The nurse understands that which of the following is a manifestation of aortic stenosis?

Narrowed pulse pressure

Sinus tachycardia

Apical diastolic murmur

S3 heart sound

Answer and Explanation

The Correct Answer is A

A. Narrowed pulse pressure: Aortic stenosis leads to obstruction of blood flow from the left ventricle to the aorta during systole, reducing systolic pressure while diastolic pressure remains unchanged or slightly elevated. This results in a narrowed pulse pressure, a classic finding in moderate to severe aortic stenosis.

B. Sinus tachycardia: While tachycardia can occur in response to decreased cardiac output or stress, it is not a defining feature of aortic stenosis. The hallmark findings relate more directly to fixed cardiac output and valve obstruction.

C. Apical diastolic murmur: Aortic stenosis produces a systolic ejection murmur, best heard at the right second intercostal space and radiating to the carotids. An apical diastolic murmur would suggest mitral stenosis or other diastolic valve pathology.

D. S3 heart sound: An S3 is more indicative of volume overload and heart failure rather than valvular stenosis. While advanced aortic stenosis can lead to heart failure, the S3 is not a primary or early manifestation of this condition.

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Correct Answer is A

Explanation

A. the heart rate is greater than 100 bpm in sinus tachycardia: Normal Sinus Rhythm is characterized by a heart rate between 60 and 100 beats per minute (bpm). Sinus tachycardia is defined as a sinus rhythm with a heart rate exceeding 100 beats per minute. The rhythm remains regular, with each P wave followed by a QRS complex, but the rate is significantly faster than normal sinus rhythm.

B. more p waves are present than QRS complexes: In sinus tachycardia, the number of P waves and QRS complexes remains one-to-one, as each atrial impulse continues to be conducted to the ventricles. More P waves than QRS complexes typically suggest atrial flutter or other forms of AV dissociation.

C. the QRS complexes measure greater than 0.10: A widened QRS complex suggests a bundle branch block or ventricular rhythm, not sinus tachycardia. In sinus tachycardia, QRS complexes typically remain narrow, measuring less than 0.10 seconds unless an intraventricular conduction delay is present.

D. the rhythm is often irregular in sinus tachycardia: Sinus tachycardia is usually a regular rhythm with consistent R-R intervals. An irregular rhythm is more indicative of atrial fibrillation or sinus arrhythmia, not a defining characteristic of sinus tachycardia.

A. Prepare the client for electrical cardioversion B. Perform a carotid massage on the client. C. Administer lidocaine 1mg/hour. D. Ask the client if they drank a caffeinated beverage

Correct Answer is B

Explanation

A. Prepare the client for electrical cardioversion: Electrical cardioversion is reserved for unstable patients (e.g., hypotension, altered mental status, chest pain, or signs of shock). This client, while tachycardic, has a blood pressure of 106/60, which indicates relative stability. Cardioversion is not the first-line intervention in stable supraventricular tachycardia (SVT).

B. Perform a carotid massage on the client: Carotid sinus massage is a vagal maneuver used to slow conduction through the AV node and can terminate paroxysmal supraventricular tachycardia (PSVT). It is a non-invasive, first-line intervention for a stable patient with narrow-complex tachycardia, as shown on the ECG strip.

C. Administer lidocaine 1 mg/hour: Lidocaine is an antiarrhythmic used primarily to treat ventricular arrhythmias, such as ventricular tachycardia or fibrillation. It is not indicated for atrial or supraventricular tachycardias and would not address the underlying rhythm.

D. Ask the client if they drank a caffeinated beverage: While excessive caffeine intake can contribute to tachycardia, asking about caffeine use does not address the acute arrhythmia or guide immediate treatment. It may be part of history-taking but is not a priority intervention in this situation.

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The nurse understands that which of the following is a manifestation of aortic stenosis?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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