A client is undergoing diagnostic testing for aortic stenosis.
What statement by the client during the nurse's interview is most suggestive of this valvular disorder?
"Sometimes when I'm resting, I can feel my heart skip a beat.”.
"Whenever I do any form of exercise, I get very short of breath.”.
"My feet and ankles have gotten very puffy the last few weeks.”.
"I get chest pain from time to time, but it usually resolves with rest.”.
The Correct Answer is B
Choice A rationale
Palpitations, described as feeling the heart skip a beat, can be a symptom of various cardiac conditions, including arrhythmias, but are not singularly indicative of aortic stenosis. While aortic stenosis can lead to arrhythmias, palpitations are not the most specific or common initial complaint directly correlating with the physiological changes of a narrowed aortic valve.
Choice B rationale
Dyspnea on exertion, or shortness of breath with exercise, is a cardinal symptom of aortic stenosis. As the aortic valve narrows, the left ventricle must generate increasingly higher pressures to eject blood into the aorta. During exercise, cardiac output demands increase, and the stenosed valve restricts blood flow, leading to exertional dyspnea due to elevated left ventricular end-diastolic pressure and pulmonary congestion.
Choice C rationale
Pitting edema in the feet and ankles suggests fluid retention, which is a common manifestation of right-sided heart failure. While severe aortic stenosis can eventually lead to biventricular heart failure, peripheral edema is not typically the earliest or most specific symptom directly linked to the mechanical obstruction of the aortic valve itself. It is a later manifestation of cardiac decompensation.
Choice D rationale
Chest pain that resolves with rest is characteristic of stable angina, often caused by coronary artery disease. While patients with severe aortic stenosis can experience anginal chest pain due to increased myocardial oxygen demand from ventricular hypertrophy and reduced coronary perfusion, this symptom is not as specific to aortic stenosis as exertional dyspnea, which directly reflects the flow obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Human immunodeficiency virus (HIV) is transmitted through specific body fluids, including blood, semen, pre-ejaculatory fluid, rectal fluids, vaginal fluids, and breast milk. Standard precautions are universally applied infection control practices designed to prevent transmission of infectious agents from recognized or unrecognized sources in healthcare settings. This includes hand hygiene and the use of personal protective equipment.
Choice B rationale
Respiratory isolation, such as airborne or droplet precautions, is implemented for diseases spread via airborne particles or respiratory droplets. HIV is not transmitted through the airborne or droplet route; therefore, respiratory isolation is an unnecessary and inappropriate measure for routine care of an HIV-positive individual.
Choice C rationale
Contact isolation is employed for infections spread by direct or indirect contact with the client or their environment, such as methicillin-resistant Staphylococcus aureus. HIV is not primarily transmitted through casual contact or fomites; thus, contact isolation is not indicated for the daily care of an HIV-positive individual.
Choice D rationale
An isolation gown is a component of personal protective equipment used in contact or droplet isolation to prevent contamination of clothing from splashes or sprays of infectious materials. Since HIV transmission requires direct contact with specific body fluids, a gown is not routinely necessary for providing care unless exposure to such fluids is anticipated. .
Correct Answer is ["10"]
Explanation
Step 1 is to determine the amount of Lasix per mL. This is 4 mL ÷ 40 mg = 0.1 mL/mg.
Step 2 is to calculate the total volume to administer. This is 100 mg × 0.1 mL/mg = 10 mL. The nurse should give 10 mL.
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