What is the cause of most cases of sudden cardiac death (SCD)?
Atrial fibrillation.
Second-degree heart block.
Ventricular dysrhythmias.
Heart failure.
The Correct Answer is C
Choice A rationale
Atrial fibrillation is a common supraventricular tachyarrhythmia characterized by disorganized atrial electrical activity, leading to an irregular and often rapid ventricular response, which usually does not precipitate sudden cardiac death directly. While it increases the risk of stroke due to clot formation, its primary mechanism involves atrial, not ventricular, electrical instability, which less frequently progresses to a lethal ventricular rhythm.
Choice B rationale
Second-degree heart block (Mobitz Type I or II) involves an intermittent failure of atrioventricular conduction, resulting in dropped QRS complexes. Although severe bradycardia can occur and cause syncope, this rhythm generally does not abruptly degenerate into a fatal ventricular fibrillation, distinguishing it from the typical electrical etiology of sudden cardiac death.
Choice C rationale
Ventricular dysrhythmias, primarily ventricular fibrillation (VF) and sometimes pulseless ventricular tachycardia (VT), are the underlying electrical cause in the vast majority of sudden cardiac death cases. These rhythms involve chaotic or rapid, ineffective electrical activity in the ventricles, preventing adequate cardiac output and resulting in immediate circulatory collapse.
Choice D rationale
Heart failure represents a chronic structural impairment of ventricular filling or ejection, leading to decreased cardiac output and symptomatic fluid congestion. While it is a major risk factor for sudden cardiac death, the terminal event itself is most often an electrical instability, specifically ventricular dysrhythmia, not the mechanical failure itself. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Encourage incentive spirometer use is a key post-operative intervention, particularly with any thoracic or general anesthesia procedure. Deep breathing prevents pulmonary complications such as atelectasis and pneumonia, which can significantly prolong recovery and increase morbidity. Early and frequent use promotes alveolar expansion and gas exchange.
Choice B rationale
Cardiac monitoring for arrhythmias is crucial because manipulation near the aortic valve and the implanting of the new valve often involve proximity to the cardiac conduction system (e.g., the AV node). This puts the patient at high risk for developing new conduction defects like AV block, which may necessitate a temporary or permanent pacemaker.
Choice C rationale
Monitor for abdominal pain is not a primary or typical concern immediately post-TAVR. The procedure is typically performed via the femoral artery in the groin; therefore, the primary site for potential complications like bleeding or hematoma is the groin/access site, not the abdomen.
Choice D rationale
Monitor for bleeding is a critical intervention. The procedure requires large-bore access to the femoral artery (or another access point like the subclavian), which poses a significant risk for immediate post-procedure retroperitoneal or groin hemorrhage requiring vigilant monitoring of the access site and serial hemoglobin levels.
Correct Answer is D
Explanation
Choice A rationale
An oxygen saturation of 95.
Choice B rationale
A temperature of 38.5°C (101.3°F) in the initial 24 hours post-CABG is often related to the inflammatory response from the surgery, atelectasis, or transfusions, and is a common, often expected finding. Though it requires monitoring and possible antipyretics, it's generally less immediately concerning than signs of critical organ hypoperfusion.
Choice C rationale
A heart rate of 90 beats per minute (bpm) is within the expected and generally acceptable range for a patient 24 hours post-surgery, with a normal sinus heart rate being 60 to 100 bpm. This rate ensures adequate cardiac output unless associated with other signs of shock and does not signal a critical instability demanding immediate, focused intervention.
Choice D rationale
Urine output of 30 mL/hour for an adult is critically low, indicating inadequate renal perfusion and potential development of acute kidney injury (AKI), as the minimum acceptable threshold is often 0.5 mL/kg/hr or >30 mL/hr. This suggests severe hypovolemia, low cardiac output, or renal ischemia requiring immediate investigation and intervention to restore perfusion. —.
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