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Med. Surg. > Valvular disorders > Flashcards

Valvular disorders Flashcards

1
Q 
A patient with acute mitral regurgitation presents to the ER showing signs and symptoms most closely related to which disorder?
A) Myocardial Infarction
B) Cardiac Tamponade
C) Heart Failure
D) Coranary Artery Disease
A 
C) Heart Failure 
S/S:
-Angina
-SOB
-Water retention
-Edema in extremities
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2
Q 
A patient with mitral regurgitation is complaining of coughing. The nurse auscultate his lung sounds and hears crackles. The nurse suspects?
A) Pneumonia
B) Pulmonary Edema
C) Common cold
D) Bronchitis
A

B) Pulmonary edema is a manifestation of mitral regurgitation

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3
Q 
Which of the following symptoms occurs in a patient diagnosed with mitral regurgitation when pulmonary edema occurs?
A) Hypertension
B) A loud, blowing murmur
C) Tachycardia
D) Shortness of breath
A

D) Shortness of breath

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4
Q

The nurse is auscultating a patient recently diagnosed with mitral regurgitation. What heart sounds will the nurse anticipate to hear?
A) S4 sounds
B) Apical diastolic murmur
C) Sinus Tachycardia
D) High-pitched systolic murmur at the apex

A

D) High-pitched systolic murmur at the apex

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5
Q 
A 53 year old woman presents to the ER with a history of repeated respiratory infections, an ECG showed atrial fibrillation, she complained of feeling short of breath when walking up stairs, the nurse auscultates her lungs and hears an low-pitched apical diastolic murmur. The nurse recognizes the symptoms to be associated with which valvular disorder? 
A) Mitral regurgitation
B) Aortic stenosis
C) Aortic regurgitation
D) Mitral stenosis
A

D) Mitral stenosis

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6
Q

A patient with a recent diagnose of mitral regurgitation has been prescribed Lisinopril and Carvedilol. What is the purpose of these medications regarding the patients recent diagnosis?

A

To reduce afterload and arterial dilation

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7
Q

The nurse is going over discharge instructions for a patient with mitral regurgitation. Which of the following shows the patient has a full understanding of the nurses instructions?
A) I will lay flat while sleeping
B) I will continue going to the gym 3 times a week
C) I will weigh myself everyday
D) Edema should not be reported because it is a normal finding with my condition

A

C) I will weigh myself everyday

- Remember to report a weight gain of 3 or more lbs in 1 day, or a weight gain of 5 or more lbs in 1 week

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8
Q

A patient reports to the nurse that he does not understand how pulmonary edema relates to mitral regurgitation. The nurse best shows an understanding of mitral regurgitation pathophysiology with which statement?
A) The lungs receive an excessive amount of blood from the right ventricle
B) Blood is shunted from the tricuspid valve to the pulmonic valve causing a sudden gush of blood
C) The backward flow decreases blood flow from the lungs into the left atrium
D) The backward flow increases blood flow from the lungs into the left atrium

A

C) The backward flow decreases blood flow from the lungs into the left atrium

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9
Q

The nurse is preparing a class on valvular disorders. The nurse knows that the mitral valve prolapse is a degenerative cause for which valvular disorder?

A

Mitral regurgitation

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10
Q 
A 43 year old male reports to the ER complaining of weakness and shortness of breath. The nurse auscultates the patients chests and hears a high-pitched systolic murmur at the apex as well as S3 sounds. She listens to the lungs and hears crackles with diminshed lung sounds in the lower lobes. An ECG shows atrial fibrillation. The nurse recognizes these symptoms to be associated with which valvular disorder?
A) Mitral Regurgitation
B) Mitral Stenosis
C) Aortic Regurgitation
D) Aortic Stenosis
A

A) Mitral regurgitation

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11
Q 
A nurse understands that the most common cause of mitral valve stenosis is?
A) Hypertension
B) H. Pylori
C) Hyperchlosterolemia
D) Infective endocarditis
A

