Nokea
In cases of myocardial infarction leading to shock, which medication is appropriate to counteract shock?
- A. Atropine
- B. Dopamine
- C. Digoxin
- D. Adenosine
Correct Answer: B
Rationale: The correct answer is B: Dopamine. In myocardial infarction leading to shock, dopamine is appropriate due to its positive inotropic effects, increasing cardiac output and blood pressure. Atropine is not indicated for shock in this context. Digoxin may be contraindicated in acute myocardial infarction. Adenosine is not used in managing shock.
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Which fibers distribute the electrical impulse to the ventricles, causing them to contract?
- A. Purkinje fibers
- B. SA node
- C. AV node
- D. Bundle of His
Correct Answer: A
Rationale: The correct answer is A: Purkinje fibers. Purkinje fibers are specialized cardiac muscle fibers that distribute the electrical impulse from the AV node to the ventricles, causing them to contract. They are located in the ventricles and ensure synchronized and efficient contraction. The SA node (B) is the pacemaker of the heart, initiating the electrical impulse. The AV node (C) delays the impulse to allow for atrial contraction before ventricular contraction. The Bundle of His (D) is a pathway for the electrical impulse from the AV node to the bundle branches, which then lead to the Purkinje fibers for ventricular contraction.
The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?
- A. Notify the healthcare provider immediately.
- B. Continue the medication and monitor lung function.
- C. Discontinue the medication and start oxygen therapy.
- D. Reduce the dose and monitor respiratory status.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Pulmonary fibrosis is a serious side effect of amiodarone.
2. Immediate notification of the healthcare provider is necessary to address this potentially life-threatening complication.
3. The healthcare provider will need to evaluate the client's condition, consider alternative treatments, and adjust the care plan accordingly.
Summary of incorrect choices:
B. Continuing the medication without intervention can worsen the pulmonary fibrosis.
C. Discontinuing the medication is necessary, but oxygen therapy alone may not address the underlying issue.
D. Reducing the dose may not be sufficient to manage the pulmonary fibrosis and delaying provider notification can lead to further complications.
What is a condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries?
- A. Pulmonary hypertension
- B. Pulmonary fibrosis
- C. Pulmonary embolism
- D. Pulmonary edema
Correct Answer: A
Rationale: The correct answer is A: Pulmonary hypertension. Pulmonary hypertension refers to the condition where the walls of the arteries in the lungs become thickened and stiff, leading to increased blood pressure in the pulmonary arteries. This results in the heart having to work harder to pump blood through the lungs, causing potential damage to the heart and lungs over time.
B: Pulmonary fibrosis is a condition characterized by scarring of lung tissue, not thickening and stiffening of artery walls.
C: Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs, usually caused by a blood clot. It does not involve thickening and stiffening of artery walls.
D: Pulmonary edema is a condition where fluid builds up in the lungs, causing difficulty in breathing. It is not related to thickened and stiffened artery walls.
Which condition is characterized by fluid collection in the lungs, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleurisy
- C. Pleural effusion
- D. Pneumothorax
Correct Answer: A
Rationale: Pulmonary edema is the correct answer because it is characterized by fluid accumulation in the lungs, leading to difficulty in breathing. This condition is often a result of heart failure, where the heart is unable to pump blood effectively, causing fluid to leak into the lungs. It can also be caused by lung infections or exposure to toxins.
Pleurisy (B) is inflammation of the pleura, the lining around the lungs, leading to chest pain exacerbated by breathing. Pleural effusion (C) is fluid accumulation in the pleural space around the lungs, not within the lungs themselves. Pneumothorax (D) is characterized by air accumulation in the pleural space, causing lung collapse, but not fluid collection in the lungs.
What is a surgical procedure to redirect blood flow around a blocked or narrowed artery, often involving the use of a graft from another part of the body?
- A. Coronary artery bypass graft (CABG)
- B. Valve replacement
- C. Aneurysm repair
- D. Atherectomy
Correct Answer: A
Rationale: The correct answer is A: Coronary artery bypass graft (CABG). This procedure is used to redirect blood flow around a blocked or narrowed artery by creating a bypass using a graft from another part of the body. Step 1: The blocked or narrowed artery is identified through diagnostic tests. Step 2: A graft, often taken from the chest, leg, or arm, is used to create a new pathway for blood to flow around the blockage. Step 3: This helps improve blood flow to the heart muscle, relieving symptoms such as chest pain and reducing the risk of a heart attack. Summary: B (Valve replacement) involves replacing a damaged heart valve, C (Aneurysm repair) deals with treating a weakened area in a blood vessel, and D (Atherectomy) is a procedure to remove plaque from arteries, none of which match the description provided.