Deck 18: Valvular Heart Disease

Question 1

The nurse evaluates a client's heart murmur and determines the murmur to be loud. In which manner does the nurse rate the heart murmur? 1.1/6
2)3/6
3)2/6
4)6/6

Answer 1

4

Question 2

While evaluating a client for a heart murmur, the nurse auscultates the murmur with the bell of a stethoscope. For which type of heart murmur is the nurse assessing?
1)A high-pitched murmur
2)A low-pitched murmur
3)A crescendo murmur
4)A decrescendo murmur

Answer 2

2

Question 3

A left ventricular impulse is seen through the chest wall of a client. On palpation, a diastolic thrill is palpated along the left sternal border, and a systolic thrill is palpable in the jugular notch. To which pathological condition are these symptoms attributed?
1)Aortic valve insufficiency
2)Mitral valve insufficiency
3)Tricuspid valve stenosis
4)Mitral valve prolapse

Answer 3

1

Question 4

A client presents with dyspnea, cough, fatigue, and orthopnea. On auscultation, there is an opening snap and a diastolic murmur heard at the fifth intercostal space in the left sternal border. The client undergoes an echocardiogram to validate a pathological condition. Which pathological condition is the client most likely to have?
1)Mitral valve stenosis
2)Hypertrophic cardiomyopathy
3)Aortic valve stenosis
4)Aortic valve insufficiency

Question 5

A client presents with dyspnea, exertional dyspnea, and exertional syncope. An echocardiogram shows a diminished left ventricular ejection fraction. Which is the reason for prescribing dobutamine to the client?
1)To enhance arterial circulation
2)To reduce the risk of coagulation
3)To augment the cardiac output
4)To diminish the effects of ventricular failure

Question 6

At which intercostal space does the nurse place the stethoscope for auscultation of the pulmonic valve?
1)The second intercostal space in the left sternal border
2)The second intercostal space in the right sternal border
3)The fifth intercostal space in the midclavicular line
4)The fourth intercostal space in the left sternal border

Question 7

A client is diagnosed with mitral annular calcification and has regurgitation of blood into the left atrium and the pulmonary vasculature. Which treatment does the nurse anticipate for the client?
1)Beta-blockers
2)Angiotensin-converting enzyme (ACE) inhibitors
3)Diuretics
4)Digitalis

Question 8

The nurse is auscultating a client's heart sounds and notices a murmur. Which differentiates a heart murmur that is caused by mitral valve stenosis from one that is caused by other mitral valve disorders?
1)Midsystolic murmur
2)Opening snap followed by a diastolic murmur
3)Holosystolic murmur
4)Late systolic murmur

Question 9

How does Ebstein's anomaly lead to a small right ventricular chamber?
1)The mitral valve leaflets push into the right ventricle, creating a small right ventricular chamber.
2)A displaced tricuspid valve lowers into the right ventricle, creating a small right ventricular chamber.
3)The pulmonic valve pushes into the right ventricle, creating a small right ventricular chamber.
4)The aortic valve pushes into the right ventricle, creating a small right ventricular chamber.

Question 10

In which manner does the nurse distinguish a grade 5 heart murmur from a grade 6 heart murmur?
1)A grade 5 heart murmur is heard with the diaphragm of a stethoscope, whereas a grade 6 heart murmur is heard with the bell of a stethoscope.
2)A grade 5 heart murmur may be heard when a stethoscope is partly off the chest wall, whereas a grade 6 heart murmur is heard when a stethoscope is completely off the chest wall.
3)A grade 5 heart murmur is moderately loud, whereas a grade 6 heart murmur is loud and has a palpable thrill.
4)A grade 5 heart murmur is faint, whereas a grade 6 heart murmur is moderately loud.

