A nurse is assessing a client who has valvular dysfunction. Which of the following manifestations should the nurse anticipate? (Select all that apply)

Heart murmur

Chest pain

Varicose veins

Palpitations

Abdominal pain

Answer and Explanation

Correct Answer : A,B,D

Choice A reason:

Heart murmur is a common manifestation of valvular dysfunction. It occurs when there is turbulent blood flow across a damaged or abnormal heart valve. This can be due to stenosis (narrowing of the valve) or regurgitation (leakage of the valve). The murmur’s characteristics, such as timing, location, and intensity, can help in diagnosing the specific type of valvular disease. For example, a systolic murmur might indicate aortic stenosis or mitral regurgitation, while a diastolic murmur could suggest aortic regurgitation or mitral stenosis.

Choice B reason:

Chest pain is another symptom that can be associated with valvular dysfunction. This pain can result from increased workload on the heart due to inefficient blood flow through the valves. Conditions like aortic stenosis can lead to angina (chest pain) because the heart muscle may not receive enough oxygenated blood. This symptom is particularly concerning and warrants immediate medical attention to prevent complications such as myocardial infarction.

Choice C reason:

Varicose veins are not typically associated with valvular dysfunction in the heart. They are more related to issues with the veins in the legs, where the valves that prevent backflow of blood become weakened or damaged. This condition is generally referred to as chronic venous insufficiency and is not directly linked to the heart’s valvular problems.

Choice D reason:

Palpitations, or the sensation of irregular or rapid heartbeats, are common in clients with valvular dysfunction. These can occur due to arrhythmias, which are often seen in conditions like mitral valve prolapse or aortic regurgitation. The irregular heartbeats can be a result of the heart trying to compensate for the inefficient blood flow caused by the faulty valve.

Choice E reason:

Abdominal pain is not a typical manifestation of valvular dysfunction. While severe heart conditions can sometimes lead to generalized symptoms, abdominal pain is more commonly associated with gastrointestinal issues rather than heart valve problems. Therefore, it is not a primary symptom to anticipate in clients with valvular dysfunction.

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Correct Answer is B

Explanation

Choice A reason: Increased Thirst, Increased Urine Output, and Weight Loss

Increased thirst, increased urine output, and weight loss are symptoms commonly associated with diabetes mellitus, particularly uncontrolled diabetes. These symptoms occur due to the body’s attempt to eliminate excess glucose through urine, leading to dehydration and subsequent weight loss. However, these symptoms are not typically associated with elevated TSH levels, which indicate hypothyroidism.

Choice B reason: Fatigue, Constipation, Weight Gain

Fatigue, constipation, and weight gain are classic symptoms of hypothyroidism2. When the thyroid gland is underactive, it produces insufficient thyroid hormones, leading to a slowdown in the body’s metabolism. This results in fatigue, weight gain, and constipation, among other symptoms. Elevated TSH levels are a compensatory response by the pituitary gland to stimulate the thyroid to produce more hormones, confirming hypothyroidism.

Choice C reason: Anxiety, Unintended Weight Loss, Palpitations

Anxiety, unintended weight loss, and palpitations are symptoms typically associated with hyperthyroidism, not hypothyroidism. Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormones, leading to an accelerated metabolism. This results in symptoms such as weight loss, increased heart rate (palpitations), and anxiety. Elevated TSH levels would not be expected in hyperthyroidism; instead, TSH levels would be low due to negative feedback from high thyroid hormone levels.

Choice D reason: Shakiness, Sweating, Nausea

Shakiness, sweating, and nausea can be symptoms of various conditions, including hypoglycemia (low blood sugar), anxiety, or panic attacks. These symptoms are not specific to thyroid dysfunction and are not typically associated with elevated TSH levels. Hypothyroidism, indicated by high TSH levels, usually presents with symptoms related to a slowed metabolism, such as fatigue and weight gain, rather than shakiness and sweating.

A. You have many dangerously low blood sugar levels. B. Your average blood sugar is high. C. Your blood sugar is too high after meals. D. Your blood sugar is very unstable.

Correct Answer is B

Explanation

Choice A Reason:

This statement is incorrect because a hemoglobin A1C level of 9% indicates that the client’s blood sugar levels have been consistently high over the past two to three months. Hemoglobin A1C is a measure of average blood glucose levels, not low blood sugar levels. Therefore, it would be inappropriate to suggest that the client has dangerously low blood sugar levels based on this result.

Choice B Reason:

This statement is correct because a hemoglobin A1C level of 9% indicates that the client’s average blood sugar levels are high. Hemoglobin A1C reflects the average blood glucose levels over the past two to three months. A normal A1C level is below 5.7%, while an A1C level between 5.7% and 6.4% indicates prediabetes, and an A1C level of 6.5% or higher indicates diabetes. Therefore, an A1C level of 9% clearly shows that the client’s average blood sugar is high.

Choice C Reason:

This statement is partially correct but not the most appropriate. While it is true that a high hemoglobin A1C level can indicate that blood sugar levels are high after meals, it is not specific enough. Hemoglobin A1C measures the average blood glucose levels over a period of time, not just after meals. Therefore, the statement “Your average blood sugar is high” is more accurate and appropriate.

Choice D Reason:

This statement is incorrect because it is too vague and does not provide specific information about the client’s blood sugar levels. While a high hemoglobin A1C level can indicate variability in blood sugar levels, it primarily reflects the average blood glucose levels over the past two to three months. Therefore, it would be more appropriate to state that the client’s average blood sugar is high.

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A nurse is assessing a client who has valvular dysfunction. Which of the following manifestations should the nurse anticipate? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing laboratory results and notes that a client has an elevated thyroid-stimulating hormone (TSH) level. Which of the following assessment findings would the nurse expect?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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