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 D

Explanation

Rationale:

A. These tiny red or purple spots are caused by microvascular emboli or vascular fragility associated with infective endocarditis. While they indicate ongoing infection, they are primarily diagnostic and usually do not pose an immediate threat to the patient’s airway, breathing, or circulation.

B. Fever reflects the systemic inflammatory response to the bacterial infection and is a common finding in endocarditis. While it needs monitoring and management with antipyretics or antibiotics, it does not require emergent action unless accompanied by hemodynamic instability or signs of sepsis.

C. These linear, dark streaks are a classic sign of embolic events in infective endocarditis. They are important diagnostic clues but are not acutely dangerous, and immediate intervention is usually not required.

D. This is the priority finding because it may indicate acute complications of infective endocarditis such as heart failure from valvular dysfunction, pulmonary embolism from septic emboli, or pneumonia secondary to infection. Dyspnea reflects compromised oxygenation or cardiac function, which can quickly become life-threatening. According to the ABC principle (Airway, Breathing, Circulation), respiratory distress takes precedence over other manifestations and requires prompt assessment and intervention.

A. The QRS duration is 0.20 seconds. B. The P-R interval measures 0.22 seconds. C. The T wave is in the inverted position D. The P wave appears before the QRS complex.

Correct Answer is D

Explanation

Rationale:
A. A normal QRS duration is 0.06–0.10 seconds. A duration of 0.20 seconds indicates a ventricular conduction delay or bundle branch block, which is not normal sinus rhythm.

B. A normal PR interval is 0.12–0.20 seconds. A measurement of 0.22 seconds suggests a first-degree heart block, which is an abnormal finding.

C. Normally, T waves are upright in most leads. Inverted T waves can indicate ischemia, infarction, or electrolyte disturbances, which are not consistent with normal sinus rhythm.

D. In normal sinus rhythm, the P wave precedes each QRS complex, reflecting proper atrial depolarization followed by ventricular depolarization. This relationship confirms that the electrical impulse is originating from the sinoatrial (SA) node, which defines normal sinus rhythm.

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

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has infective endocarditis. Which of the following findings should be the priority for the nurse to report to the provider?

Correct Answer is D

Explanation

A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?

Correct Answer is D

Explanation

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