During the acute phase of rheumatic fever, which of the following is a priority action of the nurse?

Correct Answer: B

Rationale: The correct answer is B: Assess for early signs of endocarditis. During the acute phase of rheumatic fever, endocarditis can develop as a complication due to the inflammation and damage to the heart valves. Early detection of endocarditis is crucial to prevent serious complications. By assessing for early signs such as new or changing heart murmurs, fever, fatigue, and shortness of breath, the nurse can promptly intervene and prevent further damage to the heart valves. Encouraging ambulation, maintaining hydration, and managing pain are important aspects of care but assessing for endocarditis takes precedence due to its potential impact on the patient's health and outcomes.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Handling pacemaker leads and a toaster simultaneously can lead to interference with the device, so the patient understands the importance of avoiding this. 2. This answer demonstrates awareness of potential risks and shows the patient's commitment to safety. 3. Options B, C, and D do not directly address safe care of the pacemaker site or demonstrate understanding of potential risks. 4. Option B focuses on obtaining a medic alert tag but does not address specific care instructions for the pacemaker site. 5. Option C assumes that the OR environment guarantees no risk of infection, which is incorrect. 6. Option D's reference to avoiding a home microwave is not necessary for pacemaker care unless the microwave is very old and poorly shielded.

Correct Answer: B

Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin is a positive inotrope, meaning it increases the force of heart contractions, improving cardiac output in heart failure. It also has a negative chronotropic effect by slowing the heart rate, which can be beneficial in certain heart conditions. Option A is incorrect because digoxin has a positive inotropic effect. Option C is incorrect as it contradicts itself by stating both negative and positive inotropic effects. Option D is incorrect because digoxin does not have a positive chronotropic effect; it actually slows the heart rate.

Correct Answer: D

Rationale: The correct answer is D: Supraventricular tachycardia. Beta agonists, like adenosine or beta-blockers, are commonly used to treat supraventricular tachycardia by slowing down the heart rate. This condition involves rapid heartbeats originating above the ventricles. Choices A, B, and C are incorrect because beta agonists are not typically indicated for shock, hypertension, or cardiac arrhythmias, respectively. In hypertensive emergencies, other antihypertensive medications are preferred. In shock, fluid resuscitation and vasopressors are usually used. For cardiac arrhythmias, antiarrhythmic drugs or cardioversion are more appropriate treatments.

Correct Answer: D

Rationale: Step-by-step rationale for answer D: 1. Class I anti-arrhythmic drugs work by blocking sodium channels in the heart. 2. Blocking sodium channels slows the phase 0 depolarization of cardiac cells. 3. This decreases the conduction velocity and excitability of cardiac tissue. 4. Ultimately, it helps to stabilize the heart's electrical activity and prevent arrhythmias. Summary: A: Blocking calcium channels is typical for Class IV antiarrhythmics, not Class I. B: Increasing conduction through AV node is not the mechanism of Class I antiarrhythmics. C: Decreasing excitability of SA node is not how Class I antiarrhythmics work.