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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
Rationale:
A. While pneumonia can cause fever, fatigue, and chest discomfort, it is less likely to cause severe pedal edema, irregular heart rhythms, or palpitations. The presence of edema and irregular heart sounds points toward a cardiac origin rather than a primary pulmonary infection.
B. Fatigue, chest discomfort, irregular heart sounds, pedal edema, and low blood pressure are classic signs of heart failure, particularly in a young adult who may have acute or chronic cardiac dysfunction. Heart failure can also contribute to the development of arrhythmias.
C. COPD primarily presents with chronic cough, dyspnea, and sputum production. While it can strain the heart over time, COPD alone would not account for the acute irregular heart rate, edema, and chest discomfort in this patient.
D. The irregular heart rate (HR 112 bpm) and irregular heart sounds are indicative of atrial fibrillation, which is common in patients with underlying heart disease or heart failure. Atrial fibrillation can also worsen cardiac output, contributing to edema and fatigue.
E. Pulmonary embolism typically presents with acute dyspnea, pleuritic chest pain, tachypnea, and sometimes hemoptysis. Edema and irregular heart rhythms are not primary features, making this less likely than heart failure and atrial fibrillation.
Correct Answer is B
Explanation
Rationale:
A. Cardiac enzyme tests indicate myocardial injury but do not pinpoint the exact location of the infarct; imaging or ECG is required for localization.
B. Cardiac enzymes, such as troponin and creatine kinase-MB (CK-MB), are released into the bloodstream when myocardial cells are damaged. Their levels correlate with the extent of cardiac tissue injury, helping providers assess severity and guide treatment.
C. Pulmonary congestion is assessed via physical examination, chest X-ray, or echocardiography, not cardiac enzyme levels.
D. Structural assessment requires echocardiography or other imaging, not blood enzyme studies.
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