Question 11

A client presents with paroxysmal nocturnal dyspnea (PND) and chest pain. On auscultation, the client is found to have a holosystolic murmur at the fifth intercostal space in the left sternal border. Which condition warrants the client undergoing an echocardiogram for validation of the disease?
1)Aortic valve insufficiency
2)Mitral valve insufficiency
3)Tricuspid valve stenosis
4)Mitral valve prolapse

Question 12

Which does the nurse hear when auscultating heart sounds in a client who has hypertrophic cardiomyopathy?
1)A high-pitched, blowing, decrescendo murmur
2)An opening snap after S₂
3)A harsh, diamond-shaped systolic murmur
4)A blowing holosystolic murmur

Question 13

A nurse is caring for a client who has an artificial heart valve and is scheduled for a dental procedure. Which precautionary measure does the nurse implement before the dental procedure?
1)Administering diuretics
2)Administering anticoagulant therapy
3)Administering beta-blockers
4)Administering antibiotic therapy

Question 14

The nurse is caring for a client with aortic valve stenosis and ineffective diuretic treatment. The client is not a candidate for surgery. Which procedure is likely to be prescribed for the client next?
1)Aortic valve replacement
2)Pacemaker insertion
3)Defibrillator therapy
4)Percutaneous aortic balloon valvuloplasty

Question 15

Which condition is likely to be the cause of a new heart murmur in an older adult client?
1)Aortic valve sclerosis
2)Myocardial infarction
3)High blood pressure
4)Low blood pressure

Question 16

The nurse is reviewing the manifestations of aortic valve insufficiency with staff nurses. Which statement made by an attending nurse indicates effective learning?
1)"It is a high-pitched, blowing, diastolic decrescendo murmur."
2)"It is a harsh, systolic, crescendo-decrescendo murmur."
3)"It is a high-pitched, decrescendo, blowing murmur."
4)"It is a blowing, holosystolic murmur."

Question 17

Which event needs to be ruled out in a client who has a long-standing history of mitral valve stenosis and presents with tachycardia, an irregular pulse, and left-sided weakness?
1)Ischemic stroke
2)Myocardial ischemia
3)Left ventricular ischemia
4)Right ventricular failure

Question 18

The nurse who is trained in the gold standards for coronary care has to use the most sensitive method to evaluate an intracardiac lesion. Which method does the nurse select?
1)Electrocardiogram (ECG)
2)Coronary angiography
3)Echocardiography
4)Chest x-ray

Question 19

In which manner does the nurse document a client's heart murmur that begins just before S₂ and ends at S₂?
1)Late systolic
2)Early systolic
3)Late diastolic
4)Early diastolic

Question 20

The registered nurse is teaching a client about medical treatment to prevent thromboemboli. Which response by the client indicates effective learning?
1)"I can expect to be on antibiotics."
2)"The use of diuretics will prevent the condition."
3)"Anticoagulants work to prevent clotting."
4)"Beta-adrenergic blockers are key in prevention."

Question 21

Which are the clinical manifestations of aortic valve stenosis? Select all that apply.
1)Bibasilar pulmonary crackles
2)Systolic ejection murmur
3)Blowing holosystolic murmur
4)Graham Steell murmur
5)Split S₂

Question 22

The registered nurse is teaching a nursing student about physiological heart murmurs. Which statements made by the student nurse indicate effective learning? Select all that apply.
1)"Physiological murmurs are loud."
2)"Physiological murmurs are faint."
3)"Physiological murmurs do not cause symptoms."
4)"Physiological murmurs are consistent."
5)"Physiological murmurs are intermittent."

Question 23

The nurse is reviewing how circulating blood moves through the various anatomical points of the heart. In which order does the process occur? Enter the letter of each stage in the proper sequence; do not use commas or spaces.
1) Blood enters the right atrium
2) Blood is forced into the pulmonary artery
3) Blood is pushed through the aortic valve
4) Blood flows through the tricuspid valve
5) Blood passes through the mitral valve

Question 24

The nurse is reviewing pathological heart murmurs with the nursing staff. Which statements made by an attending nurse indicate effective learning? Select all that apply.
1)"They are sounds caused by heart wall defects."
2)"They are sounds caused by valvular dysfunction."
3)"They are sounds caused by rib cage abnormalities."
4)"They are sounds caused by sternal bone defects."
5)"They are sounds caused by valvular deformities."

Question 25

A client is found to have a disproportionately enlarged interventricular septum with an eccentrically hypertrophied left ventricle. Which condition is indicated in the client?
1)Aortic valve stenosis
2)Mitral valve insufficiency
3)Hypertrophic cardiomyopathy
4)Mitral valve prolapse