The nurse is assessing a client with a diagnosis of mitral stenosis. Which piece of assessment data indicates that the disease is worsening?

Jugular vein distention and +3 peripheral edema

Increase in systolic blood pressure 10 mmHg above cents norm

Complaints of epigastric pain after eating a large meal

Complaints of dyspnea while completing ADLs

Answer and Explanation

The Correct Answer is A

A. Jugular vein distention and +3 peripheral edema are signs of right-sided heart failure, which can result from worsening mitral stenosis. As the mitral valve becomes more narrowed, it leads to increased pressure in the left atrium and eventually backs up into the lungs and right side of the heart, causing fluid retention.
B. An increase in systolic blood pressure by 10 mmHg does not directly indicate worsening mitral stenosis. Blood pressure changes can occur for various reasons but are not as specific as signs of heart failure in this context.
C. Complaints of epigastric pain after eating a large meal are typically related to gastrointestinal issues rather than directly indicating worsening mitral stenosis.
D. Complaints of dyspnea while completing activities of daily living (ADLs) can be a sign of worsening mitral stenosis, but the additional signs of jugular vein distention and edema are more definitive indicators of worsening disease.

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Correct Answer is D

Explanation

A. This is not correct because a decrease in CEA levels typically indicates that the current treatment is having a positive effect on the cancer. If CEA levels were increasing, a change in the treatment plan might be considered, but this is not the case here.

B. An increase in CEA levels is typically associated with disease progression or metastasis, not a decrease. The reduction in CEA levels suggests that the cancer is responding to treatment, not progressing.

C. Tumor lysis syndrome occurs when a large number of cancer cells break down rapidly, releasing their contents into the bloodstream. It is more common with certain aggressive cancers or when large tumor burdens are rapidly shrinking. This client's decreasing CEA levels do not indicate that tumor lysis syndrome is more likely.

D. A decrease in CEA levels is a positive indicator that the chemotherapy is working and reducing the cancer burden, which is the desired effect.

A. monitoring for dysrhythmias. B. preventing thrombus formation. C. monitoring for bleeding D. adherence to the antihypertensive drugs

Correct Answer is D

Explanation

A. While monitoring for dysrhythmias is important for certain cardiovascular conditions, it is not the primary concern for an AAA. The management of blood pressure and preventing rupture are higher priorities.

B. While blood clots can be a concern in some cardiovascular conditions, thrombus formation is not a primary concern with AAA management unless other risk factors (such as venous stasis or atrial fibrillation) are present.

C. Monitoring for bleeding would be more relevant if the aneurysm were large or there were signs of rupture, but for a small AAA, the primary concern is managing blood pressure and preventing further enlargement. Bleeding monitoring is more critical in cases of rupture or larger aneurysms.

D. Antihypertensive medications are crucial for controlling blood pressure and preventing further stress on the aneurysm. Adherence to these medications is essential in managing the condition medically to reduce the risk of rupture or further enlargement of the aneurysm.

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The nurse is assessing a client with a diagnosis of mitral stenosis. Which piece of assessment data indicates that the disease is worsening?

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Naxlex Comprehensive Predictor Exams

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