Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which of the following is considered the classic finding in a patient with mitral valve prolapse (MVP)?

1. Cholesterol over 300 mg/dL

2. S2 click followed by a diastolic murmur

3. S2 click followed by a systolic murmur

4. Increased white blood cell count

The correct answer is: S2 click followed by a systolic murmur

The classic finding in mitral valve prolapse (MVP) is the presence of a mid-systolic click, often followed by a systolic murmur, which is typically due to the regurgitation of blood through the improperly closing mitral valve. This event occurs when the ballooning of the mitral valve leaflets during systole allows a brief moment where blood flows back into the left atrium, producing the characteristic sounds. The mid-systolic click is a result of the sudden tension in the chordae tendineae and papillary muscles as the valve leaflets are pulled back into the left atrium. The associated murmur that follows may be due to the volume overload of the left atrium, leading to mitral regurgitation if the prolapse is significant enough. In the context of the other options, they do not pertain directly to the classic auscultatory findings associated with MVP. Elevated cholesterol levels are not specifically associated with MVP and pertain more to cardiovascular risk factors. An increased white blood cell count typically indicates infection or inflammation but is not relevant in the diagnosis of MVP. The S2 click followed by a diastolic murmur does not align with MVP’s characteristic sounds, as S2 marks