A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because
the cells of the myocardium become hypertrophic.
the resulting hypoxia leads to ischemic injury and myocardial cell death.
there is a temporary alteration in electrolyte balance that can be corrected.
there is too much pressure on the heart and the ventricles begin to dysfunction.
The Correct Answer is B
Choice A reason: The cells of the myocardium become hypertrophic in response to increased workload or pressure, not as a result of myocardial infarction. Hypertrophy is an adaptive mechanism that can lead to impaired ventricular function over time.
Choice B reason: The resulting hypoxia leads to ischemic injury and myocardial cell death. This is the main cause of impaired ventricular function after a myocardial infarction. The loss of viable myocardial tissue reduces the contractility and pumping ability of the heart.
Choice C reason: There is a temporary alteration in electrolyte balance that can be corrected. This is not the primary cause of impaired ventricular function after a myocardial infarction. Electrolyte imbalance can occur due to fluid loss, renal impairment, or medication side effects, but it can be managed with appropriate interventions.
Choice D reason: There is too much pressure on the heart and the ventricles begin to dysfunction. This is not the direct cause of impaired ventricular function after a myocardial infarction. Increased pressure on the heart can result from hypertension, valvular disease, or pulmonary embolism, but it is not related to myocardial ischemia or necrosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Cardiac output has not fallen below normal levels. Cardiac output is the amount of blood pumped by the heart per minute. It is affected by the heart rate and the stroke volume. Angina pectoris does not directly affect the cardiac output, but it can reduce the stroke volume due to impaired ventricular filling.
Choice B reason: The vagus nerve is not stimulated. The vagus nerve is a cranial nerve that innervates the heart and other organs. It is part of the parasympathetic nervous system, which slows down the heart rate and lowers the blood pressure. Angina pectoris does not activate the vagus nerve, but it can trigger the sympathetic nervous system, which increases the heart rate and blood pressure.
Choice C reason: Myocardial stretch has not exceeded the upper limits. Myocardial stretch is the degree of tension or load on the cardiac muscle fibers. It is determined by the end-diastolic volume, which is the amount of blood in the ventricle at the end of relaxation. Angina pectoris does not cause excessive myocardial stretch, but it can impair the myocardial contractility due to ischemia.
Choice D reason: The myocardial oxygen supply has fallen below demand. This is the main cause of angina pectoris. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, are narrowed or blocked by atherosclerosis or spasm. This creates an imbalance between the oxygen demand of the heart, which increases during exertion, and the oxygen supply, which is reduced by the obstruction.
Correct Answer is D
Explanation
Choice A reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Hyperglycemia is a high level of glucose in the blood, which can be caused by diabetes or other conditions. Nonselective beta-adrenergic blockers do not affect blood glucose levels directly, but they may mask the signs of hypoglycemia (low blood glucose) in diabetic patients.
Choice B reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Dizziness is a common side effect of many medications, especially those that lower blood pressure. Nonselective beta-adrenergic blockers can cause dizziness by reducing the heart rate and cardiac output, but this is usually mild and transient.
Choice C reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Peripheral edema is swelling of the ankles, feet, or legs, which can be caused by heart failure, kidney disease, or venous insufficiency. Nonselective beta-adrenergic blockers do not cause peripheral edema, but they may worsen it in patients with heart failure.
Choice D reason: This is a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Wheezing is a high-pitched sound that occurs when breathing is obstructed, usually due to asthma or chronic obstructive pulmonary disease (COPD). Nonselective beta-adrenergic blockers can aggravate or cause wheezing by blocking the beta-2 receptors in the lungs, which normally cause bronchodilation (widening of the airways). Therefore, nonselective beta-adrenergic blockers are contraindicated in patients with asthma or COPD.
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