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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.
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What is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing an acute myocardial infarction (MI)?
- A. History of heart disease.
- B. Sensitivity to aspirin.
- C. Size and location of the MI.
- D. Time since onset of symptoms.
Correct Answer: D
Rationale: Thrombolytic therapy is most effective when administered within a few hours of symptom onset.
The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?
- A. Take one tablet every 5 minutes, up to three tablets.
- B. Take one tablet every hour until the pain subsides.
- C. Take two tablets immediately if chest pain occurs.
- D. Take one tablet with a full glass of water.
Correct Answer: A
Rationale: The correct answer is A. Sublingual nitroglycerin is taken under the tongue to quickly relieve chest pain. The nurse should instruct the client to take one tablet every 5 minutes during an episode of chest pain, up to a maximum of three tablets. This is because nitroglycerin works rapidly to dilate blood vessels and improve blood flow to the heart, helping to relieve angina symptoms. Taking one tablet every hour or two tablets immediately may not provide adequate relief and could lead to an overdose. Taking the tablet with water is unnecessary as the medication is absorbed through the mucous membranes under the tongue.
The nurse is giving digoxin to a client. What is the most important parameter to check before administration?
- A. Heart rate
- B. Blood pressure
- C. Respiratory rate
- D. Oxygen saturation
Correct Answer: A
Rationale: Step 1: Digoxin is primarily used to treat heart conditions.
Step 2: Heart rate is crucial as digoxin can affect the heart rhythm.
Step 3: Monitoring heart rate ensures safety and effectiveness of digoxin.
Step 4: Blood pressure, respiratory rate, and oxygen saturation are important but not as directly impacted by digoxin.
During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?
- A. Coronary perfusion pressure
- B. Coronary vascular resistance
- C. Diastolic filling
- D. Ventricular ejection
Correct Answer: A
Rationale: The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure is the pressure gradient that drives blood flow through the coronary arteries into the myocardium during diastole when the coronary vascular resistance is reduced. This pressure gradient is essential for delivering oxygen and nutrients to the heart muscle when it is relaxed and filling with blood. During diastole, the coronary arteries receive blood flow predominantly due to the pressure difference between the aortic diastolic pressure and the pressure in the coronary vasculature.
Summary of why the other choices are incorrect:
B: Coronary vascular resistance - This factor is reduced during diastole, allowing for increased blood flow, but it does not directly drive blood flow to the myocardium.
C: Diastolic filling - This refers to the filling of blood into the ventricles of the heart, not specifically the flow of blood through the coronary arteries.
D: Ventricular ejection - This occurs during systole when the ventricles contract
Which condition is characterized by the lungs becoming scarred and stiff, leading to difficulty breathing and inadequate oxygen intake into the bloodstream?
- A. Pulmonary fibrosis
- B. Cystic fibrosis
- C. COPD
- D. Tuberculosis
Correct Answer: A
Rationale: Pulmonary fibrosis is characterized by scarring and stiffening of the lungs, impairing their ability to expand and contract properly for breathing. This leads to difficulty breathing and inadequate oxygen intake into the bloodstream. In contrast, cystic fibrosis primarily affects the respiratory and digestive systems, COPD is a progressive lung disease primarily caused by smoking, and tuberculosis is a bacterial infection that primarily affects the lungs. Therefore, the correct answer is A because it specifically describes the scarring and stiffness of the lungs resulting in breathing difficulties and inadequate oxygen intake.