Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

What is the most likely diagnosis for a tall, thin female patient with fatigue and a normal sinus rhythm with an S2 "click"?

1. Atrial Fibrillation

2. Paroxysmal Atrial Tachycardia

3. Mitral Valve Prolapse

4. Congestive Heart Failure

The correct answer is: Mitral Valve Prolapse

The most likely diagnosis for a tall, thin female patient presenting with fatigue and a normal sinus rhythm accompanied by an S2 "click" is mitral valve prolapse. Mitral valve prolapse is a common condition, particularly among younger women, which may present with symptoms like fatigue due to the hemodynamic effects of the prolapsed valve. The characteristic "click" sound during auscultation occurs due to the sudden tensing of the mitral valve leaflets as they prolapse into the left atrium during systole. This is typically heard just before the second heart sound (S2), and the presence of this click strongly suggests mitral valve prolapse rather than other cardiac conditions. In the context of the patient's physical description, tall and thin individuals have been observed to have a higher incidence of mitral valve prolapse. This aligns with the demographic commonly affected by this condition. The other potential diagnoses do not correlate as well with the patient's presentation. Atrial fibrillation is characterized by an irregular rhythm, which is not demonstrated in this case. Paroxysmal atrial tachycardia would present with episodes of rapid heart rate and is not indicated by a normal sinus rhythm. Congestive heart failure would generally manifest with more