Chapter 13 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

Chapter 13 High Acuity Nursing 6th Edition by Kathleen Dorman Wagner

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

Which clinical manifestation would the nurse evaluate as most significant in a patient with mitral valve stenosis?

1. Edema of the lower extremities
2. A heart rate of 110 beats per minute
3. Altered deep tendon reflexes
4. Bounding peripheral pulse

Correct Answer: 2

Rationale 1: Development of edema is important but is not the most significant finding listed.

Rationale 2: If a patient with mitral valve stenosis experiences a sudden increase in heart rate, the diastolic filling time is shortened, which results in a substantial decrease in cardiac output. A heart rate of 110 beats per minute would be the most significant finding when assessing this patient.

Rationale 3: Alteration of deep tendon reflexes could indicate electrolyte imbalances, which is a serious development. However, a different complication is more significant.

Rationale 4: A bounding peripheral pulse indicates increased contractility, which should not be a problem for this patient.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-1

 

Question 2

Type: MCSA

When conducting a health history on a patient with aortic valve stenosis, which question would be most important for the nurse to ask?

1. “Do you have a family history of coronary artery disease?”
2. “Do any of your family members have valvular problems?”
3. “Have you ever been diagnosed with rheumatic fever?”
4. “Have you ever been diagnosed with high blood pressure?”

Correct Answer: 3

Rationale 1: Family history of coronary artery disease is not the most significant finding for this patient.

Rationale 2: History of valvular problems is significant, but not as significant as another finding.

Rationale 3: A primary etiology of aortic valve stenosis is rheumatic fever.

Rationale 4: History of high blood pressure is always significant, but is not the most significant finding for this patient.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-1

 

Question 3

Type: MCSA

A patient with history of mitral valve stenosis is placed on a cardiac monitor. Which arrhythmia would the nurse anticipate since it is a common rhythm for patients with this history?

1. Ventricular tachycardia
2. Third-degree heart block
3. Junctional rhythm
4. Atrial fibrillation

Correct Answer: 4

Rationale 1: Ventricular tachycardia is not associated with mitral valve stenosis.

Rationale 2: Third-degree heart block is not associated with mitral valve stenosis.

Rationale 3: Junctional rhythm is not associated with mitral valve stenosis.

Rationale 4: With mitral valve stenosis the left atrial pressure raises and leads to changes in the left atrial electrical refractory period, which may precipitate atrial fibrillation.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 13-1