While assessing a client 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 system
Increased preload
The Correct Answer is B
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 angina by increasing the heart's workload, it is not the primary cause of the pain.
Increased afterload is more commonly associated with heart failure, hypertension, and aortic stenosis.
Choice C rationale:
The coronary artery system is the network of blood vessels that supply oxygen and nutrients to the heart muscle.
While coronary artery disease (CAD), a narrowing or blockage of these arteries, is the underlying cause of angina, it is not the direct cause of the pain.
The pain of angina is caused by the heart muscle not receiving enough oxygen, which can occur even if the coronary arteries are not completely blocked.
Choice D rationale:
Increased preload refers to the volume of blood that fills the ventricles before they contract.
While increased preload can also contribute to angina by increasing the heart's workload, it is not the primary cause of the pain.
Increased preload is more commonly associated with heart failure, valvular regurgitation, and fluid overload.
Choice B rationale:
Inadequate myocardial oxygenation is the most direct and accurate explanation for the pain of angina.
When the heart muscle does not receive enough oxygen, it experiences ischemia, which is a lack of blood flow and oxygen.
Ischemia triggers the release of chemicals that stimulate pain receptors in the heart, leading to the characteristic chest pain of angina.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Atrial fibrillation (AF) is characterized by the absence of P waves on the ECG, the presence of fibrillatory waves, and an irregularly irregular rhythm. This is due to chaotic electrical activity in the atria, which results in disorganized atrial contractions. The fibrillatory waves, which are often described as "f" waves or "sawtooth" waves, represent the rapid and irregular electrical activity in the atria. They are typically best seen in lead II, V1, or V2 of the ECG.
Here is a more detailed explanation of the key features of AF that support this answer:
Absence of P waves: In normal sinus rhythm, the P wave represents the electrical impulse that originates in the sinoatrial (SA) node and depolarizes the atria. In AF, the SA node is no longer in control of the atrial rhythm, and there is no organized atrial depolarization. As a result, P waves are absent on the ECG.
Presence of fibrillatory waves: The fibrillatory waves seen in AF represent the disorganized electrical activity in the atria. They are typically irregular in amplitude and frequency, and they can vary in appearance from patient to patient.
Irregularly irregular rhythm: The ventricular rhythm in AF is also irregular because the impulses from the atria are not conducted to the ventricles in a regular pattern. This results in an irregularly irregular rhythm, which is a hallmark feature of AF.
Key points to remember:
AF is the most common type of cardiac arrhythmia.
It can be asymptomatic or cause a variety of symptoms, including palpitations, shortness of breath, fatigue, and lightheadedness.
AF is a risk factor for stroke and heart failure.
Treatment for AF may include medications to control heart rate or rhythm, blood thinners to reduce the risk of stroke, and in some cases, procedures to restore normal heart rhythm.
Correct Answer is ["C","D"]
Explanation
Choice A rationale:
The ST segment represents the period of time between ventricular depolarization and repolarization. Its elevation or depression can indicate myocardial ischemia or injury, but it's not directly related to normal sinus rhythm determination.
The PR interval, on the other hand, measures the time it takes for the electrical impulse to travel from the atria to the ventricles. While a normal PR interval is essential for normal sinus rhythm, its height relative to the ST segment is not a determining factor.
Choice B rationale:
The number of complexes in a 6-second strip can provide a quick estimate of heart rate, but it's not a definitive criterion for normal sinus rhythm. A normal heart rate in adults typically ranges from 60 to 100 beats per minute, which could correspond to 5-10 complexes in a 6-second strip. However, other factors, such as rhythm regularity and P wave morphology, must also be considered. Choice C rationale:
RR intervals that are relatively consistent are a hallmark of normal sinus rhythm. This indicates that the heart is beating at a regular pace, with equal time intervals between each QRS complex. In contrast, irregular RR intervals suggest dysrhythmia, such as atrial fibrillation or premature ventricular contractions.
Choice D rationale:
One P wave preceding each QRS complex is another essential feature of normal sinus rhythm. The P wave represents atrial depolarization, and its consistent presence before each QRS complex (which represents ventricular depolarization) indicates that the electrical impulse is originating in the sinoatrial (SA) node, the heart's natural pacemaker, and is propagating through the atria and ventricles in a coordinated manner.
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