NCLEX Review for Valvular Disease and Diet

1. A 68-year-old woman is scheduled to undergo mitral valve replacement for severe mitral stenosis and mitral regurgitation. Although the diagnosis was made during childhood, she did not have any symptoms until 4 years ago. Recently, she noticed increased symptoms, despite daily doses of digoxin and furosemide. During the initial interview with the nice lady, the nurse would most likely learn that the client’s childhood health history included:

a. Chicken pox
b. poliomyelitis
c. Rheumatic fever
d. meningitis

2. Which of the following signs and symptoms would most likely be found in a client with mitral regurgitation?

a. Exertional dyspnea
b. Confusion
c. Elevated creatine phosphokinase concentration
d. Chest pain

3. The nurse expects that a client with mitral stenosis would demonstrate symptoms associated with congestion in the:

a. Aorta
b. Right atrium
c. Superior vena cava
d. Pulmonary circulation

4. Because a client has mitral stenosis and is a prospective valve recipient, the nurse preoperatively assesses the client’s past compliance with medical regimens. Lack of compliance with which of the following regimens would pose the greatest health hazard to this client?

a. Medication therapy
b. Diet modification
c. Activity restrictions
d. Dental care

5. Good dental care is an important measure in reducing the risk of endocarditis. A teaching plan to promote good dental care in a client with mitral stenosis should include demonstration of the proper use of:

a. A manual toothbrush
b. An electric toothbrush
c. An irrigation device
d. Dental floss

6. A client has been admitted to the hospital with a diagnosis of suspected bacterial endocarditis. The complication the nurse will constantly observe for is:

a. Presence of heart murmur
b. Systemic emboli
c. Fever
d. Congestive heart failure

7. Cholesterol, frequently discussed in relation to atherosclerosis, is a substance that:       

a. May be controlled by eliminating food sources
b. Is found in many foods, both plant and animal sources
c. All persons would be better off without because it causes the disease process
d. Circulates in the blood, the level of which usually decreases when unsaturated fats are substituted for saturated fats.

8. When teaching a client with a cardiac problem, who is on a high-unsaturated fatty-acid diet, the nurse should stress the importance of increasing the intake of:

a. Enriched whole milk
b. Red meats, such as beef
c. Vegetables and whole grains
d. Liver and other glandular organ meats

9. A 2-gram sodium diet is prescribed for a client with severe hypertension. The client does not like the diet, and the nurse hears the client request that the spouse “Bring in some good home-cooked food.” It would be most effective for the nurse to plan to:

a. Call in the dietician for client teaching
b. Wait for the client’s family and discuss the diet with the client and family
c. Tell the client that the use of salt is forbidden, because it will raise BP
d. Catch the family members before they go into the client’s room and tell them about the diet.

10. What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply.

a. The RR intervals are relatively consistent
b. One P wave precedes each QRS complex
c. Four to eight complexes occur in a 6-second strip
d.  The ST segment is higher than the PR interval
e. The QRS complex ranges from 0.12 to 0.2 seconds

ANSWERS and RATIONALE – NCLEX Review for Valvular Disease and Diet

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