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?

"I get chest pain from time to time, but it usually resolves with rest."

"Sometimes when I'm resting, I can feel my heart skip a beat."

"My feet and ankles have gotten very puffy the last few weeks."

"Whenever I do any form of exercise, I get very short of breath."

Answer and Explanation

The Correct Answer is D

A. "I get chest pain from time to time, but it usually resolves with rest.": While chest pain (angina) can occur with aortic stenosis, it is not as specific as the symptom described in option D. Angina could be related to various other cardiac conditions, including coronary artery disease.

B. "Sometimes when I'm resting, I can feel my heart skip a beat.": Palpitations or feeling like the heart skips a beat are common in many cardiac arrhythmias but are not specifically indicative of aortic stenosis.

C. "My feet and ankles have gotten very puffy the last few weeks.": Edema (puffy feet and ankles) is more commonly associated with right-sided heart failure or other conditions like chronic venous insufficiency, not specifically aortic stenosis.

D. "Whenever I do any form of exercise, I get very short of breath.": Dyspnea on exertion is a classic symptom of aortic stenosis. It occurs because the narrowed aortic valve obstructs blood flow from the left ventricle to the aorta, reducing cardiac output and causing exertional symptoms.

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Correct Answer is B

Explanation

A. Respond to ventilator alarms: Responding to ventilator alarms is important but may not be the priority if the client is not spontaneously breathing.

B. Report the absence of spontaneous respirations: This is the priority action because the absence of spontaneous respirations may indicate inadequate ventilation or respiratory arrest, requiring immediate intervention.

C. Encourage the client to take spontaneous breaths: While encouraging spontaneous breaths is beneficial, it is not appropriate if the client is paralyzed due to neuromuscular blockade.

D. Place the call bell within reach: Ensuring the call bell is within reach is important for communication but may not be the priority if the client is not breathing spontaneously.

A. Empty the drainage from the pleuravac at the end of each shift. B. Report serosanguinous drainage in the pleuravac. C. Milk the chest tube every 4 hours to dislodge clotted blood. D. Assist with coughing and deep breathing exercises every hour.

Correct Answer is D

Explanation

A. Empty the drainage from the pleuravac at the end of each shift: This is not a standard practice. Chest tube drainage systems typically have a built-in mechanism to handle drainage, and monitoring and recording the output is essential.

B. Report serosanguinous drainage in the pleuravac: Serosanguinous drainage (a mix of blood and serous fluid) can be expected in a hemothorax, especially initially. Reporting is necessary if there are significant changes in the amount or type of drainage.

C. Milk the chest tube every 4 hours to dislodge clotted blood: Milking or stripping the chest tube is generally not recommended as it can create high negative pressures that can damage lung tissue.

D. Assist with coughing and deep breathing exercises every hour: Encouraging coughing and deep breathing helps prevent atelectasis and promotes lung expansion, which is crucial for recovery from a hemothorax.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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