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

Barrel chest

Clubbing of the fingers

Bradycardia

A heart murmur

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is D

Explanation

Rationale:
A. Oxygen is administered during the initial acute phase if the client is hypoxic, to improve myocardial oxygenation, but it does not directly manage pain or anxiety once stabilized.

B. Nitroglycerin is used to relieve chest pain and reduce myocardial workload, primarily in the acute phase of MI. Its use after stabilization is for ongoing ischemia, not specifically for anxiety or persistent pain.

C. Aspirin is an antiplatelet therapy that prevents further clot formation and is continued long-term for MI management, but it does not address acute pain or anxiety.

D. Morphine is indicated after the initial acute phase to manage persistent chest pain and anxiety. It works by reducing myocardial oxygen demand through vasodilation and providing analgesia and sedation, making it appropriate for pain and anxiety management post-acute MI.

A. Left-sided heart failure B. Right-sided heart failure C. Liver cirrhosis D. Chronic kidney disease

Correct Answer is B

Explanation

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

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Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is planning care for a client who is having an acute myocardial infarction (MI). The nurse should plan to administer which of the following medications after the initial acute phase to manage the client's pain and anxiety?

Correct Answer is D

Explanation

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?

Correct Answer is B

Explanation

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