Practice questions Mitral stenosis, myocardial infarction, endocarditis, Percutaneous coronary intervention, angiography, endocardiography, stress test

A client with a history of rheumatic heart disease is being evaluated for mitral stenosis. To identify symptoms that support the diagnosis of mitral stenosis, the nurse should ask which question? 1. "How often do you get short of breath?" 2. "Have you had a lot of headaches recently?" 3. "Do you experience numbness or tingling in your extremities?" 4. "Do you have to urinate often during the night?"

1. "How often do you get short of breath?" Rationale: 1. Dyspnea on exertion is often an early sign of mitral stenosis. 2. Headaches are not associated with mitral stenosis. 3. Numbness and tingling of the extremities is not associated with mitral stenosis. 4. Nocturia is not associated with mitral stenosis.

A client with mitral stenosis asks the nurse to explain the complications of the disease and what symptoms the client and family need to be aware of. The nurse should teach the family to watch for: 1. Dry skin. 2. Signs of confusion. 3. Low hemoglobin. 4. Memory improvement.

2. Signs of confusion. Rationale: 1. Mitral stenosis does not cause dry skin. 2. One complication of mitral stenosis is an embolism to the brain. The nurse should teach the family to watch for confusion or other neurological signs and to call the physician immediately. 3. The family cannot monitor hemoglobin. 4. If there are neurologic changes, the expectation would be confusion and memory loss.

Jugular vein distention is seen in cardiogenic shock. Warm extremities are seen in early septic shock and anaphylactic shock. Laryngospasm and urticaria are seen in anaphylactic shock. A) Dysrhythmias B) Increase in blood pressure C) Increase in heart rate D) Decrease in oxygen demands

A) Dysrhythmias Cardiogenic shock occurs when the heart's ability to pump blood is impaired and the supply of oxygen is inadequate for the heart and tissues. Symptoms of cardiogenic shock include angina pain and dysrhythmias. Cardiogenic shock does not cause increased blood pressure, increased heart rate, or a decrease in oxygen demands.

A patient with mitral valve stenosis is receiving health education at an outpatient clinic. To minimize the patient's symptoms, the nurse should teach the patient to do which of the following? A) Eat a high-protein, low-carbohydrate diet. B) Avoid activities that cause an increased heart rate. C) Avoid large crowds and public events. D) Perform deep breathing and coughing exercises.

B) Avoid activities that cause an increased heart rate. Patients with mitral stenosis are advised to avoid strenuous activities, competitive sports, and pregnancy, all of which increase heart rate. Infection prevention is important, but avoiding crowds is not usually necessary. Deep breathing and coughing are not likely to prevent exacerbations of symptoms and increased protein intake is not necessary.

The nurse is caring for a newly admitted patient on the telemetry unit. The patient is experiencing progressive fatigue, hemoptysis, and dyspnea as a result of pulmonary venous hypertension due to which of the following valvular disorders? A) Aortic regurgitation B) Mitral stenosis C) Mitral valve prolapse D) Aortic stenosis

B) Mitral stenosis The left atrium has difficulty moving blood into the left ventricle due to the mitral stenosis. The pulmonary veins are subject to a backward flow of blood. Pulmonary venous hypertension results, and the patient experiences hemoptysis, dyspnea, progressive fatigue, and repeated respiratory infections.

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. His parents, who believe in "natural remedies," have been treating him with various herbal preparations without success and are now seeking antibiotic treatment. Throat cultures show infection with group A streptococci. This child is at high risk for A) myocarditis. B) mitral valve stenosis. C) infective endocarditis. D) vasculitis

B) mitral valve stenosis. Group A streptococcal infection can be adequately treated with antibiotics, but this infection may have been present long enough to trigger an immune responseâ€"rheumatic feverâ€"that will damage his heart valves, ultimately causing mitral valve stenosis. Group A streptococcal infection is not known to predispose to myocarditis, endocarditis, or vasculitis and aneurysm of coronary arteries.

A client with mitral stenosis presents to the clinic for a follow-up visit. What clinical manifestation alerts the nurse to the possibility that the client may be experiencing a worseninn of this condition? A. The client's oxygen saturation is 92%. B. The client has dyspnea on exertion. C. The client has a systolic crescendo-decrescendo murmur. D. The client experiences a loss of strength in the upper extremities.

B. The client has dyspnea on exertion. The development of dyspnea on exertion occurs as the mitral valvular orifice narrows and pres-sure in the lungs increases.

The nurse caring for a patient who is scheduled for a balloon valvuloplasty recalls that balloon valvuloplasty is most commonly used for which valvular heart disease? A) Aortic regurgitation B) Mitral valve prolapse C) Mitral stenosis D) Mitral regurgitation

C) Mitral stenosis Balloon valvuloplasty is most commonly used for patients diagnosed with mitral stenosis or aortic valve stenosis in elderly patients. For patients with mitral regurgitation, rotation of the great vessels, and thoracolumbar scoliosis, balloon valvuloplasty is contraindicated.

The nurse encourages the patient who has had a myocardial infarction (MI) to enroll in the outpatient cardiac rehabilitation service, which offers: (Select all that apply.) a. diet counseling. b. supervised progressive exercise. c. stress reduction techniques. d. sexual counseling. e. administration of cardiotonic drugs.

a. diet counseling. b. supervised progressive exercise. c. stress reduction techniques. Rehabilitation services offer diet and stress reduction counseling and supervised progressive exercise.

The nurse is giving a patient who has mitral stenosis a preoperative antibiotic. Which of these, if stated by a patient, indicates to the nurse correct understanding of why the antibiotic is necessary? a. "To prevent infection of the surgical incision." b. "To prevent postoperative pneumonia." c. "To prevent a bacterial infection in the heart." d. "To prevent an increase in body temperature."

c. "To prevent a bacterial infection in the heart." Prophylactic antibiotic therapy helps prevent a bacterial infection in the heart, rheumatic fever, and subsequent rheumatic heart disease and is recommended to prevent valvular disease.

When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for a. diastolic murmur. b. peripheral edema. c. shortness of breath on exertion. d. right upper quadrant tenderness.

c. shortness of breath on exertion. The pressure gradient changes in mitral stenosis lead to fluid backup into the lungs, resulting in hypoxemia and dyspnea. The other findings also may be associated with mitral valve disease but are not indicators of possible hypoxemia.

The nurse reinforced teaching for a patient with mitral stenosis. Which statement by the patient indicates that the teaching has been effective? a. "There is a backflow of blood into the lower left chamber of the heart." b. "There is a narrowing of the blood vessel that brings blood into the heart." c. "The right side of the heart is not pumping effectively." d. "The top chamber on the left side of the heart doesn't empty all of the way."

d. "The top chamber on the left side of the heart doesn't empty all of the way." Mitral stenosis does not allow the left atrium to empty easily, so blood builds up in the left atrium.