When taking a health history of a client with suspected aortic stenosis, which symptoms would the nurse anticipate? Select all that apply.

Bloody sputum

Peripheral edema

Dyspnea on exertion

Angina

Syncope

Answer and Explanation

Correct Answer : C,D,E

a. Bloody sputum: Bloody sputum is not typically associated with aortic stenosis. It may be indicative of other conditions such as pulmonary embolism, pneumonia, or bronchitis, but it is not a common symptom of aortic stenosis. Therefore, this symptom is not anticipated.

b. Peripheral edema: Peripheral edema is not a common symptom of isolated aortic stenosis. It is more commonly associated with conditions such as heart failure, where fluid retention leads to swelling in the extremities. Therefore, peripheral edema is not typically anticipated in aortic stenosis.

c. Dyspnea on exertion: Dyspnea on exertion is a classic symptom of aortic stenosis. It occurs due to the narrowing of the aortic valve, which leads to increased resistance to blood flow from the left ventricle to the aorta during physical activity. This can result in breathlessness and difficulty breathing during exertion.

d. Angina: Angina, or chest pain, is a common symptom of aortic stenosis, especially in cases where there is concurrent coronary artery disease (CAD). Aortic stenosis can increase myocardial oxygen demand, leading to ischemia and chest pain, particularly during exertion.

e. Syncope: Syncope, or fainting, is a serious symptom of aortic stenosis and indicates severe disease. It typically occurs due to decreased cardiac output during exertion, leading to inadequate cerebral perfusion. Syncope in aortic stenosis is often exertional and may occur with activities such as exercise or even just walking.

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Correct Answer is A

Explanation

Metabolic alkalosis is an acid-base imbalance characterized by excessive loss of acid or excessive gain of bicarbonate produced by an underlying pathologic disorder. It's essential to address this condition promptly.

a. Assess for decreased respiratory rate: Metabolic alkalosis leads to hypoventilation as the body compensates by retaining carbon dioxide. Monitoring respiratory rate is crucial to detect any signs of respiratory distress or inadequate ventilation¹.

- Priority: High

b. Diet teaching to include low protein foods: While dietary adjustments are important, addressing the underlying cause (such as vomiting, diuretic use, or excessive alkali intake) is more critical. Low protein foods alone won't correct metabolic alkalosis.

- Priority: Low

c. Obtain daily weight: Daily weight monitoring is essential for assessing fluid balance, but it doesn't directly address metabolic alkalosis. Other interventions take precedence.

- Priority: Medium.

d. Check blood glucose: Blood glucose levels are not directly related to metabolic alkalosis. Focusing on acid-base balance and electrolyte levels is more relevant.

- Priority: Low

A. Dopamine B. Warfarin C. Digoxin D. Lisinopril

Correct Answer is D

Explanation

a. Dopamine: Dopamine is a medication that primarily acts as a vasopressor and inotropic agent. While it can increase cardiac contractility and improve cardiac output, it does not directly decrease afterload. In fact, dopamine may increase systemic vascular resistance (afterload) at higher doses.

b. Warfarin: Warfarin is an anticoagulant medication used to prevent blood clot formation, particularly in individuals with certain cardiac conditions such as atrial fibrillation or mechanical heart valves. While warfarin is important for preventing thromboembolic events in individuals with mitral valve regurgitation, it does not directly affect afterload.

c. Digoxin: Digoxin is a medication that primarily acts as a positive inotropic agent by increasing myocardial contractility. While it can improve cardiac function, particularly in individuals with heart failure, it does not directly decrease afterload.

d. Lisinopril: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor medication that reduces blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing angiotensin II levels, lisinopril dilates blood vessels and decreases systemic vascular resistance (afterload), thus reducing the workload on the heart. Therefore, lisinopril is the medication that would help decrease afterload for a client with mitral valve regurgitation.

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When taking a health history of a client with suspected aortic stenosis, which symptoms would the nurse anticipate? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has developed metabolic alkalosis. Which intervention would be a priority for the nurse to implement?

Correct Answer is A

Explanation

The nurse is admitting a client diagnosed with mitral valve regurgitation. Which medication would help decrease afterload for this client?

Correct Answer is D

Explanation

The nurse is reviewing data of a client in acute heart failure who is receiving hydralazine IV push. Which is the therapeutic effect of this medication?

The nurse is caring for a client with digoxin toxicity. Which findings are consistent with this diagnosis? Select all that apply.

A client in the emergency department is being treated for hyperventilation related to anxiety. Which arterial blood gas result would the nurse anticipate for this client? Normal arterial blood gas values pH: 7.35-7.45, PaCO2: 35-45mmHg, HCO3: 22-26mEq/L.

The nurse is assessing a client who had valve replacement surgery yesterday. It would be a priority for the nurse to report which assessment finding to the healthcare provider?

The nurse is caring for a client after percutaneous coronary revascularization (PCR) via left groin site. Which assessments would the nurse obtain after the procedure? Select all that apply.

A client diagnosed with mitral stenosis asks the nurse what is wrong with her heart. How can the nurse best explain this health problem?

A client is admitted for treatment of pulmonary edema. Which medication will the nurse administer to improve the force of cardiac contraction for this client?

A client with a history of heart failure presents to the emergency department with elevated blood pressure, dyspnea and bilateral crackles throughout lung fields. Which intervention would the nurse implement first?