A patient suffers from spisodic pain diffusely localized over the chest and upper abdomen, which is relieved by sublingual glyceryl trinitrate. He could be suffering from

Correct Answer: D

Rationale: In this scenario, the correct answer is D) All of the above. The patient's symptoms of diffuse chest and upper abdominal pain relieved by sublingual glyceryl trinitrate can be indicative of various conditions. Angina pectoris is characterized by chest pain or discomfort due to reduced blood flow to the heart muscles. The patient's response to glyceryl trinitrate suggests a cardiac origin of the pain. Biliary colic refers to pain caused by gallstones obstructing the bile ducts. Although the pain is typically localized to the upper abdomen, it can radiate to the chest, mimicking cardiac conditions. Esophageal spasm presents with chest pain similar to cardiac conditions and can be relieved by medications like glyceryl trinitrate. Educationally, understanding the differential diagnosis of chest pain is crucial in nursing practice to provide prompt and accurate care. Recognizing the varying presentations of different conditions helps nurses make informed clinical decisions and prioritize interventions effectively. This quiz question highlights the importance of considering multiple differential diagnoses based on patient symptoms and responses to treatment.

Correct Answer: D

Rationale: In the context of treating paroxysmal supraventricular tachycardia (PSVT), the drug of choice is Adenosine. Adenosine is a class V antiarrhythmic medication that works by slowing conduction through the AV node, which can help terminate the reentry circuit causing PSVT. It is administered rapidly via IV push to quickly stop the abnormal rhythm. Option A, Flecainide, is a class Ic antiarrhythmic drug that is contraindicated in PSVT as it can actually worsen the condition by increasing the risk of ventricular arrhythmias. Option B, Lidocaine, is primarily used for ventricular arrhythmias and is not effective in treating PSVT. Option C, Metoprolol, is a beta-blocker that can be used for rate control in atrial fibrillation but is not the first-line choice for acute termination of PSVT like Adenosine. Understanding the appropriate medications for specific cardiac arrhythmias is crucial for nurses to provide safe and effective care to patients with cardiovascular conditions. Being able to differentiate between various antiarrhythmic drugs and their indications is essential in managing patients with cardiac rhythm disturbances. Adenosine's rapid onset of action and specific mechanism of action make it the preferred choice for terminating PSVT in clinical practice.

Correct Answer: D

Rationale: The correct answer is D) The sympathetic nervous system. When a client experiences a sudden increase in heart rate and cardiac contractility, it signifies activation of the sympathetic nervous system. The sympathetic nervous system is responsible for the "fight or flight" response in the body, which includes increasing heart rate and cardiac contractility to prepare the body for action or stress. Option A) The parasympathetic nervous system is responsible for the body's "rest and digest" functions, which work to decrease heart rate and cardiac contractility. Therefore, it is not likely activated in this scenario. Option B) The AV node is a part of the electrical conduction system of the heart and is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. It is not directly related to the increase in heart rate and contractility described in the scenario. Option C) The baroreceptors in the carotid sinus are responsible for detecting changes in blood pressure and helping to regulate it. While they play a role in cardiovascular regulation, they are not directly involved in the increase in heart rate and contractility described in the scenario. Educationally, understanding the autonomic nervous system's two branches, sympathetic and parasympathetic, and their roles in regulating cardiovascular function is crucial for nursing practice. Recognizing the signs and symptoms of sympathetic nervous system activation can help nurses assess and intervene appropriately in acute situations such as sudden changes in heart rate and contractility.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Sodium current can be blocked by quinidine in phase 0 of the cardiac action potential. Quinidine is a Class I antiarrhythmic drug that acts by blocking sodium channels, thereby inhibiting the influx of sodium ions during phase 0 of the cardiac action potential. By blocking sodium channels, quinidine decreases the rate of depolarization in cardiac cells, which can be beneficial in treating certain arrhythmias. Option A) Calcium channels opening resulting in outward current is incorrect because calcium channels primarily play a role in phase 2 of the cardiac action potential, not phase 0. Option B) Potassium channels rapidly opening and closing is incorrect as potassium channels are more active during phase 3 of the cardiac action potential, not phase 0. Option D) Transient outward current developing is also incorrect as transient outward potassium currents occur mainly during phases 1 and 2, not phase 0. Educationally, understanding the phases of the cardiac action potential and the mechanisms of action of antiarrhythmic drugs like quinidine is crucial for nursing students to provide safe and effective care to patients with cardiovascular conditions. It helps in making informed decisions regarding medication administration and monitoring for adverse effects.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Scopolamine. Scopolamine is an anticholinergic drug that, like phenylephrine, causes mydriasis or dilation of the pupil. This effect is due to its ability to block the action of acetylcholine at the muscarinic receptors in the eye. Option A) Methacholine is a cholinergic agonist that would actually cause miosis or constriction of the pupil. Option B) Neostigmine is a cholinesterase inhibitor that would also lead to miosis by increasing the levels of acetylcholine. Option C) Phentolamine is an alpha-adrenergic blocker and would not result in mydriasis. Educationally, understanding the pharmacological effects of drugs used in ophthalmology is crucial for nursing practice. Nurses need to be able to identify which medications can cause mydriasis or miosis to monitor patients for expected outcomes or potential adverse reactions, especially in pre-operative settings like LASIK surgery. This knowledge ensures safe patient care and effective communication with the healthcare team.