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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Monitor heart rhythm: While cardiac monitoring is important, it doesn’t directly assess airway status or ventilation. Respiratory compromise must be identified through airway-focused assessments.
B. Auscultate lung sounds: Hourly lung auscultation helps detect early signs of airway obstruction, stridor, or atelectasis. It’s the most direct way to monitor for post-extubation respiratory issues.
C. Assess capillary refill: Capillary refill assesses peripheral perfusion but gives little information about airway patency or breathing effectiveness after extubation.
D. Obtain vital signs: Vital signs are useful but may not change until respiratory compromise becomes severe. Lung assessment provides earlier clues of deterioration.

A. Industrial pollutants B. Region of country lived in C. Alcohol D. Age E. Tobacco

Correct Answer is ["A","C","D","E"]

Explanation

A. Industrial pollutants: Exposure to chemicals like asbestos, wood dust, and other occupational irritants increases the risk of laryngeal cancer. Workers in industrial settings may inhale carcinogens that affect the larynx.
B. Region of country lived in: Geographic region is not a direct risk factor for laryngeal cancer. While environmental exposures vary by region, the location itself does not independently increase risk without other contributing factors.
C. Alcohol: Chronic alcohol use is a well-known risk factor for laryngeal cancer. When combined with tobacco use, the risk significantly increases due to synergistic effects on mucosal tissue.
D. Age: The risk for laryngeal cancer rises with age, especially in individuals over 55. Age-related changes in tissue and longer cumulative exposure to carcinogens contribute to higher risk.
E. Tobacco: Tobacco use, including smoking and chewing, is the most significant risk factor for laryngeal cancer. It causes direct irritation and genetic mutations in the epithelial lining of the larynx.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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