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 A

Explanation

A. Dyspnea: Worsening dyspnea may indicate complications such as heart failure or embolization of infectious material to the lungs, which can occur in infective endocarditis as a result of vegetation formation on heart valves. Dyspnea can suggest decreased cardiac output or pulmonary involvement, indicating a worsening condition.

B. Malaise: Malaise is a nonspecific symptom that is common in infective endocarditis due to systemic infection and inflammation. While it can be present in both mild and severe cases, it may not specifically indicate worsening of the condition without other signs of deterioration.

C. Fever: Fever is a hallmark symptom of infective endocarditis and may persist or worsen with progressive infection. However, fever alone may not necessarily indicate worsening if the client is already febrile due to the underlying infection.

D. Anorexia: Anorexia or loss of appetite can occur in infective endocarditis due to systemic illness but may not specifically indicate worsening without other signs of deterioration. It is important to assess for other signs of worsening condition, such as hemodynamic instability or embolic events, in conjunction with anorexia.

A. "I will be placing electrodes on your breasts." B. "I will lower the head of your bed so you can lie flat." C. "Relax and try not to move or speak once I have attached the gel pads." D. "Try to hold your breath until this procedure is complete."

Correct Answer is C

Explanation

A. "I will be placing electrodes on your breasts": This statement is incorrect and may cause unnecessary concern or discomfort for the client. Electrodes for a 12-lead electrocardiogram are typically placed on the chest, not the breasts.

B. "I will lower the head of your bed so you can lie flat": This statement may be relevant for certain procedures but is not specific to applying electrode gel pads for a 12-lead electrocardiogram.

C. "Relax and try not to move or speak once I have attached the gel pads": This instruction is essential for obtaining a clear and accurate electrocardiogram recording. Movement or talking during the procedure can interfere with the quality of the tracing.

D. "Try to hold your breath until this procedure is complete": This instruction is unnecessary and could cause discomfort or anxiety for the client. There is no need for the client to hold their breath during a standard electrocardiogram procedure.

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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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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client diagnosed with infective endocarditis. Which of the following manifestations indicate that the client's condition is worsening?

Correct Answer is A

Explanation

A nurse is preparing to perform a 12-lead electrocardiogram. Which of the following instructions should the nurse provide to the client while applying the electrode gel pads?

Correct Answer is C

Explanation

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