Question 6071)
ECG change in myocardial infarction is:
A. ST segment elevation
B. Wide QRS complex
C. Presence of U wave
D. Prolonged PR interval
Answer: A
Explanation: ECG changes in myocardial infarction. In the first few hours the T waves become abnormally tall and the ST segments begin to rise. In the first 24 hours the T wave will become inverted, as the ST elevation begins to resolve. Pathological Q waves may appear within hours or may take greater than 24 hour.
Question 6072)
The nurse is administering a calcium channel blocker to the client diagnosed with a myocardial infarction. Which assessment data would cause the nurse to question administering this medication?
A. The client's apical pulse is 64
B. The client's calcium level is elevated
C. The client's telemetry shows occasional PVC's
D. The client's blood pressure is 90/62
Answer: D
Explanation: The client's blood pressure is low, and a calcium channel blocker could cause the blood pressure to bottom out.
Question 6073)
In acute myocardial infarction which enzyme is raised first?
A. CPK-MB
B. SGPT
C. SGOT
D. Troponin - T
Answer: A
Explanation: Myocardial muscle creatine kinase (CK-MB) is found mainly in the heart. -> CK-MB levels increase within 3-12 hours of onset of chest pain, reach peak values within 24 hours, and return to baseline after 48-72 hours. -> Sensitivity and specificity are not as high as for troponin levels.
Question 6074)
The enzyme level which is found elevated after myocardial infarction is :
A. Serum creatine
B. Alkaline phosphatase
C. Phosphokinase
D. Creatine kinase
Answer: D
Explanation: Myocardial muscle creatine kinase (CK-MB) is found mainly in the heart.CK-MB levels increase within 3- 12 hours of onset of chest pain, reach peak values within 24 hours, and return to baseline after 48-72 hours. Sensitivity and specificity are not as high as for troponin levels.
Question 6075)
The procedure that has to be performed in order to shift the high pressure from the right ventricle to the left ventricle in Transposition of the Great Arteries (TGA) is:
A. Rashkind Procedure
B. Rastelli Procedure
C. Pulmonary Artery Banding
D. Jatene Procedure
Answer: D
Explanation: The Jatene procedure,arterial switch operation or arterial switch, is an open-heart surgical procedure used to correct dextro-transposition of the great arteries (d-TGA).
Question 6076)
Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing a myocardial infarction?
A. Mid-epigastric pain and pyrosis
B. Diaphoresis and cool clammy skin
C. Intermittent claudication and pallor
D. Jugular vein distention and dependent edema
Answer: B
Explanation: Diaphoresis is a systemic reaction to the MI. The body vasoconstricts to shunt blood from the periphery to the trunk of the body this in turn leads to cold,clammy skin.
Question 6077)
The lack of oxygen supply to myocardium of heart leads to
A. Fibrillation
B. Heart failure
C. Angina
D. Infarction
Answer: C
Explanation: Angina pectoris is the medical term used to describe chest pains related to heart disease, particularly due to myocardial ischemia. The lack of adequate oxygen (ischemia) in the heart muscles (myocardium) due to a reduced blood supply brought about by disease produces symptoms of: -> Chest tightness, discomfort or heaviness. -> Squeezing, constricting or crushing pains behind the breastbone or sternum -> Prickling, stabbing or burning chest pain -> Choking sensation
Question 6078)
Blood pressure in the systemic circulation is highest in the:
A. Arterioles
B. Capillaries.
C. Aorta
D. Venules
Answer: C
Explanation: Blood pressure is the highest in the aorta as the blood is being ejected out of the left ventricle into the aorta. The pressure declines as the blood flows through the arteries, capillaries, arterioles, veins, capillaries and venules. The force of the contraction of the heart and resistance of vessels influence flow, however it is the pressure differences that control blood flow.
Question 6079)
Which of the following classes of medication maximizes cardiac performance in client with heart failure by increasing ventricular contractility?
A. Beta-adrenergic blockers
B. Diuretics
C. Calcium channel blockers
D. Inotropic agents
Answer: D
Explanation: Inotropic agents, drugs that increase the force of contraction of cardiac muscle.(for example, digitalis glycosides, amrinone, and epinephrine)
Question 6080)
The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs hurt when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:
A. Decreased blood flow
B. Increased blood flow
C. Slow blood flow.
D. Thrombus formation.
Answer: A
Explanation: Decreased blood flow is a common characteristic of all PVD. When the demand for oxygen to the working muscles becomes greater than the supply, pain is the outcome. Slow blood flow throughout the circulatory system may suggest pump failure. Thrombus formation can result from stasis or damage to the intima of the vessels.
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