ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 24 : Caring for Clients With Valvular Disorders of the Heart Questions
Question 1 of 5
The nurse is interviewing a client who is being admitted for possible mitral regurgitation. Which historical fact is of greatest value to the nurse?
Correct Answer: B
Rationale: Rheumatic fever and subsequent heart disease is the prominent cause of valvular insufficiency. Congenital neural tube defect is associated with spina bifida not mitral regurgitation. Smoking and insertion of pacemaker are significant to heart disorders but not of greatest value as rheumatic fever.
Question 2 of 5
The nurse provides care for an older adult client who is diagnosed with valvular heart disease. On auscultation of the client's heart sounds, the nurse notes an erratic heart rhythm. Which age-related change is the most likely cause for this finding?
Correct Answer: A
Rationale: Age-related effects, such as stiffening of the aorta, calcification, and fibrotic thickening (not thinning) of the mitral and aortic valves, contribute to development of symptoms (e.g., increased systolic blood pressure [BP], dangerous arrhythmias [erratic heart rhythms or rates that are too fast or slow] sometimes referred to as dysrhythmias) and complications (e.g., increased myocardial oxygen demand, heart failure, and alterations in cardiac output) in the older adult with valvular heart disease. A decrease in metabolism is an age-related effect for clients with valvular heart disease; however, this affects the dosage of prescribed medication and is not the cause of the client's dysrhythmia. A decrease, not increase, in thirst sensation is an age-related change that could lead to dehydration, and, thus, changes in the client's heart rhythm.
Question 3 of 5
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?
Correct Answer: A
Rationale: A damaged mitral valve leads to incomplete emptying of the left atrium and accumulation of blood resulting in increased pressure. As the backup of blood continues, pressure is increased into the lungs and right ventricle and cardiac output decreases.
Question 4 of 5
Before an invasive procedure, a client is prescribed antibiotics. The nurse understands the reason for this preventative action is to avoid which complication?
Correct Answer: B
Rationale: Infective endocarditis can compound valvular damage but can be minimized with the preventative use of antibiotics before invasive procedures and dental work. Rheumatic heart disease is associated with the original cause of valve disease and is not prevented with prophylactic antibiotic use. Although congestive heart failure is a complication associated with valvular disease, prophylactic antibiotic therapy is not prescribed for prevention. One type of valvular disease is mitral valve regurgitation. When this occurs rapidly, the heart is less able to compensate, causing the client to develop signs of cardiogenic shock leading to pulmonary congestion. The use of antibiotics is not meant to avoid this complication.
Question 5 of 5
Before administering digoxin to a client with valvular disease, the nurse assesses the apical heart rate as 62 beats/minute. The client's usual rate ranges between 66 to 72 beats/minute. Which is the best action for the nurse to take?
Correct Answer: C
Rationale: A heart rate of 62 beats/minute falls within the normal range for administration of this drug. Holding the medication would not be recommended unless a specific prescription was detailed to do so. The nurse may decide to recheck the pulse but this is not required. Notifying the physician of normal findings is not efficient use of time or resources.