A client is undergoing diagnostic testing for aortic stenosis. What statement by the client during the nurse's interview is most suggestive of this valvular disorder?

"I get chest pain from time to time, but it usually resolves with rest."

"Sometimes when I'm resting, I can feel my heart skip a beat."

"My feet and ankles have gotten very puffy the last few weeks."

"Whenever I do any form of exercise, I get very short of breath."

Answer and Explanation

The Correct Answer is D

A. "I get chest pain from time to time, but it usually resolves with rest.": While chest pain (angina) can occur with aortic stenosis, it is not as specific as the symptom described in option D. Angina could be related to various other cardiac conditions, including coronary artery disease.

B. "Sometimes when I'm resting, I can feel my heart skip a beat.": Palpitations or feeling like the heart skips a beat are common in many cardiac arrhythmias but are not specifically indicative of aortic stenosis.

C. "My feet and ankles have gotten very puffy the last few weeks.": Edema (puffy feet and ankles) is more commonly associated with right-sided heart failure or other conditions like chronic venous insufficiency, not specifically aortic stenosis.

D. "Whenever I do any form of exercise, I get very short of breath.": Dyspnea on exertion is a classic symptom of aortic stenosis. It occurs because the narrowed aortic valve obstructs blood flow from the left ventricle to the aorta, reducing cardiac output and causing exertional symptoms.

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Correct Answer is D

Explanation

A. Grilled chicken, white rice, sliced peaches: While grilled chicken is a lean protein source, white rice is low in fiber and may not be the best choice for someone experiencing severe diarrhea. Sliced peaches are a good fruit choice, but the meal lacks sufficient fiber and other nutrients.

B. Spaghetti with tomato sauce, meatballs, and garlic bread: This meal contains high-fat and high-carbohydrate foods, which may exacerbate diarrhea. Tomato sauce can be acidic and irritating to the digestive system for some individuals.

C. Fried shrimp, cauliflower, yogurt with granola: Fried foods are high in fat and may worsen diarrhea. Cauliflower is a good vegetable choice, but yogurt with granola may not be well- tolerated if the client is lactose intolerant or sensitive to dairy products.

D. Grilled salmon, brown rice, broccoli: Grilled salmon provides lean protein and omega-3 fatty acids, which can be beneficial for overall health. Brown rice is higher in fiber compared to white rice and can help regulate bowel movements. Broccoli is a good source of fiber and essential nutrients. This meal is well-balanced and nutritious, making it a suitable choice for someone experiencing diarrhea.

A. Encourage mouth care before and after meals. B. Monitor the client for changes in mental status. C. Assess the client's laboratory work for increased calcium levels. D. Advise the client to keep a food diary. E. Instruct the client to drink extra fluids between meals.

Correct Answer is ["A","B","D","E"]

Explanation

A. Encouraging mouth care before and after meals helps maintain oral hygiene, which is essential for appetite stimulation and preventing oral infections.

B. Monitoring the client for changes in mental status is important as malnutrition can lead to cognitive impairment and changes in mental status.

C. Assessing the client's laboratory work for increased calcium levels may not be directly related to malnutrition due to cancer. Elevated calcium levels are more commonly associated with conditions like hyperparathyroidism or certain cancers, but it's not typically a direct consequence of malnutrition.

D. Advising the client to keep a food diary helps track food intake, identify any patterns related to malnutrition, and guide dietary interventions.

E. Instructing the client to drink extra fluids between meals helps prevent dehydration, especially if the client's intake is compromised due to malnutrition or cancer-related treatments.

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A client is undergoing diagnostic testing for aortic stenosis. What statement by the client during the nurse's interview is most suggestive of this valvular disorder?

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