A nurse is teaching several newly licensed nurses about cardiac valve replacement. Which of the following should the nurse include in the teaching?

The aortic and mitral valves are the most commonly replaced valves.

Mitral valve insufficiency occurs during the diastolic phase of the cardiac cycle.

Inadequate closure of the tricuspid valve causes overload in the left ventricle.

Aortic stenosis increases right ventricular systolic pressure and decreases afterload.

Answer and Explanation

The Correct Answer is A

A. The aortic and mitral valves are the most commonly replaced valves: This statement is accurate. The aortic and mitral valves are indeed the most commonly replaced valves in cardiac valve replacement surgeries. Aortic valve replacement is commonly performed for conditions such as aortic stenosis or regurgitation, while mitral valve replacement is often indicated for mitral regurgitation or stenosis.

B. Mitral valve insufficiency occurs during the diastolic phase of the cardiac cycle: This statement is incorrect. Mitral valve insufficiency, also known as mitral regurgitation, occurs during the systolic phase of the cardiac cycle. It involves the backflow of blood from the left ventricle into the left atrium during ventricular systole, leading to volume overload of the left atrium and potentially causing symptoms such as dyspnea and fatigue.

C. Inadequate closure of the tricuspid valve causes overload in the left ventricle: This statement is incorrect. Inadequate closure of the tricuspid valve leads to regurgitation of blood from the right ventricle back into the right atrium during ventricular systole. This condition, known as tricuspid regurgitation, causes volume overload in the right atrium and ventricle, rather than overload in the left ventricle.

D. Aortic stenosis increases right ventricular systolic pressure and decreases afterload: This statement is partially correct. Aortic stenosis indeed increases left ventricular systolic pressure and decreases afterload, not right ventricular pressure. The increased afterload on the left ventricle can lead to left ventricular hypertrophy and eventually heart failure. However, aortic stenosis does not directly affect right ventricular systolic pressure.

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Correct Answer is D

Explanation

A. Creatine kinase (CK) test: While creatine kinase isoenzymes, including CK-MB, can be elevated following myocardial infarction (MI), they are not specific to cardiac muscle injury. CK is found in various tissues throughout the body, so elevated levels can also indicate damage to skeletal muscle or brain tissue, among other sources.

B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is a cardiac-specific isoform of creatine kinase, and elevated levels can indicate myocardial injury, particularly in the context of an acute MI. However, troponin T is a more sensitive and specific marker for myocardial injury.

C. Brain natriuretic peptide (BNP) test: Brain natriuretic peptide is primarily used in the diagnosis and management of heart failure. While elevated BNP levels can indicate heart muscle strain or stress, they are not specific markers for acute myocardial infarction or early injury to the cardiac muscle.

D. Troponin T test: This is the correct answer. Troponin T is a highly specific marker for cardiac muscle injury. Elevated troponin levels can be detected within hours of myocardial infarction and persist for several days, making it an essential tool in the diagnosis of acute coronary syndromes, including myocardial infarction. Troponin T is considered one of the gold standard biomarkers for detecting early injury to the cardiac muscle.

A. "I can't see anything from the sides of my eyes." B. "My vision is almost gone from the center part of my eye." C. "My contact lenses just don't fit like they used to." D. "l keep seeing flashes of lights moving around in my eye."

Correct Answer is B

Explanation

A. "I can't see anything from the sides of my eyes." This statement suggests a visual field deficit, which may be indicative of conditions affecting peripheral vision, such as glaucoma, retinal detachment, or optic nerve disorders. It is not a typical symptom of cataracts.

B. "My vision is almost gone from the center part of my eye." This statement indicates a central visual impairment, which is a common symptom of cataracts. Cataracts cause clouding of the lens, leading to blurred or dimmed vision, especially in the center of the visual field. This symptom often progresses gradually over time.

C. "My contact lenses just don't fit like they used to." This statement suggests discomfort or fit issues with contact lenses and is not specifically indicative of cataracts. It may be related to changes in the shape or health of the cornea, conjunctiva, or tear film.

D. "I keep seeing flashes of lights moving around in my eye." Flashes of light in the visual field are not typical symptoms of cataracts. They may indicate other ocular conditions such as vitreous detachment, migraines with aura, or retinal disorders.

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A nurse is teaching several newly licensed nurses about cardiac valve replacement. Which of the following should the nurse include in the teaching?

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