D) Infective endocarditis

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12
Q

A patient with mitral stenosis has an appointment to get his wisdom teeth removed. The patient demonstrates an understanding of his condition by which of the following statements?
A) Prophylactic antibiotics are not necessary for this valvular disorder
B) Wisdom teeth removal lowers the risk of infective endocarditis
C) I must monitor my blood pressure following dental work
D) Prophylactic antibiotics are necessary for this valvular disorder

A

D) Prophylactic antibiotics are necessary for this valvular disorder

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13
Q

The nurse anticipates the treatment for a patient with a newly diagnosis of mitral stenosis to include: Select all that apply.
A) Prophylactic antibiotics for invasive procedures to mucous membranes
B) Treatment of Angina
C) Anticoagulation therapy
D) Medications that control ventricular rate
E) Valve replacement

A

A, B, C, D, E

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14
Q

A nurse recognizes that pulmonary hypertension is a manifestation of mitral stenosis. The nurse understands this pathophysiology is caused by?
A) Backflow of blood
B) Pressure from the right ventricle causes the increase pressure in the pulmonic artery
C) This manifestation is due to right-sided failure
D) The pulmonic valve closes completely shut

A

A) Backflow of blood

B) is incorrect because pulmonic hypertension increases the pressure that the right ventricle has to overcome to open the pulmonic valve.
C) is incorrect because pulmonic hypertension can lead to ride-sided failure

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15
Q

A nursing student is observing a nurse care for a patient with mitral stenosis. The student anticipates the nurses interventions will be: Select all that apply.
A) Promote activity tolerance
B) Manage fluid and sodium restrictions
C) Monitor LOC
D) Encourage the patient to participate in strenuous activity

A

A, B, C

D) is incorrect. The nurse should encourage the patient to avoid strenuous activity

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16
Q 
A nurse understands that the most common cause of mitral regurgitation is?
A) Infective endocarditis
B) Congenital valvular disorder
C) PFO 
D) Mitral valve prolapse
A

D) Mitral valve prolapse

17
Q 
A patient presents to the ER complaining of angina and anxiety. The nurse auscultates the patients chest and hears a mitral click. What is nurse going to do first? 
A) Notify the doctor to order an ECG
B) Give supplemental oxygen
C) Administer Amiodarone 
D) Administer Potassium IV push
A

A) Notify the doctor to order an ECG
An ECG used to diagnose and monitor progression of mitral valve prolapse

C) Would be something to consider, but need a doctors order and is not the priority upon assessment
D) You would never do this as a nurse, this is lethal
B) Is incorrect, the patient is not experiencing shortness of breath

18
Q

The nurse is caring for a patient recently diagnosed with mitral valve prolapse. Treatment typical for this patient would include? Select all that apply.
A) Calcium channel or beta blockers for chest pain
B) Antiarrythmic medications
C) Prophylactic antibiotics prior to invasive procedures
D) Alcohol and caffeine elimination

A

A,B,D

C) is incorrect mitral valve prolapse does not require prophylactic antibiotics prior to invasive procedures

19
Q 
A patient with a recent diagnosis of mitral valve prolapse is at CVS looking for over the counter medications. What should he avoid in making his purchase?
A) OTCs that contain milk products
B) OTCs that contain soybean products
C) OTCs that contain caffeine
D) OTCs that contain salicylic acid
A

C) OTCs that contain caffeine

as well as epinephrine, and alcohol

20
Q

A nurse is preparing her discharge instructions for a patient with mitral valve prolapse. What teachings should be included? Select all that apply.
A) Educate the pt and family on possible heredity
B) How to minimize risk of endocarditis
C) Avoid caffeine and alcohol
D) Sleep with the head elevated

A

A,B,C

D) is incorrect

21
Q

A patient was diagnosed with mitral valve prolapse. The nurse understand that mitral valve prolapse is:
A) When the mitral valve collapse
B) When mitral valve leaflets balloon back into the atrium during systole
C) When the mitral valve leaflets fuse together creating so much tension they tear
D) When the mitral valve loses its ability to allow blood to pass through

