The nurse is interviewing a client who is being admitted for possible mitral regurgitation. Which historical fact is of greatest value to the nurse?
Congenital neural tube defect
Pacemaker inserted 2 years ago
One-pack-a-day smoker for 20 years
Rheumatic fever
The Correct Answer is D
A. Congenital neural tube defect: This condition affects the central nervous system and is unrelated to the structure or function of the heart valves. It does not contribute to the development of mitral regurgitation.
B. Pacemaker inserted 2 years ago: While a pacemaker reflects a history of cardiac rhythm issues, it does not directly affect the mitral valve. It provides less diagnostic value for assessing structural valve disorders.
C. One-pack-a-day smoker for 20 years: Smoking is a major risk factor for coronary artery disease and other cardiovascular problems like hypertension. While these can indirectly affect the heart, smoking is not a primary cause of mitral valve damage leading to regurgitation.
D. Rheumatic fever: Rheumatic fever is a leading cause of mitral valve damage, often resulting in regurgitation due to scarring and deformation of the valve as a complication of untreated or poorly treated strep throat infection. This history is highly relevant and provides strong diagnostic value.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
A. "What brought you to the emergency department today?": This is a general intake question that helps determine the current complaint but does not specifically screen for risk factors or history of cardiomyopathy.
B. "When was the last time you had any nausea or heartburn?": These symptoms may relate to gastrointestinal or cardiac concerns but are nonspecific and not directly used to screen for cardiomyopathy.
C. "Did you have any common childhood diseases?": While relevant in some cases, childhood illnesses are not typically a key factor in identifying familial or inherited forms of cardiomyopathy.
D. "Have you ever had a close family member die unexpectedly?": Sudden cardiac death in a family member can be a red flag for inherited forms of cardiomyopathy, such as hypertrophic cardiomyopathy. This is a critical screening question to assess genetic risk.
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