Nokea
A 70 year female patient arrives to the emergency department, reporting nausea, vomiting, fatigue and abdominal discomfort. The health care provider requests myocardial infarction (MI) protocols to begin. For which reason is this protocol beginning?
- A. The provider is concerned a lawsuit could occur due to missed diagnosis.
- B. Women tend to have less classic symptoms of a myocardial infarction.
- C. Women are more likely to die from breast or cervical cancer than an MI.
- D. The troponin I level is not as accurate for females as it is in male patients.
Correct Answer: B
Rationale: Women experiencing an MI tend to experience symptoms that are unrelated to chest pain: nausea, vomiting, fatigue, indigestion, shortness of breath, and upper back or abdominal discomfort.
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Which patient teaching would help to prevent venous stasis?
- A. Dangle legs when sitting.
- B. Avoid crossing the legs at the knee.
- C. Elevate legs when lying in bed or sitting.
- D. Massage extremities to help maintain blood flow.
- E. Wear elastic stockings when ambulating.
Correct Answer: B,C,E
Rationale: Avoid prolonged sitting or standing. Avoid crossing the legs at the knee. Elevate legs when sitting. Wear elastic stockings when ambulatory. Do not massage extremities because of danger of embolization of clots (thrombus breaking off and becoming an embolus).
The process by which a heart is shocked from a persistent arrhythmia back into sinus rhythm is called a
Correct Answer: cardioversion
Rationale: Cardioversion is the restoration of the heart's normal sinus rhythm with the delivery of synchronized electric shock.
The cardiac marker rises 3 hours after a myocardial infarct and measures myocardial contractile protein.
Correct Answer: troponin I
Rationale: Troponin I is a serum cardiac marker that rises 3 hours after an MI and can measure myocardial contractile tissue. Troponin I is not affected by skeletal muscle injury as is troponin T.
The life support system that uses special techniques, ventilation equipment, and therapies for emergency situations is
Correct Answer: advanced cardiac life support (ACLS)
Rationale: ACLS is a life support system that uses special techniques, ventilation equipment, and therapies for emergency situations.
During a health interview by the home health nurse, which patient report suggests left-sided heart failure?
- A. I have to sleep in my recliner and I have this hacking cough.'
- B. I have no appetite and I have lost $3 \mathrm{lb}$ in the last week.'
- C. I have to urinate every 2 hours, even during the night.'
- D. I go barefoot most of the time because my feet are so hot.'
Correct Answer: A
Rationale: Left ventricular failure is often among the first of signs and symptoms of decreased cardiac output. The second is pulmonary congestion. Signs and symptoms of this condition include dyspnea, orthopnea, pulmonary crackles, hemoptysis, and cough.