Nokea
To assess whether Mr. Young's synchronous pacemaker is working properly, which statement do you need to remember about a synchronous pacemaker?
- A. His pacemaker will fire regardless of Mr. Young's own spontaneous heart rate
- B. His pacemaker will fire only when his own heart rate drops below 72 beats per minute
- C. If his pacemaker does not fire 72 times every minute, it is not working properly
- D. This type of pacemaker can precipitate ventricular fibrillation because of its increased chance of firing on the T wave
Correct Answer: B
Rationale: Demand pacemakers fire only when needed.
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What condition is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues?
- A. Peripheral artery disease
- B. Atherosclerosis
- C. Raynaud's disease
- D. Varicose veins
Correct Answer: A
Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues due to reduced blood flow. Atherosclerosis refers to the buildup of plaque in arteries but doesn't specify limbs. Raynaud's disease is a condition affecting blood supply to extremities due to cold or stress, not arterial blockages. Varicose veins involve enlarged, twisted veins, not arterial blockages. Therefore, the correct choice is A as it specifically addresses the narrowed or blocked arteries in limbs causing pain and mobility issues.
Which measure would be most useful in evaluating a client's compensation in chronic congestive heart failure?
- A. Weekly digoxin blood level assessment
- B. Daily weight assessment
- C. Hourly urinary output
- D. Monthly activity level assessment
Correct Answer: B
Rationale: Daily weight reflects fluid status.
What is a condition where the right side of the heart fails due to increased pressure in the pulmonary arteries, often caused by chronic lung disease?
- A. Cor pulmonale
- B. Heart failure
- C. Pulmonary embolism
- D. Myocarditis
Correct Answer: A
Rationale: The correct answer is A: Cor pulmonale. Cor pulmonale is right-sided heart failure due to increased pressure in the pulmonary arteries, typically caused by chronic lung disease. This leads to the right side of the heart working harder to pump blood through the lungs, resulting in eventual failure. Pulmonary embolism (C) is a sudden blockage in the pulmonary artery, not a chronic condition. Heart failure (B) is a general term for when the heart is unable to pump blood effectively, not specific to the right side. Myocarditis (D) is inflammation of the heart muscle, not directly related to pulmonary hypertension.
What is the ability of cardiac cells to respond to an impulse by contracting?
- A. Excitability
- B. Contractility
- C. Rhythmicity
- D. Conductivity
Correct Answer: A
Rationale: The correct answer is A: Excitability. Excitability refers to the ability of cardiac cells to respond to an impulse by generating an action potential and contracting. This is the fundamental property that allows the heart to beat. Contractility (B) is the ability of cardiac muscle to contract once stimulated, but it does not specifically refer to the response to an impulse. Rhythmicity (C) is the ability of cardiac cells to generate spontaneous electrical impulses, not directly related to responding to an impulse. Conductivity (D) is the ability of cardiac cells to transmit electrical impulses, not specifically related to the response of cells contracting.
The echocardiogram indicates a large thrombus in the left atrium of a patient admitted with heart failure. During the night, the patient complains of severe, sudden onset left foot pain. You note that no pulse is palpable in the left foot and that it is cold and pale. Which action should you take next?
- A. Lower the patient's left foot below heart level.
- B. Administer oxygen at 4 L/minute to the patient.
- C. Notify the patient's physician about the assessment data.
- D. Check the patient's vital signs and oximetry.
Correct Answer: C
Rationale: This likely indicates embolic occlusion, requiring immediate physician intervention.