A patient comes to the emergency department (ED) and reports a swollen and painful leg but denies sustaining any injury. The physical examination reveals a tense calf muscle, decreased sensation to the foot and leg, and absent pedal pulses. The cardiac-vascular nurse asks the patient when the symptoms began because:

Correct Answer: C

Rationale: The correct answer is C because irreversible anoxic injury to muscles and nerves can occur in as few as four hours in cases of acute arterial occlusion. This is a medical emergency requiring immediate intervention to restore blood flow and prevent tissue damage. A: Arterial thrombosis and embolism both lead to sudden occlusion of blood vessels, but the focus here is on the rapid onset of irreversible tissue damage, not the timing of symptom development. B: Compartment syndrome usually occurs hours to days after arterial occlusion, not days after. However, the key here is the potential for irreversible anoxic injury within a shorter timeframe. D: Metabolic alkalosis from muscle swelling is not directly related to the symptoms described and is not cardiotoxic in this context.

Correct Answer: C

Rationale: Rationale: Spironolactone is a potassium-sparing diuretic, meaning it helps retain potassium in the body. Hypertensive patients taking spironolactone may experience potassium loss, making dietary teaching on potassium sources crucial to prevent hypokalemia. Enalapril, Labetalol, and Hydrochlorothiazide do not directly affect potassium levels, so dietary teaching about potassium is not as essential for patients taking these medications.

Correct Answer: B

Rationale: The correct answer is B: Increased cardiac workload with aortic stenosis. In aortic stenosis, the heart has to work harder to pump blood against the narrowed valve, leading to increased oxygen demand. This results in myocardial ischemia due to the imbalance between oxygen demand and supply. A: Hypovolemia or anemia may decrease oxygen supply but do not directly increase oxygen demand. C: Narrowed coronary arteries from atherosclerosis decrease oxygen supply but do not directly increase oxygen demand. D: Angina in the patient with atherosclerotic coronary arteries indicates decreased oxygen supply but does not directly increase oxygen demand.

Correct Answer: C

Rationale: The correct answer is C because transmyocardial laser revascularization (TMR) involves using a laser to create channels between the left ventricular cavity and coronary circulation, improving blood flow to ischemic areas. This procedure is used to treat refractory angina in patients who are not candidates for traditional revascularization procedures. A is incorrect as TMR does not involve using a structure to hold vessels open. B is incorrect as TMR does not necessarily require anticoagulation following the procedure. D is incorrect as TMR does not involve the surgical construction of new vessels. In summary, TMR involves creating channels with a laser to improve blood flow, making option C the correct choice.

Correct Answer: A

Rationale: The correct answer is A: Arterial aneurysm. Aneurysms are abnormal bulges or ballooning in the walls of arteries. They can occur in any artery in the body. Arterial aneurysms are the most common type and can be further classified based on their shape and location. Venous aneurysms (B) occur in veins, not arteries. Dissecting aneurysms (C) involve a tear in the inner layer of the artery wall, causing blood to flow between the layers. Fusiform aneurysms (D) are a type of arterial aneurysm characterized by a uniform dilation of the entire circumference of the artery.