Nokea
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.
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What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?
- A. Preload
- B. Afterload
- C. Contractility
- D. Ejection fraction
Correct Answer: A
Rationale: Rationale:
1. Preload refers to myocardial fiber stretch before contraction.
2. It is related to the volume of blood in ventricles at end of diastole.
3. Preload is determined by the amount of venous return to the heart.
4. It influences the force of contraction and stroke volume.
5. Afterload (B) is the resistance the heart must overcome to pump blood.
6. Contractility (C) is the intrinsic strength of the heart muscle.
7. Ejection fraction (D) is the percentage of blood ejected from ventricles.
Summary:
- Preload is correct as it specifically relates to fiber stretch and volume of blood.
- Afterload, contractility, and ejection fraction do not directly relate to ventricular volume and venous return.
What is a condition where the alveoli are gradually destroyed, leading to shortness of breath and reduced oxygen exchange?
- A. Emphysema
- B. Pulmonary fibrosis
- C. Pulmonary edema
- D. Lung cancer
Correct Answer: A
Rationale: Emphysema is the correct answer. Alveoli destruction in emphysema leads to shortness of breath and reduced oxygen exchange. This condition is primarily caused by smoking and results in irreversible damage to the air sacs in the lungs. Pulmonary fibrosis involves scarring of lung tissue, not alveoli destruction. Pulmonary edema is fluid accumulation in the lungs, disrupting oxygen exchange. Lung cancer is the uncontrolled growth of abnormal cells in the lung, which may not directly lead to alveoli destruction.
Which medication is used to lower high blood pressure and reduce the risk of heart attacks and strokes?
- A. ACE inhibitor
- B. Beta-blocker
- C. Diuretic
- D. Calcium channel blocker
Correct Answer: A
Rationale: The correct answer is A: ACE inhibitor. ACE inhibitors work by dilating blood vessels to lower blood pressure and reduce the risk of heart attacks and strokes. They also help protect the heart and improve its function. Beta-blockers (B) lower heart rate, diuretics (C) reduce fluid retention, and calcium channel blockers (D) relax blood vessels, but they do not offer the same comprehensive benefits for high blood pressure and cardiovascular health as ACE inhibitors.
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
What is the condition where the heart's mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle?
- A. Mitral stenosis
- B. Aortic stenosis
- C. Tricuspid regurgitation
- D. Pulmonary hypertension
Correct Answer: A
Rationale: The correct answer is A: Mitral stenosis. Mitral stenosis refers to the narrowing of the mitral valve, which obstructs blood flow from the left atrium to the left ventricle. This condition leads to increased pressure in the left atrium and lungs, causing symptoms like shortness of breath and fatigue.
Explanation:
1. Mitral stenosis specifically involves the mitral valve, not the aortic valve (B) or the tricuspid valve (C).
2. Tricuspid regurgitation (C) involves leakage of blood backward through the tricuspid valve, not narrowing.
3. Pulmonary hypertension (D) is a condition characterized by high blood pressure in the arteries of the lungs due to various causes, not specifically related to mitral valve narrowing.