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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Complete Heart Block: Complete heart block (third-degree AV block) occurs when there is no communication between the atria and ventricles. The atria and ventricles beat independently, resulting in a very slow ventricular rate. This rhythm is characterized by regular P waves that have no relation to the QRS complexes.
B. Sinus Tachycardia: Sinus tachycardia is a rhythm originating from the sinoatrial node with a heart rate typically between 100-150 beats per minute. The rhythm is regular, and the P waves precede each QRS complex consistently.
C. Ventricular Tachycardia: Ventricular tachycardia is a fast heart rhythm that originates from the ventricles. It is characterized by wide and abnormal QRS complexes with a rate usually between 150-250 beats per minute. There may be no visible P waves, and if present, they are not associated with the QRS complexes.
D. Idioventricular Rhythm: Idioventricular rhythm is a slow rhythm originating from the ventricles with a heart rate usually between 20-40 beats per minute. It has wide and abnormal QRS complexes and no visible P waves.
Correct Answer is C
Explanation
A. Instruct the client to avoid high-potassium foods: While important for long-term management, it is not the priority when the client is experiencing hyperkalemia, as immediate interventions are necessary to prevent complications.
B. Redraw the potassium to verify results: Redrawing the potassium may be necessary if there is concern about sample contamination or if the result is significantly different from what is expected. However, it is not the priority when the client is at risk of complications from hyperkalemia.
C. Check the client's blood pressure: This is the priority action because hyperkalemia can lead to cardiac dysrhythmias, including potentially life-threatening arrhythmias. Checking the blood pressure helps assess the client's cardiovascular status and any potential effects of hyperkalemia on cardiac function.
D. Obtain a serum sodium level: While monitoring electrolyte levels is important in ESRD, sodium levels are not the priority when the client is experiencing hyperkalemia. Monitoring potassium and managing its effects take precedence.
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