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Which term describes a valve that does not open completely, resulting in reduced blood flow?
A. Regurgitation
B. Stenosis
C. Prolapse
D. Hypertrophy
Answer: B. Stenosis
Rationale: Stenosis occurs when a valve does not open completely, leading to resistance in blood flow.
A patient with mitral regurgitation is expected to have which abnormal heart sound?
A. S3 gallop
B. Opening snap
C. Murmur
D. Friction rub
Answer: C. Murmur
Rationale: Mitral regurgitation is characterized by a murmur caused by blood backflow from the left ventricle to the left atrium.
Which diagnostic test is most commonly used to confirm mitral regurgitation?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Echocardiogram or transesophageal echocardiogram (TEE)
D. Cardiac catheterization
Answer: C. Echocardiogram or transesophageal echocardiogram (TEE)
Rationale: Mitral regurgitation is diagnosed using echocardiography, particularly transesophageal echocardiography, which provides detailed images of the heart valves.
Which nursing intervention is a priority for a patient with a valvular heart disorder?
A. Encourage a high-protein diet
B. Monitor for weight gain
C. Increase sodium intake
D. Promote bed rest at all times
Answer: B. Monitor for weight gain
Rationale: Weight gain may indicate fluid retention and worsening heart failure, a complication of valvular disorders.
A patient with a new valve replacement asks about preventing infective endocarditis. What should the nurse include in education? (Select all that apply.)
A. Practice good hand hygiene
B. Avoid contact with sick individuals
C. Take prophylactic antibiotics before dental procedures
D. Avoid all physical activity
E. Stop taking anticoagulation therapy
Answer: A, B, C
Rationale: Infection prevention includes good hygiene, avoiding sick contacts, and taking prophylactic antibiotics before invasive procedures.
What is the most common cause of mitral regurgitation?
A. Aortic stenosis
B. Hypertension
C. Rheumatic heart disease
D. Cardiomyopathy
Answer: C. Rheumatic heart disease
Rationale: Rheumatic heart disease can cause scarring of the mitral valve, leading to mitral regurgitation.
In mitral stenosis, what structural change occurs in the heart?
A. Left ventricular hypertrophy
B. Left atrium hypertrophy
C. Right ventricular dilation
D. Aortic root dilation
Answer: B. Enlargement of the left atrium
Rationale: Mitral stenosis causes resistance in blood flow, leading to left atrial enlargement due to increased pressure.
A patient is scheduled for a valvuloplasty. What is the primary goal of this procedure?
A. To replace the valve entirely
B. To prevent future valve problems
C. To repair the valve
D. To completely close a leaking valve
Answer: C. To repair the valve
Which statement about mechanical valve replacement is correct?
A. Mechanical valves require lifelong anticoagulation
B. Mechanical valves last a shorter time than tissue valves
C. Mechanical valves are made from cadaver tissue
D. Patients with mechanical valves do not need follow-up
Answer: A. Mechanical valves require lifelong anticoagulation
Rationale: Mechanical valves have a high risk of clot formation, requiring lifelong anticoagulation therapy.
Which interventions can help improve cardiac output in cardiomyopathy patients? (Select all that apply.)
A. Positioning with legs down
B. Resting as needed
C. Encouraging dehydration
D. Increasing daily sodium intake
E. Low sodium diet
Answer: A, B,E
Rationale: Positioning with legs down reduces workload on the heart, resting as needed prevents overexertion, and a low-sodium diet helps prevent fluid overload.
Which psychosocial factor is important to assess in patients with cardiomyopathy?
A. Increased appetite
B. Social isolation and depression
C. Excessive energy levels
D. Insomnia
Answer: B. Social isolation and depression
Rationale: Patients with cardiomyopathy may struggle with fatigue and limited activity, leading to social isolation and depression.
What is a primary complication of aortic regurgitation?
A. Left ventricular dilation
B. Right atrial enlargement
C. Pulmonary embolism
D. Decreased venous return
Answer: A. Left ventricular dilation
Rationale: In aortic regurgitation, blood backflows from the aorta to the left ventricle, leading to dilation of the ventricle due to increased volume.
What is the purpose of an annuloplasty in valve repair?
A. To close a valve permanently
B. To strengthen the valve ring
C. To remove the valve leaflets
D. To bypass the valve
Answer: B. To strengthen the valve ring
Rationale: Annuloplasty reinforces the valve ring to improve function and prevent regurgitation.
What is the main advantage of bioprosthetic (tissue) valves over mechanical valves?
