NR 601 Week 3: Valvular Disorders – 80 Multiple-
Choice Questions with Rationales- Chamberlain
AORTIC STENOSIS (~15 questions)
1. Which murmur is characteristic of aortic stenosis?
A. Holosystolic murmur at the apex radiating to the axilla
B. Crescendo-decrescendo systolic murmur at the right upper sternal border radiating
to the carotids
C. Diastolic decrescendo murmur at the left sternal border
D. Low-pitched diastolic rumble with opening snap at the apex
Answer: B
Rationale: Aortic stenosis produces a crescendo-decrescendo (diamond-shaped)
systolic murmur heard best at the right upper sternal border with radiation to the
carotids.
2. Which symptom is a classic triad presentation of severe aortic stenosis?
A. Dyspnea, fatigue, and palpitations
B. Exertional dyspnea, syncope, and angina
C. Orthopnea, paroxysmal nocturnal dyspnea, and edema
D. Chest pain, cough, and hemoptysis
Answer: B
Rationale: The classic triad of severe aortic stenosis is exertional dyspnea, syncope,
and angina. These indicate significant obstruction and increased myocardial oxygen
demand.
3. Which is the most common cause of aortic stenosis in older adults?
A. Rheumatic heart disease
B. Congenital bicuspid aortic valve
C. Age-related calcification
D. Infective endocarditis
Answer: C
Rationale: Age-related calcific degeneration is the most common cause of aortic
stenosis in adults over 65. Bicuspid valve is more common in younger patients.
,4. A client with aortic stenosis has a weak and delayed carotid pulse. This is known
as:
A. Pulsus paradoxus
B. Pulsus alternans
C. Pulsus parvus et tardus
D. Pulsus bisferiens
Answer: C
Rationale: Pulsus parvus et tardus (weak and delayed) is characteristic of severe aortic
stenosis due to reduced stroke volume and prolonged ejection.
5. Which diagnostic test confirms the diagnosis and severity of aortic stenosis?
A. Chest X-ray
B. Electrocardiogram
C. Echocardiogram
D. Cardiac MRI
Answer: C
Rationale: Echocardiography is the gold standard for diagnosing aortic stenosis,
assessing valve area, pressure gradients, and left ventricular function.
6. Which ECG finding is most commonly associated with severe aortic stenosis?
A. Left atrial enlargement
B. Left ventricular hypertrophy
C. Right bundle branch block
D. Atrial fibrillation
Answer: B
Rationale: Chronic pressure overload from aortic stenosis leads to left ventricular
hypertrophy, seen as increased QRS voltage on ECG.
7. Which medication is used cautiously in aortic stenosis to manage pulmonary
congestion?
A. Beta-blockers
B. Diuretics
C. ACE inhibitors
D. Digoxin
Answer: B
Rationale: Diuretics reduce pulmonary congestion but must be used cautiously to
, avoid reducing preload, which is critical for maintaining cardiac output in aortic
stenosis.
8. A client with severe aortic stenosis is scheduled for valve replacement. Which
finding indicates the need for surgery?
A. Mild stenosis on echocardiogram
B. Asymptomatic with normal exercise tolerance
C. Symptoms of chest pain, shortness of breath, or syncope
D. Ejection fraction of 60%
Answer: C
Rationale: Valve replacement is indicated for severe aortic stenosis with symptoms
(angina, dyspnea, syncope) or evidence of significant heart damage.
9. Which chest X-ray finding is consistent with aortic stenosis?
A. Left atrial enlargement
B. Pulmonary congestion
C. Post-stenotic aortic dilation
D. Kerley B lines
Answer: C
Rationale: Post-stenotic dilation of the ascending aorta is often seen on chest X-ray
due to turbulent flow through the narrowed valve.
10. Which condition is a common cause of aortic stenosis in younger individuals?
A. Rheumatic heart disease
B. Congenital bicuspid aortic valve
C. Hypertension
D. Hyperlipidemia
Answer: B
Rationale: A congenital bicuspid aortic valve is a common cause of aortic stenosis in
patients under 65, often becoming symptomatic earlier.