A

B) When mitral valve leaflets balloon back into the atrium during systole

22
Q 
A nurse is giving a presentation on valvular disorders. She knows that some causes of aortic regurgitation include: Select all that apply.
A) Infective rheumatic endocarditis
B) Syphillis
C) Hyperglycemia
D) Congenital abnormalities
A

A,B,D

23
Q 
A patient reports to the ER complaining of feeling her head and neck pulsating, and shortness of breath playing with her kids. The nurse aid takes her blood pressure noting an elevated systolic pressure and low diastolic pressure. The nurse auscultates the patients chest and hears a high-pitched diastolic murmur after S2. An ECG shows sinus tachycardia. The nurse recognize these symptoms to be associated with which valvular disorder?
A)  Mitral stenosis
B) Aortic stenosis
C) Aortic regurgitation
D) Mitral valve prolapse
A

C) Aortic regurgitation

24
Q 
The nurse anticipates the treatment for aortic regurgitation to include: Select all that apply.
A) Aspirin
B) Salt restriction 
C) Cardizem
D) Lisinopril
E) Digoxin
A

A,B,D,E

C) is incorrect. You may administer calicum channel blockers, but cardizem and verapamil are contraindicated

25
Q

A patient is being discharged today after recent diagnosis of aortic regurgitation. The nurse should include which of the following in her teaching? Select all that apply.
A) Limit salt intake
B) Minimize acne breakouts
C) IUDs are the preferred contraceptive for these patients
D) Avoid using toothpicks
E) Watch for signs of infections and seek treatment

A

A,B,D,E

C) is incorrect, IUDs are contraindicated

26
Q 
A nurse is caring for a patient with aortic regurgitation. What should the nurse make her priority care.
A) Infection control 
B) Bowel management program
C) Daily weight
D) Continuous hemodynamic monitoring
A

A) Infection control
The nurse must be vigilant with IV sites and during invasive procedures. Take out catheters or IVs as soon as they are not needed. Maintain meticulous hygiene. Prophylactic antibiotic therapy before dental or invasive procedures.

27
Q 
A patient presents to the ER complaining of syncope, SOB, and chest pain. The nurse auscultates his chest and hears a loud, rough systolic murmur over the aortic area, and S4. The nurse palpates the carotid arteries and feels vibration over the base of the heart. The nurse aid check his blood pressure and the readings show a narrow pulse pressure. The nurse recognizes these manifestations to be associated with which valvular disorder?
A) Mitral stenosis
B) Aortic regurgitation
C) Mitral regurgitation
D) Aortic stenosis
A

D) Aortic stenosis

28
Q

A patient recently diagnosed with aortic stenosis asks the nurse to explain what the valvular disorder is. The nurse best summarizes this with which statement?
A) Aortic stenosis is a narrowing of the aortic valve causing increased pressure on the left ventricle
B) Is a narrowing of the aortic valve causing increased pressure in the left atrium
C) Is a narrowing of the aortic valve causing ventricular atrophy
D) Is a widening of the aortic valve

A

A) The narrowing of the aortic valve causes increased pressure on the left ventricle

29
Q

A nurse is caring for a patient with a recent diagnosis of aortic stenosis. The nurse anticipates the doctor will prescribe what medical treatment? Select all that apply.
A) Antiarrhythmic medications
B) Balloon percutaneous valvuloplasty with or without transcatheter aortic valve implantation (TAVI)
C) Diuretics
D) Beta blockers
E) ACE inhibitors

A

A, B, C, D, E

30
Q 
A student nurse is observing a nurse caring for a patient with aortic stenosis. The student nurse anticipates the nurses interventions to be: Select all that apply.
A) Low sodium diet
B) Keeps the patients legs elevated
C) Monitor signs for fluid overload
D) Antibiotic prophylaxis 
E) Use of a bedside commode
A

A,B,C,D,E

Med. Surg. (3 decks)

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