The nurse auscultates a client's heart sounds and hears a midsystolic click associated with mitral valve prolapse. Which diagnostic test should the nurse prepare the client to expect the healthcare provider (HCP) to prescribe?
Troponin and creatine kinase-myocardial band (CK-MB) levels.
Computed tomography (CT) scan of the chest.
2D-echocardiography.
12-lead electrocardiogram (ECG).
The Correct Answer is C
A. Troponin and creatine kinase-myocardial band (CK-MB) levels: These cardiac biomarkers are used to assess myocardial injury, such as in acute coronary syndrome. They are not appropriate for evaluating valvular abnormalities like mitral valve prolapse.
B. Computed tomography (CT) scan of the chest: A CT scan of the chest is used to evaluate pulmonary conditions, aortic dissection, or mediastinal structures, but it is not the test of choice for assessing cardiac valve function or structure.
C. 2D-echocardiography: Echocardiography is the primary diagnostic tool for evaluating mitral valve prolapse. It allows real-time visualization of valve structure and function, including leaflet motion and regurgitation severity, making it the most appropriate step after identifying a midsystolic click.
D. 12-lead electrocardiogram (ECG): An ECG can detect rhythm disturbances or signs of chamber enlargement but cannot diagnose structural valve issues. While useful as part of a general cardiac evaluation, it is not specific enough for diagnosing mitral valve prolapse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Accelerated junctional rhythm: An accelerated junctional rhythm originates in the AV junction (40-100 bpm), typically has absent, inverted, or hidden P waves (before, during, or after QRS), and a regular rhythm. This strip has clear, upright P waves, an irregular rhythm, and a lengthening PR interval.
B. Premature atrial contractions (PAC): PACs are single ectopic beats that occur earlier than expected, originating in the atria. While they involve P waves, they don't show a pattern of progressively lengthening PR intervals or dropped beats in the characteristic Wenckebach pattern.
C. Atrial fibrillation (A-fib): Atrial fibrillation is characterized by irregularly irregular R-R intervals, chaotic atrial activity with no discernible P waves, and a variable ventricular rate. This strip clearly shows discernible P waves.
D. Wenckebach, Mobitz Type I atrioventricular (AV) block: This rhythm is defined by a progressive lengthening of the PR interval until a QRS complex is dropped. The cycle then repeats. This is what is observed in the ECG strip.
Correct Answer is ["A","B","E"]
Explanation
- Agitation: Agitation may indicate hypoxia or reduced cerebral perfusion due to cardiac compromise. In a patient with chest pain and borderline hypoxia, it can be an early warning sign of clinical deterioration that requires follow-up.
- Chest pain described as pressure tightness unrelieved by rest: Unrelieved chest pain lasting longer than 20 minutes is strongly suggestive of myocardial infarction rather than stable angina. Immediate cardiac workup and intervention are needed to prevent myocardial damage.
- Pain rated 7/10: A moderate to severe pain rating in the chest warrants urgent evaluation, especially when consistent with cardiac characteristics like tightness and pressure. High pain intensity is often correlated with worsening ischemia.
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