Nokea
At what point in the healing process of the myocardium following an infarct does early scar tissue result in an unstable heart wall?
- A. 2 to 3 days after MI
- B. 4 to 10 days after MI
- C. 10 to 14 days after MI
- D. 6 weeks after MI
Correct Answer: B
Rationale: Scar tissue forms 4 to 10 days post-MI.
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The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse's priority action?
- A. Administer a potassium supplement.
- B. Hold the furosemide and notify the healthcare provider.
- C. Continue the current dose of furosemide.
- D. Administer Digibind.
Correct Answer: A
Rationale: The correct answer is A because a potassium level of 3.1 mEq/L indicates hypokalemia, a common side effect of furosemide. Administering a potassium supplement is essential to prevent complications like cardiac dysrhythmias. Choice B is incorrect because holding furosemide can worsen the client's condition. Choice C is incorrect as continuing the current dose can further lower potassium levels. Choice D is incorrect as Digibind is used to treat digoxin toxicity, not hypokalemia. Administering a potassium supplement addresses the underlying issue.
The most life-threatening cardiac arrhythmia following myocardial infarction is
- A. ventricular fibrillation
- B. premature ventricular contractions
- C. premature atrial contractions
- D. atrial fibrillation
Correct Answer: A
Rationale: Ventricular fibrillation disrupts cardiac function and requires immediate intervention.
If Dr. Baker complains of loss of appetite and nausea after starting chlorothiazide, it would be important to
- A. check her digitalis and potassium levels
- B. obtain a urine specimen
- C. get an electrocardiogram immediately
- D. reassure her that since her blood pressure is normal these symptoms are to be expected
Correct Answer: A
Rationale: Chlorothiazide can affect electrolyte balance, requiring monitoring.
Which term conceptualizes that the greater the myocardial fiber stretch, within physiologic limits, the more forceful the ventricular contraction, thereby increasing stroke volume?
- A. Frank-Starling's Law
- B. Automaticity
- C. Contractility
- D. Excitability
Correct Answer: A
Rationale: The correct answer is A: Frank-Starling's Law. This law states that within physiologic limits, the greater the myocardial fiber stretch, the more forceful the ventricular contraction, leading to increased stroke volume. This is because increased fiber stretch results in optimal overlap of actin and myosin filaments in the sarcomeres, enhancing contractile force.
Summary:
B: Automaticity refers to the ability of cardiac cells to spontaneously generate electrical impulses.
C: Contractility is the intrinsic ability of cardiac muscle to generate force.
D: Excitability refers to the ability of cardiac cells to respond to electrical stimuli.
Mr. Ross experiences nausea and vomiting as the result of receiving large-volume irradiation to his thoracic region. Which is the best approach in planning to meet his nutritional needs?
- A. Plan for frequent small meals of palatable foods
- B. Offer Mr. Ross three balanced meals a day
- C. Determine Mr. Ross' caloric needs
- D. Ask the physician to prescribe an oral antiemetic for p.r.n. use
Correct Answer: A
Rationale: Frequent small meals can help manage nausea and improve intake compared to large meals.