Option A: An altered level of consciousness does not occur in clients with mitral regurgitation. Physical examination may reveal altered mental status, tachycardia (or bradycardia if there is ischemic involvement of the conduction system), hypotension, tachypnea, hypoxemia, and cyanosis. o Option C: Creatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle. High levels of CPK may be seen in people who have brain injury, convulsions, heart attack, myocarditis, and myopathy. o Option D: The client feels no chest pain, but may feel palpitations as a result of chronic atrial dilatation. They Correct Answer: B. Exertional Dyspnea Mitral regurgitation (MR) is defined as an abnormal reversal of blood flow from the left ventricle (LV) to the left atrium (LA). Weight gain due to retention of fluids and worsening heart failure causes exertional dyspnea in clients with mitral regurgitation. The patient will usually complain of significant dyspnea at rest, exacerbated in the supine position, as well as cough with clear or pink, frothy sputum. 1