A patient with cerebral ischemia has signs and symptoms of right homonymous hemianopia and inability to move the right arm.

This is indicative of increased intracranial pressure that is most probably due to a lesion in the:

Choice A rationale
Cerebral ischemia due to an embolus that originates in the left atrium is a common complication of chronic atrial fibrillation (AFib). AFib causes irregular and chaotic electrical signals in the atria, leading to poor blood flow and the formation of blood clots. These clots can travel to the brain, causing a stroke. This is the most acute and severe event associated with chronic AFib.
Choice B rationale
Development of ventricular fibrillation is a life-threatening arrhythmia that can occur in patients with severe heart disease, but it is not a common acute event in chronic AFib.
Ventricular fibrillation involves the ventricles and is characterized by rapid, erratic electrical impulses, leading to ineffective heart contractions and sudden cardiac arrest.
Choice C rationale
Ischemia of the cerebellum due to a ruptured intracranial aneurysm is not directly related to chronic AFib. While AFib increases the risk of stroke, it does not specifically cause aneurysms or cerebellar ischemia. Aneurysms are typically related to other risk factors such as hypertension and vascular abnormalities.
Choice D rationale
Prolonged capillary refill secondary to a complete lack of cardiac output is a sign of severe cardiac dysfunction or shock. While AFib can lead to heart failure and reduced cardiac output, it does not typically cause a complete lack of cardiac output. The most acute event related to AFib is the formation of emboli and subsequent stroke.

Choice A rationale
Sepsis is a systemic inflammatory response to infection, often characterized by fever (temperature of 38°C or higher) and tachycardia (heart rate of 120 beats per minute or higher). These symptoms indicate the body’s response to a severe infection.
Choice B rationale
Hypovolemic shock is caused by significant fluid loss, leading to decreased blood volume and perfusion. It typically presents with hypotension and tachycardia, but not necessarily fever.
Choice C rationale
Myocardial infarction (heart attack) is characterized by chest pain, shortness of breath, and other symptoms, but fever and tachycardia are not primary indicators.
Choice D rationale
Pulmonary embolism involves a blockage in the pulmonary arteries, leading to symptoms such as sudden shortness of breath, chest pain, and rapid heart rate, but not typically fever.