A 55-year-old client who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The nurse encourages the client to be admitted because he knows that within the first 24 hours of a MI, there is a high risk for which of the following?

ventricular aneurysm

heart failure

pulmonary embolism

dysrhythmia

Answer and Explanation

The Correct Answer is D

A. Ventricular aneurysm. Ventricular aneurysms are a complication that typically develops weeks or months after an MI.

B. Heart failure. While heart failure is a risk following an MI, it is more of a concern in the longer term after the acute phase.

C. Pulmonary embolism. Pulmonary embolism is not a direct complication of MI and is less common in the immediate post-MI period.

D. Dysrhythmia: Within the first 24 hours following a myocardial infarction, dysrhythmias, particularly ventricular arrhythmias, are common and can be life-threatening. This is the highest risk during the early period after MI.

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Correct Answer is C

Explanation

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

A. Junctional tachycardia B. Sinus tachycardia C. Atrial flutter D. Ventricular fibrillation

Correct Answer is B

Explanation

A. Junctional tachycardia: Junctional tachycardia originates from the atrioventricular (AV) node, with a faster rate and usually no visible P waves preceding the QRS complexes.

B. Sinus tachycardia: Sinus tachycardia is characterized by a regular, rapid heart rhythm originating from the sinus node, typically seen after exercise, with identifiable P waves before each QRS complex.

C. Atrial flutter: Atrial flutter presents with a “sawtooth” pattern of P waves, indicating rapid atrial contractions, which is different from sinus tachycardia.

D. Ventricular fibrillation: Ventricular fibrillation is a chaotic and irregular rhythm originating from the ventricles, which is a life-threatening condition.

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A 55-year-old client who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The nurse encourages the client to be admitted because he knows that within the first 24 hours of a MI, there is a high risk for which of the following?

Nursing Test Bank

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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A 55-year-old client who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The nurse encourages the client to be admitted because he knows that within the first 24 hours of a MI, there is a high risk for which of the following?