A patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction. Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?

Correct Answer: C

Rationale: The correct answer is C: “What time did your chest pain begin?” This question is crucial for determining if the patient is a candidate for thrombolytic therapy as the time of symptom onset is a key factor in deciding the eligibility for this treatment. Thrombolytic therapy is most effective when administered within a specific timeframe from the onset of symptoms, typically within the first few hours of symptom onset. Therefore, knowing the exact time when the chest pain started will help healthcare providers assess if the patient falls within the window of opportunity for thrombolytic therapy. Choices A, B, and D are incorrect because they do not directly address the time-sensitive nature of thrombolytic therapy eligibility. Allergies and daily aspirin intake are important considerations in healthcare, but they are not immediate factors in determining thrombolytic therapy candidacy. The pain rating on a scale of 0 to 10 is subjective and does not provide specific information regarding the urgency of thrombolytic therapy

Correct Answer: D

Rationale: The correct answer is D: Reinforcement of teaching about the purpose of prescribed medications. This task is appropriate for delegation to an LPN/LVN because it involves reinforcing previously taught information to the patient, which does not require advanced assessment or critical thinking skills. LPN/LVNs are typically trained to provide education and reinforcement of information to patients under the supervision of an RN. Choice A is incorrect because evaluating the patient's response to walking in the hallway requires ongoing assessment and monitoring, which should be done by an RN. Choice B is incorrect as completing a referral form involves making decisions about follow-up care, which is beyond the scope of an LPN/LVN. Choice C is incorrect because educating the patient about the pathophysiology of heart disease requires a comprehensive understanding of the disease process and is best done by an RN or healthcare provider with advanced knowledge.

Correct Answer: A

Rationale: The correct answer is A: PTT (Partial Thromboplastin Time). PTT measures the effectiveness of heparin therapy by assessing the clotting time. Monitoring PTT helps ensure that the client's blood is within the therapeutic range for anticoagulation. HCT (Choice B) measures the percentage of red blood cells in the blood and is not directly related to heparin effectiveness. CBC (Choice C) is a complete blood count that includes various parameters, but it does not specifically indicate heparin effectiveness. PT (Choice D) is the Prothrombin Time, which is used to monitor warfarin therapy, not heparin.

Correct Answer: C

Rationale: The correct answer is C: Return of the ST segment to baseline. This is because in acute myocardial ischemia, ST segment elevation or depression is indicative of myocardial injury. Therefore, the improvement in blood flow would be reflected by the ST segment returning to baseline. Widening of the QRS complex (A) is not specific to blood flow improvement. Frequency of ectopic beats (B) may be present but is not a direct indicator of improved blood flow. Presence of a significant Q wave (D) indicates a previous myocardial infarction and does not necessarily reflect current blood flow status.

Correct Answer: C

Rationale: The correct answer is C: Meperidine (Demerol). During a tet spell in tetralogy of Fallot, there is a sudden decrease in pulmonary blood flow leading to cyanosis and hypoxia. Meperidine is a vasodilator and helps increase pulmonary blood flow, improving oxygenation. Propranolol (A) is a beta-blocker and can worsen cyanosis by decreasing cardiac output. Morphine (B) can depress the respiratory system and exacerbate hypoxia. Furosemide (D) is a diuretic and does not address the acute decrease in pulmonary blood flow seen in a tet spell.