

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