The nurse is caring for a client with a dignosis of aortic stenosis. The client reports episodes of angina and passing out recently at home. The client has surgery scheduled in 2 weeks. Which of the following would be the nurse's best explanation about activity at this time?

Correct Answer: A

Rationale: The correct answer is A because in aortic stenosis, there is an obstruction of blood flow from the heart to the body. Strenuous activities can worsen the condition by increasing the workload on the heart, leading to angina and fainting. Preoperative preparation focuses on reducing the risk of complications during surgery. Therefore, advising the client to avoid strenuous exercise, stairs, and lifting helps minimize the risk of exacerbating symptoms and potential complications before surgery. Explanation for other choices: B: Taking short walks may be too strenuous for a client with aortic stenosis and can potentially worsen symptoms. C: Allowing unrestricted activity can be dangerous for a client with aortic stenosis, as it may lead to worsening symptoms and increased risk of complications. D: Gradually increasing activity can be risky for a client with aortic stenosis, as it can increase the workload on the heart and exacerbate symptoms.

Correct Answer: B

Rationale: The correct answer is B: Bruit to left of the midline in the abdominal area. This is indicative of a possible ruptured AAA, as a bruit in the abdominal area can suggest turbulent blood flow due to an aneurysm. The other choices are incorrect because: A) Midsternal chest pressure relieved with nitroglycerin paste is more indicative of cardiac issues; C) Extreme headache is not typically associated with AAA; D) Numbness and tingling in the hands and arms are more suggestive of neurological issues rather than AAA. In summary, the presence of a bruit in the abdominal area is a key sign that should raise suspicion for a ruptured AAA in this patient.

Correct Answer: C

Rationale: The correct answer is C: Atrial flutter. A saw-toothed appearance of P waves at a rate of 300 bpm is characteristic of atrial flutter. In atrial flutter, the atria depolarize at a rapid rate, leading to a typical saw-tooth pattern on ECG. Paroxysmal atrial tachycardia (PAT) typically presents with sudden onset and termination of a regular tachycardia, not saw-toothed P waves. Premature atrial contractions (PACs) are early atrial depolarizations, not sustained at 300 bpm. Atrial fibrillation is characterized by irregularly irregular rhythm with no discernible P waves.

Correct Answer: A

Rationale: The correct answer is A) Bubbling crackles and tachycardia. In acute left-sided heart failure, there is an accumulation of fluid in the lungs leading to pulmonary congestion. Bubbling crackles (also known as pulmonary crackles or rales) are a common auscultation finding in patients with pulmonary congestion due to heart failure. Tachycardia is also expected as the heart tries to compensate for the decreased cardiac output. Option B) Hepatosplenomegaly and tachycardia is incorrect because hepatosplenomegaly would be more indicative of right-sided heart failure, not left-sided heart failure. Peripheral edema and cool, diaphoretic skin (Option C) are more characteristic of right-sided heart failure as well, due to fluid accumulation in the body's tissues. Option D) Frothy blood-tinged sputum and distended jugular veins are more indicative of severe left-sided heart failure with pulmonary edema. In an educational context, understanding these specific physical assessment findings in heart failure is crucial for early recognition, prompt intervention, and improved patient outcomes. Nurses need to be proficient in recognizing these signs and symptoms to provide timely and appropriate care for patients with heart failure. A thorough understanding of the pathophysiology and clinical manifestations of heart failure is essential for nurses to deliver high-quality, patient-centered care.

Correct Answer: D

Rationale: The correct answer is D) Low-sodium food choices when eating out. This topic is crucial for the patient because excessive sodium intake can exacerbate hypertension by causing fluid retention and increasing blood pressure. Educating the patient on making low-sodium food choices when eating out empowers her to make healthier dietary decisions and manage her blood pressure effectively. Option A) Benefits and adverse effects of beta-blockers is incorrect because the patient is at an early stage of hypertension management where lifestyle modifications are typically the first line of treatment before considering medications like beta-blockers. Option B) Adverse effects of alcohol on blood pressure is not the most immediate concern for this patient as she only consumes alcohol occasionally. While alcohol can impact blood pressure, the patient's alcohol intake frequency is not high enough to be the primary focus at this stage. Option C) Methods for decreasing dietary caloric intake is important for overall health and weight management but is not the most pressing issue in this scenario. The immediate concern is managing hypertension through dietary changes, specifically reducing sodium intake. In an educational context, teaching about low-sodium food choices is essential for patients with hypertension as dietary modifications play a significant role in blood pressure management. Providing practical tips on making healthier food choices when eating out empowers patients to take control of their health and make informed decisions that support their well-being.