Which clinical manifestations would you expect to see in a patient with Aortic Valve Stenosis?
Hemoptysis.
Angina on exertion.
Ascites.
Bradycardia.
The Correct Answer is B
Choice A rationale
Hemoptysis (coughing up blood) is more commonly associated with conditions causing elevated pulmonary capillary pressure, such as mitral stenosis or severe left-sided heart failure leading to pulmonary congestion. Aortic valve stenosis primarily causes a pressure overload on the left ventricle, which may progress to failure, but hemoptysis is not a typical initial or specific finding.
Choice B rationale
Angina on exertion is a classic symptom of severe aortic stenosis. The stenotic valve limits the blood flow from the left ventricle into the aorta, reducing cardiac output and thus, coronary artery perfusion, especially when the myocardial oxygen demand increases during physical activity, leading to chest pain.
Choice C rationale
Ascites (fluid accumulation in the abdomen) is a sign of severe right-sided heart failure, which can occur late in the progression of aortic stenosis if the left-sided failure leads to pulmonary hypertension and subsequent right ventricular strain. It is generally not an expected initial clinical manifestation of isolated aortic stenosis.
Choice D rationale
Bradycardia (slow heart rate, normal range 60-100 beats/min) is uncommon in aortic stenosis unless there is coexisting conduction system disease. The body often attempts to compensate for the fixed, low cardiac output caused by the stenosis by maintaining or slightly increasing the heart rate. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
An asymptomatic bradycardia with a heart rate of 50 beats per minute, which is within the range of 50-60 bpm for normal sinus bradycardia in some individuals, particularly well-conditioned athletes, generally does not require a permanent pacemaker. Pacemaker implantation is typically reserved for symptomatic bradycardia or higher-degree Atrioventricular (AV) blocks.
Choice B rationale
Third-Degree (Complete) Atrioventricular (AV) Block is characterized by a complete failure of electrical conduction between the atria and the ventricles, resulting in independent atrial and ventricular rhythms. The slow, unreliable ventricular escape rhythm often leads to symptoms like syncope, heart failure, or sudden cardiac death, making a permanent pacemaker mandatory.
Choice C rationale
First-degree Atrioventricular (AV) block is a benign condition characterized by a prolonged PR interval (normal range 0.12 - 0.20 seconds) with every impulse conducted. It rarely progresses to higher-degree blocks and is typically asymptomatic, so it does not meet the criteria or indication for permanent pacemaker implantation.
Choice D rationale
Atrial flutter with a controlled ventricular rate means the AV node is effectively regulating the rapid atrial impulses. This rhythm is generally managed with rate-control medications like beta-blockers or calcium channel blockers, and does not warrant a permanent pacemaker, which is primarily for correcting symptomatic bradyarrhythmias. —.
Correct Answer is C
Explanation
Choice A rationale
The 30-minute window is the recommended maximum door-to-needle time for administering fibrinolytic therapy to eligible STEMI patients at hospitals without PCI capability. Fibrinolysis is less definitive than PCI because it doesn't mechanically open the vessel and has a higher risk of bleeding complications, thus a shorter goal is needed to minimize ischemic time.
Choice B rationale
The 60-minute interval is not the current guideline for door-to-balloon time in STEMI patients receiving primary PCI. The aim is to restore blood flow rapidly to minimize myocardial damage, as irreversible injury starts within 20-40 minutes of total coronary occlusion, making a faster time goal necessary.
Choice C rationale
For patients presenting to a PCI-capable hospital with STEMI, the goal is to achieve reperfusion via Primary Percutaneous Coronary Intervention (PCI) within 90 minutes of first medical contact or hospital arrival (door-to-balloon time). This rapid intervention minimizes myocardial necrosis and improves outcomes by re-establishing coronary blood flow.
Choice D rationale
While 120 minutes is an acceptable time goal for patients transferred from a non-PCI center to a PCI center for primary PCI, it is too long for a direct presentation to a PCI-capable hospital. A longer delay increases the size of the infarct and the risk of cardiogenic shock or death. —.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.