Which acute event is most likely to occur in a patient who has chronic atrial fibrillation?

Cerebral ischemia due to an embolus that originates in the left atrium.

Development of ventricular fibrillation.

Ischemia of the cerebellum due to a ruptured intracranial aneurysm.

Prolonged capillary refill secondary to a complete lack of cardiac output.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is B

Explanation

Choice A rationale
Deep vein thrombosis (DVT) can lead to pulmonary embolism but does not directly cause chest pain and shortness of breath.
Choice B rationale
Pulmonary embolus (PE) is characterized by chest pain, shortness of breath, and hemoptysis (coughing up blood), especially in patients on bed rest.
Choice C rationale
Anemia can cause fatigue and shortness of breath but not typically chest pain and hemoptysis.
Choice D rationale
Right heart failure can cause shortness of breath and edema but not typically chest pain and hemoptysis.

A. This intracellular substance can leak into the blood with cardiac cellular injury or death. B. Elevated serum levels of troponin occur because of sustained glycogenolysis. C. This substance is elevated when a patient has acute tubular necrosis. D. Serum elevation of this acute phase reactant occurs because of tissue injury.

Correct Answer is A

Explanation

Choice A rationale
Elevated serum levels of troponin indicate cardiac cellular injury or death. Troponin is a protein released into the bloodstream when heart muscle cells are damaged, such as during a myocardial infarction.
Choice B rationale
Sustained glycogenolysis does not cause elevated troponin levels. Glycogenolysis is the breakdown of glycogen to glucose, primarily occurring in the liver and muscles, not related to troponin release.
Choice C rationale
Acute tubular necrosis does not elevate troponin levels. This condition affects the renal tubules and is typically indicated by elevated creatinine and BUN levels.
Choice D rationale
Troponin is not an acute phase reactant. Acute phase reactants are proteins whose levels change in response to inflammation, such as C-reactive protein (CRP), not troponin.

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Which acute event is most likely to occur in a patient who has chronic atrial fibrillation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient, who is on complete bed rest following extensive surgery, begins to complain of chest pain and shortness of breath with hemoptysis. His SO2 measures 90%. The nurse recognizes that the patient is most likely exhibiting signs and symptoms of which condition?

Correct Answer is B

Explanation

What is the significance of elevated serum levels of troponin?

Correct Answer is A

Explanation

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