While evaluating a patient diagnosed with angina, the patient asks, “What causes this pain in my heart?” What is the nurse’s BEST response?
Increased afterload.
Inadequate myocardial oxygenation.
Coronary artery disease.
Increased preload.
The Correct Answer is C
Choice A rationale:
Increased afterload refers to the resistance against which the heart must pump to eject blood into the aorta. While increased afterload can contribute to chest pain in certain conditions like aortic stenosis, it's not the primary cause of angina.
Angina is typically triggered by exertion or emotional stress, which increase myocardial oxygen demand. Increased afterload doesn't directly cause this imbalance in oxygen supply and demand, making it less likely to be the primary driver of angina pain.
Choice B rationale:
Inadequate myocardial oxygenation is a key concept in understanding angina, but it's not the most precise answer to the patient's question about the cause of their pain.
It's important to explain the underlying reason for the inadequate oxygenation, which is coronary artery disease.
Choice C rationale:
Coronary artery disease (CAD) is the most common cause of angina. It's characterized by narrowing or blockage of the coronary arteries, which supply oxygen-rich blood to the heart muscle.
When the heart's demand for oxygen exceeds the supply available through the narrowed arteries, it experiences ischemia (lack of oxygen), leading to the characteristic chest pain of angina.
This explanation directly addresses the patient's question about the cause of their pain, linking the symptom to the underlying disease process. Choice D rationale:
Increased preload refers to the amount of blood filling the ventricles before they contract. While increased preload can contribute to heart failure and pulmonary edema, it's not typically a direct cause of angina.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Rationale:
Atrial Flutter is a rapid, regular atrial rhythm characterized by a "sawtooth" pattern on the ECG. It is caused by a reentrant circuit in the atria, usually involving the cavo-tricuspid isthmus. The atrial rate in atrial flutter is typically between 250 and 350 beats per minute. However, the ventricular rate is often slower due to varying degrees of AV block.
Key differentiating features: Atrial flutter has a regular, sawtooth pattern on ECG, while ventricular fibrillation is irregular and chaotic. Atrial flutter usually has a slower ventricular rate than ventricular fibrillation.
Choice B Rationale:
Ventricular Tachycardia (VT) is a rapid heart rhythm that originates in the ventricles. It is defined as three or more consecutive ventricular beats at a rate greater than 100 beats per minute. VT can be either non-sustained (lasting less than 30 seconds) or sustained (lasting more than 30 seconds).
Key differentiating features: VT has a regular or slightly irregular rhythm with wide QRS complexes, while ventricular fibrillation is irregular and chaotic with no discernible QRS complexes. VT may have a pulse, while ventricular fibrillation is pulseless.
Choice C Rationale:
Atrial Fibrillation (AF) is a common heart rhythm disorder characterized by rapid, irregular atrial electrical activity. This results in an irregular and often rapid heart rate. AF can be caused by a variety of factors, including high blood pressure, heart valve disease, coronary artery disease, and hyperthyroidism.
Key differentiating features: AF has an irregular, disorganized rhythm with no discernible P waves, while ventricular fibrillation is irregular and chaotic with no discernible QRS complexes. AF may have a pulse, while ventricular fibrillation is pulseless.
Choice D Rationale:
Ventricular Fibrillation (VF) is a life-threatening heart rhythm that is characterized by rapid, disorganized electrical activity in the ventricles. This results in the heart muscle quivering instead of pumping blood effectively. VF is a medical emergency that requires immediate treatment with cardiopulmonary resuscitation (CPR) and defibrillation.
Key features: VF is characterized by an irregular, chaotic rhythm with no discernible QRS complexes on the ECG. It is also pulseless, meaning that there is no palpable pulse.
Correct Answer is C
Explanation
Answer and explanation
The correct answer is C. Normal Sinus Rhythm.
Choice A rationale:
Asystole is the absence of all electrical activity in the heart, as evidenced by a flat line on the electrocardiogram (ECG). It is a medical emergency that requires immediate cardiopulmonary resuscitation (CPR) and defibrillation.
Key features of asystole on ECG:
No discernible P waves, QRS complexes, or T waves.
A completely flat or nearly flat line on the ECG tracing.
Choice B rationale:
Atrial flutter is a rapid heart rhythm that arises from abnormal electrical activity in the atria. It is characterized by a sawtooth pattern on the ECG, with atrial rates typically between 250 and 350 beats per minute.
Key features of atrial flutter on ECG:
Absence of distinct P waves, instead replaced by flutter waves (sawtooth pattern).
Regular, rapid atrial rate (typically 250-350 bpm).
QRS complexes may be normal or slightly irregular in appearance.
Choice C rationale:
Normal sinus rhythm is the natural, healthy rhythm of the heart. It originates in the sinoatrial (SA) node, the heart's natural pacemaker, and is characterized by a regular rate of 60-100 beats per minute, with consistent P waves, QRS complexes, and T waves on the ECG.
Key features of normal sinus rhythm on ECG:
Presence of distinct P waves, QRS complexes, and T waves.
Regular rhythm with a rate of 60-100 beats per minute.
PR interval (the time between the P wave and QRS complex) is 0.12-0.20 seconds.
QRS duration (the time it takes for the ventricles to depolarize) is less than 0.12 seconds.
Choice D rationale:
Sinus bradycardia is a slow heart rhythm, with a rate below 60 beats per minute. It is often a normal finding in healthy individuals, especially athletes or during sleep. However, it can also be a sign of underlying medical conditions.
Key features of sinus bradycardia on ECG:
Presence of distinct P waves, QRS complexes, and T waves.
Regular rhythm with a rate less than 60 beats per minute.
PR interval and QRS duration are typically normal.
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