11. A client with aortic stenosis reports dizziness and fainting during exercise. The
nurse understands this is due to:
A. Decreased cerebral perfusion from fixed cardiac output
B. Increased heart rate causing hypertension
Choice Questions with Rationales- Chamberlain
AORTIC STENOSIS (~15 questions)
1. Which murmur is characteristic of aortic stenosis?
A. Holosystolic murmur at the apex radiating to the axilla
B. Crescendo-decrescendo systolic murmur at the right upper sternal border radiating
to the carotids
C. Diastolic decrescendo murmur at the left sternal border
D. Low-pitched diastolic rumble with opening snap at the apex
Answer: B
Rationale: Aortic stenosis produces a crescendo-decrescendo (diamond-shaped)
systolic murmur heard best at the right upper sternal border with radiation to the
carotids.
2. Which symptom is a classic triad presentation of severe aortic stenosis?
A. Dyspnea, fatigue, and palpitations
B. Exertional dyspnea, syncope, and angina
C. Orthopnea, paroxysmal nocturnal dyspnea, and edema
D. Chest pain, cough, and hemoptysis
Answer: B
Rationale: The classic triad of severe aortic stenosis is exertional dyspnea, syncope,
and angina. These indicate significant obstruction and increased myocardial oxygen
demand.
3. Which is the most common cause of aortic stenosis in older adults?
A. Rheumatic heart disease
B. Congenital bicuspid aortic valve
C. Age-related calcification
D. Infective endocarditis
Answer: C
Rationale: Age-related calcific degeneration is the most common cause of aortic
stenosis in adults over 65. Bicuspid valve is more common in younger patients.
,4. A client with aortic stenosis has a weak and delayed carotid pulse. This is known
as:
A. Pulsus paradoxus
B. Pulsus alternans
C. Pulsus parvus et tardus
D. Pulsus bisferiens
Answer: C
Rationale: Pulsus parvus et tardus (weak and delayed) is characteristic of severe aortic
stenosis due to reduced stroke volume and prolonged ejection.
5. Which diagnostic test confirms the diagnosis and severity of aortic stenosis?
A. Chest X-ray
B. Electrocardiogram
C. Echocardiogram
D. Cardiac MRI
Answer: C
Rationale: Echocardiography is the gold standard for diagnosing aortic stenosis,
assessing valve area, pressure gradients, and left ventricular function.
6. Which ECG finding is most commonly associated with severe aortic stenosis?
A. Left atrial enlargement
B. Left ventricular hypertrophy
C. Right bundle branch block
D. Atrial fibrillation
Answer: B
Rationale: Chronic pressure overload from aortic stenosis leads to left ventricular
hypertrophy, seen as increased QRS voltage on ECG.
7. Which medication is used cautiously in aortic stenosis to manage pulmonary
congestion?
A. Beta-blockers
B. Diuretics
C. ACE inhibitors
D. Digoxin
Answer: B
Rationale: Diuretics reduce pulmonary congestion but must be used cautiously to
, avoid reducing preload, which is critical for maintaining cardiac output in aortic
stenosis.
8. A client with severe aortic stenosis is scheduled for valve replacement. Which
finding indicates the need for surgery?
A. Mild stenosis on echocardiogram
B. Asymptomatic with normal exercise tolerance
C. Symptoms of chest pain, shortness of breath, or syncope
D. Ejection fraction of 60%
Answer: C
Rationale: Valve replacement is indicated for severe aortic stenosis with symptoms
(angina, dyspnea, syncope) or evidence of significant heart damage.
9. Which chest X-ray finding is consistent with aortic stenosis?
A. Left atrial enlargement
B. Pulmonary congestion
C. Post-stenotic aortic dilation
D. Kerley B lines
Answer: C
Rationale: Post-stenotic dilation of the ascending aorta is often seen on chest X-ray
due to turbulent flow through the narrowed valve.
10. Which condition is a common cause of aortic stenosis in younger individuals?
A. Rheumatic heart disease
B. Congenital bicuspid aortic valve
C. Hypertension
D. Hyperlipidemia
Answer: B
Rationale: A congenital bicuspid aortic valve is a common cause of aortic stenosis in
patients under 65, often becoming symptomatic earlier.
11. A client with aortic stenosis reports dizziness and fainting during exercise. The
nurse understands this is due to:
A. Decreased cerebral perfusion from fixed cardiac output
B. Increased heart rate causing hypertension
