Which of the following is an advantage of percutaneous transluminal balloon valvuloplasty over valve replacement in treating mitral stenosis?

Avoids the need for lifelong anticoagulant therapy

Can be performed under local anesthesia

Provides permanent correction of the valve defect

Has a lower risk of infection compared to valve replacement.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Percutaneous transluminal balloon valvuloplasty (PTBV) is a minimally invasive procedure that dilates the stenotic mitral valve without replacing it. Since no prosthetic valve is implanted, clients typically do not require lifelong anticoagulation, which is a major advantage over mechanical valve replacement.

B. While PTBV is less invasive than open surgery, it usually requires moderate sedation or general anesthesia for patient comfort and safety. Local anesthesia alone is rarely sufficient.

C. PTBV improves valve opening temporarily, but valve restenosis can occur over time, so the correction is not necessarily permanent. Valve replacement provides a more long-term solution.

D. While PTBV avoids prosthetic material and thus may reduce some infection risks, infection is generally not the primary concern with valve replacement, and the overall difference in infection risk is not a primary advantage cited for PTBV.

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Correct Answer is ["C","E"]

Explanation

Rationale:
A. A thready, weak pulse is typically associated with fluid volume deficit, not excess. Clients with FVE often have bounding pulses due to increased intravascular volume.

B. Dizziness is more commonly a sign of hypovolemia or hypotension, rather than fluid overload.

C. Edema occurs when excess fluid accumulates in the interstitial spaces, commonly in the lower extremities in clients with heart failure, making it a classic manifestation of FVE.

D. FVE usually causes distended (full) neck veins due to increased central venous pressure. Flat neck veins are associated with hypovolemia.

E. Rapid or unexplained weight gain in a client with HF is an early sign of fluid retention and is commonly used to monitor FVE.

A. Plasma low-density lipoproteins (LDL) B. Myoglobin C. BUN D. Troponin E. Creatinine

Correct Answer is ["B","D"]

Explanation

Rationale:

A. LDL cholesterol levels are used to assess a patient’s long-term risk for atherosclerosis and cardiovascular disease, but they do not rise acutely during myocardial infarction and therefore are not useful for diagnosing an MI in the emergency setting.

B. Myoglobin is a small heme protein released rapidly from damaged cardiac and skeletal muscle. It can appear in the blood within 1–4 hours after myocardial injury, making it useful for early detection of myocardial infarction. However, it is not specific to cardiac muscle, so elevations could also occur with skeletal muscle injury. Myoglobin is often used in conjunction with other cardiac biomarkers.

C. Blood urea nitrogen reflects renal function and may increase in kidney disease or dehydration, but it does not indicate myocardial injury and is not part of the standard diagnostic workup for acute MI.

D. Troponin I and T are structural proteins of cardiac muscle, and their levels rise within 3–6 hours after myocardial injury and remain elevated for up to 10–14 days. They are highly sensitive and specific for cardiac injury, making troponin the gold standard for confirming myocardial infarction.

E. Creatinine measures kidney function and may be monitored in patients receiving contrast dye or nephrotoxic drugs, but it does not aid in diagnosing an acute MI.

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Which of the following is an advantage of percutaneous transluminal balloon valvuloplasty over valve replacement in treating mitral stenosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has fluid volume excess (FVE) due to heart failure (HF). Which of the following manifestations should the nurse associate with FVE? (Select all that apply.)

Correct Answer is ["C","E"]

Explanation

A nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Select all that apply)

Correct Answer is ["B","D"]

Explanation

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