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

Increase in systolic blood pressure 10 mmHg above client's norm

reports dyspnea after walking up 2 flights of stairs

Jugular vein distention and +3 peripheral edema

Complaints of epigastric pain after eating a large meal

Answer and Explanation

The Correct Answer is C

A. Increase in systolic blood pressure 10 mmHg above client's norm: A mild increase in systolic blood pressure is not a specific indicator of mitral stenosis progression. Blood pressure fluctuations may occur due to various factors and are not typically used as a primary marker of worsening valve disease.

B. reports dyspnea after walking up 2 flights of stairs: Exertional dyspnea is a common early symptom of mitral stenosis due to reduced left atrial emptying and pulmonary congestion. However, this does not necessarily indicate worsening unless the symptom becomes more severe or occurs with minimal exertion.

C. Jugular vein distention and +3 peripheral edema: These are signs of right-sided heart failure, which may result from long-standing mitral stenosis leading to pulmonary hypertension and subsequent right ventricular hypertrophy and failure. This indicates disease progression and worsening cardiac function.

D. Complaints of epigastric pain after eating a large meal: Epigastric discomfort is not a typical symptom of mitral stenosis and is more likely related to gastrointestinal issues. It does not reflect the status or progression of the cardiac condition.

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Correct Answer is B

Explanation

A. "All patients with this disorder have a genetic defect which causes it.": Restrictive cardiomyopathy is not primarily a genetic disorder. While there may be rare familial forms, most cases are acquired, often secondary to systemic diseases, making this statement inaccurate and misleading.

B. "There are many theories about its development but amyloidosis in your history is a probable cause.": This is the most accurate response. Restrictive cardiomyopathy is commonly associated with infiltrative diseases such as amyloidosis, hemochromatosis, and sarcoidosis, which impair ventricular filling due to stiff, non-compliant myocardium.

C. "You probably had a silent heart attack which caused this disorder.": Silent myocardial infarctions can contribute to ischemic cardiomyopathy, typically leading to dilated, not restrictive, changes in the myocardium. They are not a primary cause of restrictive cardiomyopathy.

D. "Your long-standing hypertension caused this disorder.": Chronic hypertension more commonly leads to left ventricular hypertrophy and may contribute to diastolic heart failure, but it is not a typical cause of restrictive cardiomyopathy.

A. Administer an antidiarrheal medication B. Assess the pupils for constriction C. Provide frequent oral care D. Insert an indwelling catheter

Correct Answer is C

Explanation

A. Administer an antidiarrheal medication: Atropine is an anticholinergic agent that reduces gastrointestinal motility, often leading to constipation rather than diarrhea. Administering an antidiarrheal would not be appropriate and could cause harmful effects if unnecessary.

B. Assess the pupils for constriction: Atropine causes pupil dilation (mydriasis), not constriction. Checking for constriction would not align with the expected pharmacologic effects of the drug and is not a priority assessment after administration.

C. Provide frequent oral care: Atropine inhibits secretions as part of its anticholinergic effects, often leading to dry mouth (xerostomia). Frequent oral care helps maintain mucous membrane integrity and client comfort, making this an appropriate nursing action following administration.

D. Insert an indwelling catheter: Although atropine can cause urinary retention, especially in older adults, catheter insertion is not routinely required after administration; a single 0.5 mg IV dose is less likely to cause significant urinary retention requiring catheterization. It should only be considered if the client shows clinical signs of acute urinary retention.

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WBC	8.5
Hemoglobin	17g/dL
Hematocrit	54%
BUN	28mg/dL
Creatinine	1.1 mg/dL
Potassium	4.9 mEq/L

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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