Nokea
In the patient with chest pain, which results can differentiate unstable angina from an MI?
- A. ECG changes present at the onset of the pain
- B. A chest x-ray indicating left ventricular hypertrophy
- C. Appearance of troponin in the blood 48 hours after the infarct
- D. Creatine kinase (CK)-MB enzyme elevations that peak 18 hours after the infarct
Correct Answer: A
Rationale: ECG changes distinguish unstable angina from MI.
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What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleural effusion
- C. Pulmonary hypertension
- D. Pneumothorax
Correct Answer: A
Rationale: Step-by-step rationale:
1. Pulmonary edema is the condition where lungs fill with fluid due to heart failure, causing breathing difficulty.
2. Pleural effusion is fluid accumulation in the pleural space, not in the lung tissue.
3. Pulmonary hypertension is high blood pressure in the pulmonary arteries, not related to fluid accumulation.
4. Pneumothorax is the presence of air in the pleural space, not fluid.
Summary:
Pulmonary edema is the correct answer as it specifically describes the condition of fluid accumulation in the lungs due to heart failure, leading to breathing difficulties. Pleural effusion, pulmonary hypertension, and pneumothorax are incorrect as they involve different pathologies not related to lung fluid accumulation.
What is the condition where the blood vessels that supply blood to the legs and feet become narrowed or blocked, causing pain and difficulty walking?
- A. Peripheral artery disease
- B. Raynaud's disease
- C. Varicose veins
- D. Pulmonary embolism
Correct Answer: A
Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is characterized by narrowed or blocked blood vessels in the legs, leading to reduced blood flow, causing pain and difficulty walking (claudication). The narrowing is typically due to atherosclerosis. Raynaud's disease (B) involves spasms of small arteries, causing reduced blood flow to fingers and toes, not legs. Varicose veins (C) are enlarged, twisted veins, not arteries. Pulmonary embolism (D) is a blockage in the lungs' arteries, not the legs.
What is a condition where the heart's ability to pump blood is reduced because the heart muscle is enlarged, thickened, or stiffened?
- A. Cardiomyopathy
- B. Endocarditis
- C. Myocarditis
- D. Aortic stenosis
Correct Answer: A
Rationale: The correct answer is A: Cardiomyopathy. Cardiomyopathy refers to a condition where the heart muscle is enlarged, thickened, or stiffened, leading to a reduced ability to pump blood effectively. This condition directly relates to the heart's structural changes, impacting its pumping function. Endocarditis (B) is an infection of the heart's inner lining, not directly related to heart muscle changes. Myocarditis (C) is inflammation of the heart muscle but does not necessarily involve structural changes leading to reduced pumping ability. Aortic stenosis (D) is a condition where the heart's aortic valve is narrowed, impeding blood flow, but it does not specifically refer to the heart muscle changes seen in cardiomyopathy.
You are working in the ED caring for a patient who was just admitted with left anterior chest pain, possible unstable angina or myocardial infarction. Which nursing activity will you accomplish first?
- A. Auscultate heart sounds.
- B. Administer sublingual nitroglycerin.
- C. Insert an IV catheter.
- D. Obtain a brief patient health history.
Correct Answer: B
Rationale: Relieving chest pain is a priority to reduce myocardial oxygen demand and prevent further damage.
What is a condition where the heart muscle becomes abnormally enlarged, thickened, or stiffened, often leading to heart failure?
- A. Cardiomyopathy
- B. Pericarditis
- C. Aortic stenosis
- D. Mitral valve prolapse
Correct Answer: A
Rationale: The correct answer is A: Cardiomyopathy. Cardiomyopathy is a condition characterized by abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. This condition directly affects the heart muscle itself, causing it to function improperly. Pericarditis (B) is inflammation of the pericardium, the outer lining of the heart, not the heart muscle. Aortic stenosis (C) and Mitral valve prolapse (D) involve issues with heart valves, not the heart muscle itself. Therefore, A is the correct choice as it directly addresses the abnormal changes in the heart muscle leading to heart failure.