A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for hypotension. The primary cause of hypotension is most likely:

decreased afterload due to vasodilation.

rapid heart rate.

decreased cardiac contractility, resulting in decreased cardiac output.

increased capillary permeability.

Answer and Explanation

The Correct Answer is C

Choice A reason:
Decreased afterload due to vasodilation is not the primary cause of hypotension in acute myocardial infarction. While vasodilation can lower blood pressure, in the context of MI, the more direct and significant cause of hypotension is the reduced cardiac contractility leading to decreased cardiac output. Vasodilation and afterload reduction are not the primary mechanisms in this scenario.

Choice B reason:
A rapid heart rate, or tachycardia, can contribute to hypotension by reducing the time for the heart to fill with blood between beats. However, in the context of an acute myocardial infarction, the primary issue is the heart's ability to contract effectively. Therefore, while a rapid heart rate might exacerbate the condition, it is not the main cause of hypotension.

Choice C reason:
Decreased cardiac contractility, resulting in decreased cardiac output, is the primary cause of hypotension in acute myocardial infarction. The damaged heart muscle cannot pump effectively, leading to reduced blood flow and low blood pressure. This is a direct consequence of the myocardial damage caused by the infarction, making this the correct answer.

Choice D reason:
Increased capillary permeability is not a primary cause of hypotension in acute myocardial infarction. This condition is more associated with inflammatory responses, sepsis, or allergic reactions. The main cause of hypotension in MI is related to the heart's reduced pumping ability.

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Correct Answer is A

Explanation

Choice A reason:
In patients with chronic renal failure, the kidneys cannot effectively excrete magnesium, leading to the risk of hypermagnesemia. Magnesium hydroxide, commonly used as an antacid and laxative, should be used with caution or avoided in these patients to prevent magnesium accumulation in the blood, which can have serious cardiovascular and neuromuscular effects.

Choice B reason:
While cirrhosis affects liver function and can alter drug metabolism, magnesium hydroxide does not have a direct contraindication for use in patients with cirrhosis. However, caution is necessary due to potential electrolyte imbalances and altered pharmacokinetics. The primary concern with magnesium hydroxide in these patients is less critical compared to those with renal failure.

Choice C reason:
Hemorrhoids do not directly contraindicate the use of magnesium hydroxide. This condition primarily affects the veins around the rectum and anus and is unrelated to the systemic effects of magnesium. Therefore, the presence of hemorrhoids does not necessitate withholding the medication.

Choice D reason:
Undiagnosed abdominal pain is a significant consideration before administering magnesium hydroxide. The use of laxatives can exacerbate conditions like intestinal obstruction or acute abdomen. Therefore, caution is advised, but the immediate and more critical concern remains the risk posed to patients with chronic renal failure.

A. Abdominal ultrasound and chest X-ray. B. Test of the acidity of the gastric contents and assessment of the throat. C. Electrocardiogram (EKG) and serum troponin levels. D. Abdominal X-ray and colonoscopy.

Correct Answer is C

Explanation

Choice A reason:
Abdominal ultrasound and chest X-ray are not the first-line tests for a patient presenting with these symptoms. While they can be useful in assessing certain conditions, the priority in this case is to rule out cardiac causes, especially given the symptoms that could indicate a cardiac event.

Choice B reason:
Testing the acidity of gastric contents and assessing the throat is not relevant for the initial evaluation of these symptoms. While gastrointestinal issues can present with similar symptoms, the first step should be to rule out more serious cardiac causes.

Choice C reason:
Electrocardiogram (EKG) and serum troponin levels are the correct answer. These tests are critical in assessing cardiac function and identifying potential myocardial infarction or other cardiac issues. Given the patient's symptoms, which can be indicative of a cardiac event, these tests are prioritized to rule out any immediate cardiac threats.

Choice D reason:
Abdominal X-ray and colonoscopy are not appropriate first-line tests in this scenario. While they may be necessary later to investigate gastrointestinal issues, the primary concern given the patient's symptoms is to rule out cardiac events with an EKG and serum troponin levels.

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A patient was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI) and is being treated for hypotension. The primary cause of hypotension is most likely:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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