A nurse responds to a telemetry alarm and determines that the client is in which rhythm, where the rate is greater than 150, diastole is shortened, and the heart does not have sufficient time to fill?

Correct Answer: C

Rationale: In this case, the correct answer is C) Supraventricular Tachycardia (SVT). SVT is characterized by a heart rate greater than 150 beats per minute, shortened diastole, and inadequate time for the heart to fill properly. This rapid rhythm originates above the ventricles and can lead to symptoms such as palpitations, chest pain, dizziness, and even syncope. Sinus bradycardia (option A) is a slow heart rhythm, not consistent with the scenario described in the question. Sinus tachycardia (option B) is a fast heart rhythm, but diastole is not shortened in this rhythm. Atrial flutter (option D) is a specific type of supraventricular arrhythmia, but it typically presents with a sawtooth pattern on ECG, which is not mentioned in the question stem. Understanding different cardiac rhythms is crucial for nurses working in telemetry units or any healthcare setting where cardiac monitoring is performed. Recognizing these rhythms promptly is essential for initiating appropriate interventions and preventing potential complications for the patient. Nurses must be adept at interpreting telemetry alarms accurately to provide timely and effective care.

Correct Answer: D

Rationale: The correct answer is D) One or more arteries that supply blood to his heart are blocked, thereby preventing an adequate amount of blood from getting to his cardiac muscles. This response is the most appropriate because it directly addresses the patient's condition of myocardial infarction (heart attack). It provides a clear and accurate explanation in simple terms, helping the patient understand the cause of his symptoms. Option A is incorrect because leaving the patient uninformed can increase anxiety and hinder patient-provider communication. It is important to provide basic information to the patient to alleviate fear and facilitate understanding. Option B is incorrect as it refers to a congenital heart condition related to the aortic valve, which is not relevant to the patient's current situation of myocardial infarction. Option C is incorrect and promotes a harmful stereotype that overweight individuals are destined to have a heart attack. This statement lacks medical accuracy and can contribute to patient stigma. Educational context: In healthcare, effective communication with patients is essential for building trust, ensuring informed decision-making, and promoting patient satisfaction. Providing clear and accurate information empowers patients to participate in their care and promotes better health outcomes. Educating patients about their condition in simple language helps them understand the importance of treatment and lifestyle modifications.

Correct Answer: D

Rationale: In the scenario of administering thrombolytic therapy to a patient with an acute myocardial infarction (MI), the primary consideration should be the time since the onset of symptoms, making option D the correct answer. Time is crucial in this situation as thrombolytic therapy is most effective when given promptly after the onset of symptoms to dissolve the blood clot causing the MI and restore blood flow to the heart muscle. Option A, history of heart disease, while important for assessing the patient's overall cardiac health, is not the primary consideration in the acute management of an MI. Option B, sensitivity to aspirin, is relevant for other aspects of treatment but not the primary consideration for thrombolytic therapy administration. Option C, size and location of the MI, is also significant for prognosis and further management but does not take precedence over the urgency of timely thrombolytic therapy. Educationally, understanding the critical importance of timely intervention in acute myocardial infarction highlights the need for healthcare providers to rapidly assess and initiate appropriate treatments to minimize cardiac damage and improve patient outcomes. This knowledge underscores the significance of quick decision-making and action in emergency cardiac care.

Correct Answer: D

Rationale: In the context of a patient with chronic venous insufficiency, the most appropriate nursing diagnosis is "D) Skin Integrity, impaired." This is because chronic venous insufficiency often leads to poor circulation in the lower extremities, which can result in skin breakdown and ulcer formation due to decreased oxygen and nutrient delivery to the tissues. Option A) Activity Intolerance may be a common symptom of chronic venous insufficiency, but it does not address the direct impact on skin integrity that is characteristic of this condition. Option B) Body Image, disturbed may be relevant if the patient is experiencing emotional distress related to changes in physical appearance due to chronic venous insufficiency, but it is not the primary concern from a nursing diagnosis perspective. Option C) Fluid Volume, deficient is not typically associated with chronic venous insufficiency, as this condition is more focused on issues related to venous circulation and skin integrity rather than fluid volume imbalance. Educationally, understanding the rationale behind selecting the correct nursing diagnosis is crucial for providing effective care to patients with chronic venous insufficiency. By focusing on skin integrity, nurses can implement interventions to prevent skin breakdown, promote wound healing, and improve overall patient outcomes in this population. This reinforces the importance of thorough assessment and individualized care planning based on the specific needs of the patient.

Correct Answer: C

Rationale: The correct answer is C) Decrease CO by decreasing rate and strength of the heart and renin secretion by the kidneys. Beta-adrenergic blockers like atenolol primarily work by blocking the beta-adrenergic receptors in the heart and kidneys. By doing so, they decrease the heart rate and contractility, leading to a reduction in cardiac output (CO). This results in a decrease in blood pressure (BP) as the heart is pumping with less force. Option A is incorrect because vasodilation by blocking calcium movement is associated with calcium channel blockers, not beta-blockers. Option B is incorrect because blocking aldosterone leads to sodium and water retention, not reduction, and this would not significantly affect BP. Option D is incorrect as beta-blockers do not directly inhibit sympathetic outflow, rather they block the response of the heart to sympathetic stimulation. In an educational context, understanding the mechanisms of action of medications like beta-blockers is crucial for healthcare professionals in managing patients with cardiovascular conditions. Knowing how these drugs affect BP helps in making informed decisions regarding treatment options and monitoring for potential side effects.