The nurse is caring for a client with mitral stenosis. Which assessment finding would cause the greatest concern in providing nursing care to this client?
Increased cardiac output
Decreased pulmonary pressure
Decreased right ventricular pressure
Increased left atrial pressure
The Correct Answer is D
A. Increased cardiac output: Mitral stenosis typically reduces cardiac output due to impaired left ventricular filling. Increased output would be unusual but not immediately concerning compared to pressure-related complications.
B. Decreased pulmonary pressure: Pulmonary pressure often increases, not decreases, in mitral stenosis due to blood backing up from the left atrium. Decreased pressure is not a critical concern in this condition.
C. Decreased right ventricular pressure: This is not commonly associated with mitral stenosis. The right ventricle may experience increased pressure if pulmonary hypertension develops, but a decrease is less concerning.
D. Increased left atrial pressure: Mitral valve narrowing impairs blood flow into the left ventricle, leading to blood accumulation and elevated pressure in the left atrium. This can cause pulmonary congestion and is the most critical finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Multivitamins: Most multivitamins do not interact significantly with MAOIs unless they contain high levels of tyramine, which is rare. They are generally safe but should still be reviewed by the healthcare provider.
B. Laxatives: Laxatives are not known to have direct interactions with MAOIs. However, excessive use could alter electrolyte balance, which might complicate overall medication management but not specifically with MAOIs.
C. Cold and allergy medications: Many over-the-counter cold and allergy drugs contain sympathomimetic agents like pseudoephedrine, which can cause hypertensive crises. This is because these decongestatnts increase norepinephrine levels while MAOIs prevent the breakdown of norepinephrine. This combination is dangerous and must be strictly avoided.
D. Antiulcer medications: Most antiulcer drugs, such as proton pump inhibitors and H2 blockers, do not significantly interact with MAOIs. They should still be reviewed, but they are not commonly contraindicated.
Correct Answer is A
Explanation
A. Echocardiography: This test uses ultrasound to visualize heart structures and assess left ventricular function and thickness. It’s the primary tool for evaluating hypertensive effects on the heart.
B. Positron emission tomography (PET) scan: PET scans assess metabolic activity and are used in oncology and some cardiac studies but are not first-line for evaluating left ventricular changes due to hypertension.
C. Fluorescein angiography: This test is used in ophthalmology to assess retinal blood vessels and has no relevance to cardiac or ventricular function.
D. Computed tomographic (CT) scan: CT scans may detect structural abnormalities but are not typically used to assess left ventricular function in hypertension. Echocardiography is more precise and noninvasive for this purpose.
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