A. They require lifelong anticoagulation
B. They last longer than mechanical valves
C. They do not require anticoagulation therapy
D. They are made from the patient's own tissue
Answer: C. They do not require anticoagulation therapy
Rationale: Bioprosthetic valves do not require lifelong anticoagulation, making them preferable for patients who cannot tolerate anticoagulants.
The nurse is educating a patient about different types of valve replacements. Which statements are correct regarding valve replacement options? (Select all that apply.)
A. Homografts are obtained from cadaver donors.
B. Bioprosthetic valves last longer than mechanical valves.
C. Autografts involve using the patient’s own tissue.
D. Mechanical valves require lifelong anticoagulation therapy.
E. Bioprosthetic valves are made from animal tissue.
Answer: A, C, D, E
Rationale:
Which electrolyte plays the most significant role in cardiomyopathy?
A. Calcium
B. Potassium
C. Sodium
D. Magnesium
Answer: C. Sodium
Rationale: Sodium retention leads to fluid overload, increasing the workload on the heart and worsening cardiomyopathy.
What should the nurse educate the patient with cardiomyopathy to report?
A. Decreased shortness of breath
B. Increased activity tolerance
C. Sudden weight gain
D. Increased appetite
Answer: C. Sudden weight gain
Rationale: Weight gain may indicate worsening heart failure due to fluid retention.
Which surgical procedure involves separating fused valve leaflets in mitral stenosis?
A. Annuloplasty
B. Commissurotomy
C. Chordoplasty
D. Bioprosthesis
Answer: B. Commissurotomy
Rationale: Commissurotomy is performed to separate fused valve leaflets in patients with mitral stenosis to improve blood flow.
Which type of valve replacement is created from the patient's own tissue?
A. Bioprosthesis
B. Homograft
C. Autograft
D. Annuloplasty
Answer: C. Autograft
Rationale: Autografts use the patient’s own tissue, reducing the risk of rejection and eliminating the need for anticoagulation therapy.
Which complications are associated with cardiomyopathy? (Select all that apply.)
A. Heart failure
B. Ventricular arrhythmias
C. Pulmonary embolism
D. Increased ejection fraction
E. Valvular dysfunction
Answer: A, B, C, E
Rationale: Cardiomyopathy can lead to heart failure (r/t decreased stroke volume), arrhythmias, embolism due to stagnant blood, and valvular dysfunction.
A patient with mitral stenosis is most likely to experience which symptom?
A. Hypertension
B. Syncope
C. Pulmonary congestion
D. Bounding peripheral pulses
Answer: C. Pulmonary congestion
Rationale: Mitral stenosis restricts blood flow from the left atrium to the left ventricle, leading to increased left atrial pressure and pulmonary congestion, resulting in dyspnea and orthopnea.
A nurse is assessing a patient with cardiomyopathy. Which physical assessment findings are expected?
A. Bounding peripheral pulses and hypertension
B. Crackles in the lungs and jugular vein distention (JVD)
C. Bradycardia and dry skin
D. Hyperactive bowel sounds and increased urine output
Answer: B. Crackles in the lungs and jugular vein distention (JVD)
Rationale: Cardiomyopathy can lead to fluid overload, causing pulmonary congestion (crackles) and right-sided heart failure (JVD due to venous congestion).
What is a primary nursing goal for a patient with cardiomyopathy?
A. Increase fluid intake
B. Improve cardiac output and peripheral blood flow
C. Encourage strenuous exercise
D. Restrict all physical activity
Answer: B. Improve cardiac output and peripheral blood flow
Rationale: Increasing cardiac output and blood flow helps reduce symptoms and improve patient outcomes.
Which patient statement indicates the need for further education after valve replacement surgery?
A. "I need to take my anticoagulants as prescribed."
B. "I will need follow-up echocardiograms."
C. "I can go back to my normal routine right away."
D. "I should report any signs of infection to my provider."
Answer: C. "I can go back to my normal routine right away."
Rationale: Patients should gradually resume activity and avoid overexertion after valve surgery.
A nurse is preparing a patient for a valvuloplasty. Which preoperative education points should be included? (Select all that apply.)
A. You may have a central line or chest tube after surgery
B. You will need follow-up echocardiograms
C. You will require lifelong anticoagulation therapy
D. You should report worsening shortness of breath
E. You should avoid all physical activity after discharge
Answer: A, B, D
Rationale: A central line or chest tube may be required postoperatively. Follow-up echocardiograms are necessary to assess valve function. Patients should report worsening symptoms to prevent complications.