A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

The client who is out of work and has been experiencing increased stress.

The client who is recovering from a recent illness that caused vomiting and diarrhea.

The client whose mother and uncle were diagnosed with this same condition

The client who had a myocardial infarction and required stent placement.

Answer and Explanation

The Correct Answer is D

Rationale:

A. While stress can contribute to arrhythmias, it is not the highest risk factor for atrial flutter. Stress alone is less likely to trigger atrial flutter without underlying cardiac disease.

B. The client who is recovering from a recent illness that caused vomiting and diarrhea – Electrolyte imbalances from vomiting and diarrhea can predispose to arrhythmias, but the risk is temporary and generally lower compared with structural heart disease.

C. The client whose mother and uncle were diagnosed with this same condition – A family history increases susceptibility, but genetic predisposition alone is not the highest risk factor for atrial flutter.

D. Structural heart disease, such as ischemic heart disease following a myocardial infarction (MI), is a major risk factor for developing atrial flutter because damaged atrial tissue can create abnormal electrical pathways that facilitate reentry circuits, leading to flutter.

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Correct Answer is C

Explanation

Rationale:
A. While assessing vital signs is important, blood pressure alone cannot confirm or rule out a myocardial infarction (MI); it only provides information about hemodynamic status.

B. Heart sounds may reveal murmurs or extra sounds but cannot definitively diagnose an MI.

C. A 12-lead ECG is the primary diagnostic tool for identifying an acute MI, as it can detect ST-segment changes, T-wave inversions, or Q waves indicative of myocardial injury or ischemia.

D. Pain radiation is a clinical symptom that supports suspicion of MI, but symptoms alone cannot confirm the diagnosis; objective evidence from ECG and cardiac biomarkers is required.

A. Serum amylase B. Unconjugated bilirubin C. Aspartate aminotransferase (AST). D. Troponin I

Correct Answer is D

Explanation

Rationale:

A. Amylase is an enzyme primarily elevated in pancreatic disorders such as pancreatitis, not myocardial infarction.

B. Unconjugated bilirubin is elevated in hemolysis or liver dysfunction. It is not a marker of myocardial injury.

C. AST can be elevated after myocardial infarction, but it is nonspecific because it is also found in liver, skeletal muscle, and kidneys. It rises later and is not the most sensitive early marker.

D. Troponin I is highly specific to cardiac muscle injury and increases within 3–6 hours after myocardial infarction, making it a primary early diagnostic marker. It remains elevated for 7–10 days, helping confirm myocardial injury.

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A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory values of a client who had a myocardial infarction 3 hr ago. The nurse should expect which of the following laboratory values to be elevated?

Correct Answer is D

Explanation

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