A client is being seen in the clinic to rule out mitral valve stenosis. Which assessment data would be an early indication of this condition?

The client's blood pressure has decreased since the last visit

The client's liver is enlarged and the abdomen is edematous

The client has jugular vein distention and 3+ pedal edema

The client complains of shortness of breath when walking

Answer and Explanation

The Correct Answer is D

A. The client's blood pressure has decreased since the last visit. Decreased blood pressure is not a typical early sign of mitral valve stenosis.

B. The client's liver is enlarged and the abdomen is edematous. These are signs of more advanced heart failure, which can result from mitral valve stenosis but are not early indicators.

C. The client has jugular vein distention and 3+ pedal edema. Jugular vein distention and pedal edema are later signs of heart failure caused by mitral valve stenosis, not early signs.

D. The client complains of shortness of breath when walking. Shortness of breath on exertion is an early sign of mitral valve stenosis as the left atrium is unable to effectively pump blood into the left ventricle, leading to pulmonary congestion and difficulty breathing.

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Correct Answer is A

Explanation

A. Troponin: Troponin is the most specific and reliable biomarker for myocardial injury. Levels rise within 3-6 hours and remain elevated for days, providing diagnostic and prognostic information.

B. Alkaline phosphatase: This is related to liver and bone disorders, not cardiac events.

C. Creatine kinase (CK): While CK-MB is specific to cardiac tissue, it is less specific and remains elevated for a shorter period compared to troponin.

D. Myoglobin: Myoglobin is an early but nonspecific marker of muscle damage and is not as reliable for diagnosing myocardial injury.

A. Subdural hematoma B. Diffuse axonal injury C. Intracranial hemorrhage D. Epidural hematoma

Correct Answer is D

Explanation

A. Subdural hematoma: Subdural hematomas develop more slowly and typically present a higher risk for delayed deterioration, but not usually within the first 24 hours.

B. Diffuse axonal injury: While severe, diffuse axonal injury typically causes a prolonged coma rather than immediate fatality within 24 hours.

C. Intracranial hemorrhage: This is severe but often depends on the size and location of the bleed.

D. Epidural hematoma: Epidural hematomas are associated with arterial bleeding and rapid deterioration due to increased intracranial pressure, making them the most fatal within 24 hours.

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A client is being seen in the clinic to rule out mitral valve stenosis. Which assessment data would be an early indication of this condition?

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Naxlex Comprehensive Predictor Exams

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