A client presents to the emergency department with an acute myocardial infarction (MI) at 1500 (3:00 PM). The facility has 24-hour catheterization laboratory capabilities. To meet The Joint Commission's Core Measures set, by what time should the client have a percutaneous coronary intervention performed?

Correct Answer: C

Rationale: The correct answer is C: 1630 (4:30 PM). The rationale is as follows: 1. The standard guideline for performing percutaneous coronary intervention (PCI) in acute MI is within 90 minutes of arrival at the hospital. 2. The client arrived at 1500 (3:00 PM), so adding 90 minutes to this time gives us 1630 (4:30 PM). 3. This timing aligns with The Joint Commission's Core Measures for timely PCI in acute MI cases. 4. Therefore, the correct time for the client to have PCI performed is 1630 (4:30 PM). In summary, choices A, B, and D are incorrect because they do not align with the 90-minute guideline for performing PCI in acute MI cases, as mandated by The Joint Commission's Core Measures.

Correct Answer: A

Rationale: The correct answer is A: Assess the client's lung sounds. This is important because after a myocardial infarction, there is a risk of pulmonary edema, which can present as crackles or wheezes in the lungs. By assessing the lung sounds, the healthcare provider can identify any signs of respiratory distress and promptly intervene if necessary. Choice B is incorrect because calling the Rapid Response Team is not warranted based solely on abnormal heart sounds. Choice C is incorrect as having the client sit upright is not directly related to addressing abnormal heart sounds. Choice D is also incorrect as it focuses solely on assessing lung sounds without considering the potential implications of the abnormal heart sounds.

Correct Answer: A

Rationale: The correct action is to assess the client's blood pressure and level of consciousness. This is crucial in a client with an inferior wall MI to monitor for potential complications like cardiogenic shock. Assessing these vital signs can provide immediate information on the client's hemodynamic stability. Calling the health care provider or Rapid Response Team may be necessary based on assessment findings. Obtaining a permit for a temporary pacemaker insertion and preparing to administer antidysrhythmic medication are not the most immediate priorities and may not address the client's current needs.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Hypertension is a modifiable risk factor as it can be controlled through lifestyle changes and medication. 2. Age is a non-modifiable risk factor, as it naturally increases the risk of coronary artery disease. 3. Obesity is a modifiable risk factor, as weight management through diet and exercise can reduce the risk. 4. Smoking is a modifiable risk factor, as quitting smoking can significantly reduce the risk. Summary: B is correct as it is a modifiable risk factor that can be actively managed. A, C, and D are incorrect as age is non-modifiable and obesity and smoking are modifiable but were not selected as correct options.

Correct Answer: A

Rationale: The correct answer is A: Age. Age is a non-modifiable risk factor for coronary artery disease, meaning it cannot be changed or controlled. Hypertension, obesity, and smoking are modifiable risk factors as they can be managed through lifestyle changes or medical interventions. By controlling blood pressure, maintaining a healthy weight, and quitting smoking, individuals can reduce their risk of developing coronary artery disease. Age, however, is a natural process that cannot be altered. Therefore, focusing on managing modifiable risk factors is crucial in preventing coronary artery disease.