A client presents to the emergency department with an acute ST elevation myocardial infarction (STEMI) at 1500. The facility has 24-hour catheterization laboratory abilities. To improve client outcomes, by what time would the client have a percutaneous coronary intervention performed?
1630.
160.
1700.
1530
The Correct Answer is A
A. 1630: Current guidelines recommend that for a client presenting with an acute STEMI, a percutaneous coronary intervention (PCI) should be performed within 90 minutes of first medical contact, often referred to as the "door-to-balloon" time. If the client arrives at 1500, performing PCI by 1630 meets this benchmark, optimizing myocardial salvage and improving survival rates.
B. 1600: Performing PCI at 1600 would only allow a 1-hour window, which is faster than the 90-minute guideline, but 1630 aligns with the standard maximum timeframe for door-to-balloon time.
C. 1700: A PCI at 1700 would be 2 hours after arrival, exceeding the 90-minute guideline. Delays beyond this window increase myocardial tissue damage and risk of complications.
D. 1530: PCI at 1530 is not feasible because it interventions must occur after assessment, consent, and preparation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The rhythm strip shown in A exhibits a regular underlying rhythm interrupted by a Premature Ventricular Contraction (PVC), which is a wide, bizarre QRS complex occurring earlier than expected. While PVCs can cause palpitations, they do not typically present as a sustained "rapid, irregular" heart rate with a total absence of P-waves across the entire strip.
B. The rhythm strip in B represents Atrial Fibrillation (AFib), characterized by a "normally irregular" ventricular response and the replacement of distinct P-waves with chaotic fibrillatory waves. In AFib, the atria quiver rather than contract, leading to a significant pulse deficit because not every electrical impulse results in a ventricular contraction strong enough to produce a peripheral pulse.
Correct Answer is D
Explanation
A. Call the health care provider for a change in cardiac drugs: Notifying the provider is important for ongoing management, but the rhythm shown in the image is ventricular fibrillation (VF), which is immediately life-threatening. Delaying action to call the provider risks the client’s survival.
B. Place the client in a sitting position and administer oxygen: Positioning and oxygen may support a stable client with mild symptoms, but VF causes ineffective cardiac output, so interventions that only support oxygenation are insufficient. Immediate resuscitative measures are required.
C. Call the rapid response team to come and assess the client: While the rapid response team can assist, VF requires immediate intervention—delaying defibrillation and CPR while waiting for others significantly reduces survival chances.
D. Call a code and initiate cardiopulmonary resuscitation: Ventricular fibrillation is a pulseless, life-threatening arrhythmia that requires immediate activation of a code and initiation of CPR, followed by defibrillation. Early chest compressions and defibrillation are critical to restoring cardiac output and preventing sudden cardiac death.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.