A patient with known tricuspid regurgitation presents with worsening symptoms.
Which of the following would the nurse most likely observe?
Pulmonary crackles.
Jugular venous distention.
Left parasternal heave.
Absent peripheral pulses.
The Correct Answer is B
Choice A rationale
Pulmonary crackles result from fluid accumulation in the alveoli, primarily associated with left-sided heart failure or mitral valve issues, where blood backs up from the left ventricle into the lungs. Tricuspid regurgitation (TR) affects the right side of the heart, causing systemic venous congestion rather than pulmonary edema.
Choice B rationale
Tricuspid regurgitation is the incomplete closure of the tricuspid valve, leading to a backflow of blood from the right ventricle into the right atrium during systole. This increases right atrial pressure and consequently the systemic venous pressure, which is clinically manifested as visible jugular venous distention (JVD) in the neck.
Choice C rationale
A left parasternal heave is an outward thrust palpable along the left sternal border, typically caused by right ventricular hypertrophy or dilation due to conditions like severe pulmonary hypertension. While TR can cause right ventricular dilation, the heave is a structural finding, whereas JVD is a direct sign of the acute volume backflow.
Choice D rationale
Absent peripheral pulses indicate severe peripheral vascular disease or critical limb ischemia, conditions unrelated to the primary pathophysiology of tricuspid regurgitation. While severe right heart failure can cause low cardiac output, it does not characteristically lead to absent peripheral pulses; dependent edema is more common. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Young age is typically a factor that favors traditional open-heart surgery for valve replacement. Younger patients have a longer life expectancy, and a surgical valve has historically been considered more durable than TAVR devices, which have uncertain long-term durability and may require future interventions.
Choice B rationale
A low surgical risk profile generally makes the patient a better candidate for traditional open-heart surgery (SAVR). SAVR allows for direct visualization, precise placement, and is associated with very low risk in this patient group, whereas TAVR is typically reserved for those who cannot tolerate the risks of SAVR.
Choice C rationale
A high surgical risk (e.g., due to advanced age, severe comorbidities like renal failure or severe lung disease) is the primary indication making TAVR the more suitable option. TAVR is a minimally invasive procedure performed via a catheter, which significantly reduces the trauma, recovery time, and overall risk of major complications compared to open-heart surgery.
Choice D rationale
TAVR currently only uses bioprosthetic (tissue) valves, which do not require lifelong anticoagulation but have a limited lifespan. Preference for a mechanical valve (which requires anticoagulation but is very durable) would necessitate traditional open-heart surgery, not TAVR. —.
Correct Answer is C
Explanation
Choice A rationale
While chest pain (angina) is a serious complication often associated with reduced cardiac output from the rapid rate, especially in those with underlying coronary artery disease (CAD), managing the underlying rate is the most direct way to improve myocardial oxygen supply and demand balance, which is the cause of the pain.
Choice B rationale
Educating the patient is crucial for long-term management and preventing recurrence but is not the immediate, priority action for a patient presenting with an unstable, rapid ventricular response that significantly impairs cardiac output and could lead to cardiogenic shock or heart failure.
Choice C rationale
In atrial fibrillation with rapid ventricular response (RVR), the heart rate often exceeds 100 bpm, reducing the time for diastolic filling and thus significantly decreasing stroke volume and cardiac output. Therefore, the priority is to administer rate-controlling medications (e.g., beta-blockers, calcium channel blockers) to slow the ventricular response and stabilize hemodynamics.
Choice D rationale
Anticoagulation is essential to prevent systemic embolization and stroke risk due to stasis and clot formation in the fibrillating atria. However, it addresses a long-term risk and is not the immediate, life-saving priority over controlling the dangerously rapid heart rate that acutely compromises perfusion. —.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.