A woman presents to a clinic with JVD (jugular venous distension), liver congestion, ascites, and ankle edema. Upon auscultation of her heart, the RN notes a murmur. The etiologies that would best account for all aspects of this patient picture are
aortic atherosclerosis & mitral insufficiency.
aortic valve stenosis & left heart failure.
bronchogenic cancer & diaphoresis.
pulmonic valve stenosis & right heart failure.
The Correct Answer is D
A. Aortic atherosclerosis and mitral insufficiency could lead to some symptoms of congestion but would not fully explain jugular venous distension and liver congestion.
B. Aortic valve stenosis and left heart failure primarily affect left-sided heart function, which typically does not present with jugular venous distension or peripheral edema.
C. Bronchogenic cancer and diaphoresis do not explain the cardiovascular symptoms present in this case.
D. Pulmonic valve stenosis can lead to right heart failure, causing systemic venous congestion, which results in JVD, liver congestion, ascites, and ankle edema, thus accounting for all aspects of the patient's presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Medications in unstable angina aim to prevent platelet aggregation and thrombus formation, not increase platelet adhesion.
B. Increasing preload would increase cardiac workload, which is counterproductive in managing unstable angina, as the goal is to reduce workload on the heart.
C. Constricting coronary arteries would worsen ischemia and exacerbate unstable angina, not help it.
D. Decreasing afterload (the resistance the heart must pump against) reduces the workload on the heart, helping to improve cardiac output and alleviate ischemia in unstable angina.
Correct Answer is C
Explanation
A. Troponin is a biomarker used to diagnose myocardial infarction (heart attack), not heart failure.
B. Calcium levels are important for overall metabolic function but are not specific for heart failure.
C. B-type natriuretic peptide (BNP) is elevated in heart failure, specifically in left heart failure, and helps confirm the diagnosis. BNP is a hormone released by the ventricles in response to increased pressure and volume.
D. C-reactive protein (CRP) is a marker of inflammation but does not specifically confirm a heart failure diagnosis.
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