A patient has been receiving a heparin sodium IV for the last three days. The patient's most current platelet count is 65,000 × 103/uL; while the platelet count on admission was 350,000 × 103/uL. The cardiac-vascular nurse contacts the physician to:

Correct Answer: B

Rationale: The correct answer is B) report that the patient is exhibiting signs of an adverse reaction. When a patient's platelet count drops significantly while on heparin therapy, it raises concern for heparin-induced thrombocytopenia (HIT), an adverse reaction to heparin. HIT is a serious condition that can lead to thrombosis and requires immediate intervention. Option A is incorrect because a low platelet count does not necessarily indicate subtherapeutic levels of heparin. Option C is incorrect because increasing the medication infusion rate could worsen the adverse reaction. Option D is incorrect because platelet transfusion is not the first-line treatment for HIT. In an educational context, understanding the implications of a decreasing platelet count in a patient on heparin is crucial for nurses and healthcare providers. Recognizing signs of adverse reactions promptly and taking appropriate actions can prevent serious complications and improve patient outcomes. This scenario highlights the importance of pharmacovigilance and critical thinking in clinical practice.

Correct Answer: D

Rationale: In teaching women about risks and incidence of Coronary Artery Disease (CAD), emphasizing that CAD is the leading cause of death in women, with a higher mortality rate after myocardial infarction (MI) than in men (Option D) is crucial. This information is vital as CAD is often underestimated in women leading to delayed diagnosis and treatment. By highlighting this fact, nurses can empower women to take preventive measures and seek timely medical attention. Option A is incorrect because smoking is a significant risk factor for CAD in both men and women. Option B is incorrect as studies show that women tend to delay seeking treatment for CAD due to atypical symptoms. Option C is incorrect as recent research has shown that estrogen replacement therapy in postmenopausal women may not reduce the risk of CAD and can even have adverse effects. Educationally, understanding these nuances is essential for nurses to provide accurate and up-to-date information to their patients. By emphasizing the unique aspects of CAD in women, nurses can contribute to better outcomes through early detection, prevention, and treatment strategies tailored to women's specific needs.

Correct Answer: B

Rationale: The correct answer is B) 4 to 10 days after MI. During this time frame, the healing process in the myocardium following a myocardial infarction (MI) is characterized by the formation of early scar tissue. This scar tissue is initially weak and can result in an unstable heart wall, posing a risk for complications such as cardiac rupture. Option A) 2 to 3 days after MI is too early in the healing process for significant scar tissue to have formed, so the heart wall would not be unstable at this point. Option C) 10 to 14 days after MI is too late in the healing process for early scar tissue to be the cause of an unstable heart wall. By this time, the scar tissue would have started to mature and strengthen. Option D) 6 weeks after MI is also too late for early scar tissue to result in an unstable heart wall. By this time, the scar tissue would have undergone further remodeling and would be more stable. Educationally, understanding the timeline of healing following a myocardial infarction is crucial for healthcare professionals involved in the care of patients with heart conditions. Recognizing the potential complications, such as an unstable heart wall, at different stages of the healing process can inform clinical decision-making and improve patient outcomes.

Correct Answer: A

Rationale: In cardiac rehabilitation, patient safety is paramount. The correct answer is A) Pain or dyspnea develop. This is because experiencing chest pain or shortness of breath during exercise could indicate cardiac distress or inadequate oxygen supply to the heart muscle, necessitating immediate cessation of activity to prevent potential cardiac events. Option B) The HR exceeds 150 bpm is incorrect because heart rate alone may not always be a reliable indicator of exercise tolerance, especially in individuals with varying fitness levels or on medications affecting heart rate. Option C) The respiratory rate increases to 30 is incorrect because an increased respiratory rate may be a normal response to exercise and does not necessarily indicate a need to stop exercising unless accompanied by other symptoms. Option D) The HR is 30 bpm over the resting HR is incorrect because some individuals may have a naturally high resting heart rate or may be on medications that affect heart rate, making this guideline too general and not individualized. Educationally, understanding these nuances is crucial for healthcare providers working with cardiac patients to ensure safe and effective rehabilitation programs tailored to each patient's specific needs and limitations. It highlights the importance of monitoring multiple parameters during exercise and responding appropriately to signs and symptoms of cardiac distress to prevent adverse events during rehabilitation.

Correct Answer: C

Rationale: The correct answer is C) Both A and B, which includes Controlled Mechanical Ventilation (CMV) and Assist-Control Mode. In educational context, understanding the different modes of ventilator settings is crucial in managing patients with respiratory issues, especially in critical care settings. Controlled Mechanical Ventilation (A) is a mode where the ventilator completely controls the patient's breathing pattern. It delivers a set tidal volume at a set rate, regardless of the patient's own respiratory efforts. This mode is typically used for patients who are unable to initiate a breath on their own. Assist-Control Mode (B), on the other hand, allows the patient to trigger the ventilator to deliver a breath. The ventilator delivers a set tidal volume whenever the patient initiates a breath, but will also provide breaths at a set rate if the patient does not trigger the ventilator. This mode is more patient-friendly as it allows for some level of patient control over their breathing. Option D (None of the above) is incorrect as both A and B are valid modes of ventilation commonly used in clinical practice. Understanding the differences between these modes is essential for healthcare providers to effectively manage ventilation strategies based on individual patient needs. In summary, a comprehensive knowledge of the various modes of ventilation is vital for healthcare professionals working with patients requiring respiratory support. This knowledge ensures safe and effective management of ventilation, tailored to each patient's condition and respiratory needs.