The 85 year old patient with a newly diagnosed heart

4.
The 85-year-old patient with a newly diagnosed heart murmur expresses concern that he has
never been notified of this finding before. What is the most likely cause of this patient’s heart
murmur?
a. Hypertension
b. Atherosclerosis
c. Insufficient valves
d. Weakened pacemaker
ANS: C
Systolic murmurs commonly appear in people over the age of 80. These murmurs are usually
related to valvular dysfunction caused by thickening of the valves, especially the mitral and
aortic valves.
MEDICAL SURGICAL NURSING CONCEPTS AND PRACTICE 3RD EDITION DEWIT TEST BANK
PTS: 1 DIF: Cognitive Level: Application REF: 372
OBJ: 2 (theory) TOP: Murmur in the Older Adult
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5.
The nurse is caring for an older adult patient. While auscultating the patient’s apical pulse, the
nurse notices an irregular rhythm. The nurse suspects which causative factor for the patient’s
dysrhythmia?
PTS: 1 DIF: Cognitive Level: Application REF: 372
OBJ: 2 (clinical) TOP: Dysrhythmia in the Older Adult
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6.
The nurse is assessing a female patient with a family history of coronary artery disease
(CAD). Which report is most concerning to the nurse?

NURSINGTB.COM
d. “I notice wheezing after I dust or when I exercise.”
ANS: B
In addition to displaying a positive family history for CAD, report of fatigue and shoulder and
back discomfort are most concerning to the nurse. Chest pain is often atypical in women and
may manifest as pain in the shoulders, back, or abdomen. Mild shortness of breath after
climbing three flights of stairs is consistent with exertion. Awakening frequently in the night
and snoring are suspicious for obstructive sleep apnea. Wheezing in the presence of dust or
with exercise are findings consistent with potential asthma.
PTS: 1 DIF: Cognitive Level: Analysis REF: 374
OBJ: 9 TOP: Chest Pain in Women
KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance