ECG changes in myocardial infarction.

Correct Answer: C

Rationale: In the context of a myocardial infarction (MI), also known as a heart attack, it is crucial to understand the electrocardiogram (ECG) changes that occur. The correct answer, option C (Both A and B - ST elevation and Q waves), is indicative of an MI. ST elevation is a classic ECG finding in acute myocardial infarction. It represents transmural myocardial injury and is seen in the leads facing the area of infarction. Q waves, on the other hand, develop due to necrosis of the myocardium. They are a sign of irreversible damage and are often seen after an MI has occurred. Option A (ST elevation) alone is not sufficient because Q waves need to be present to suggest an old MI. Option B (Q waves) alone may indicate a previous MI, but without ST elevation, it may not be an acute event. Option D (None of the above) is incorrect as both ST elevation and Q waves are important ECG changes seen in myocardial infarction. Understanding these ECG changes is vital for healthcare professionals in diagnosing and managing patients with suspected or confirmed myocardial infarction. Recognizing these patterns can lead to prompt intervention and potentially life-saving treatment for the patient.

Correct Answer: C

Rationale: In the context of a myocardial infarction (MI), the correct answer is C) Creatine phosphokinase isoenzymes (CPK-MB) because CPK-MB is a specific marker for cardiac muscle damage. CPK is predominantly found in the heart, brain, and skeletal muscle, with CPK-MB being the cardiac-specific isoenzyme. After an MI, the damaged heart muscle releases CPK-MB into the bloodstream, making it one of the earliest markers to elevate. Option A) Serum glutamic-oxaloacetic transaminase (SGOT) is not a specific marker for cardiac injury and is found in multiple organs, including the liver and heart. Option B) Lactic acid dehydrogenase (LDH) is also not specific to cardiac muscle and can be elevated in various conditions, including liver disease. Option D) Serum glutamic-pyruvic transaminase (SGPT) is primarily a liver enzyme and not specific to myocardial damage. Educationally, understanding the kinetics and specificity of cardiac enzymes post-MI is crucial for accurate diagnosis and management of patients presenting with chest pain or other cardiac symptoms. Monitoring CPK-MB levels, along with troponin and other cardiac markers, helps in the timely identification of myocardial damage and initiation of appropriate interventions to reduce morbidity and mortality associated with cardiac events.

Correct Answer: C

Rationale: In the context of a patient recovering from a myocardial infarction (heart attack), the highest priority goal two months post-event would be option C) Developing a physical-conditioning program. This is because physical conditioning is crucial for cardiac rehabilitation and overall recovery after a heart attack. Exercise helps improve cardiovascular fitness, strengthens the heart muscle, lowers blood pressure, and reduces the risk of future cardiac events. Option A) Having his wife perform most of his activities of daily living may be necessary initially but does not address the long-term goal of improving his physical health and independence. Option B) Following a weight-reduction diet is important for overall health but may not be the immediate priority over physical conditioning post-heart attack. Option D) Assisting him to prepare for retirement is not directly related to his current health status and recovery needs. In an educational context, it is important for healthcare providers to prioritize interventions that directly impact the patient's recovery and well-being. Understanding the rationale behind each option helps in making informed clinical decisions and providing patient-centered care. Emphasizing the significance of physical conditioning in cardiac rehabilitation can lead to better outcomes and quality of life for patients recovering from a myocardial infarction.

Correct Answer: D

Rationale: Following bypass surgery, it is crucial for Mr. Murphy to contact his physician if he experiences an inability to increase walking distance without pain (Option D). This symptom could indicate a potential complication with the surgery or a complication related to his cardiovascular health. It is essential to address this issue promptly to prevent further complications and ensure proper recovery. Option A, a generalized feeling of being weak and tired, is a common postoperative symptom and may be expected as the body recovers. It is not necessarily a cause for immediate concern unless it is severe or persistent. Option B, incisional discomfort for 4 postoperative weeks, is within the expected timeframe for incisional pain and healing following bypass surgery. As long as there are no signs of infection or other complications, this symptom is typically part of the normal recovery process. Option C, the presence of some pink drainage from the leg incision site, can be common in the initial stages of wound healing and may not necessarily indicate a problem. However, if the drainage becomes excessive, foul-smelling, or is accompanied by other signs of infection, it would be important to contact the physician. Educationally, understanding the common postoperative symptoms and potential complications following bypass surgery is crucial for patients and healthcare providers. Recognizing when to seek medical attention can help in ensuring timely intervention and promoting successful recovery outcomes.

Correct Answer: C

Rationale: In the case of Mr. Johnson with possible acute myocarditis, the most important action would be option C) Keeping him on a regimen of complete bed rest. Acute myocarditis is an inflammatory condition of the heart muscle that can lead to serious complications, including heart failure. Bed rest is crucial in this condition as it reduces the workload on the heart, allowing it to heal and recover. Physical exertion can exacerbate the inflammation and damage to the heart muscle, so complete bed rest is essential for Mr. Johnson's recovery. Option A) Placing him in a darkened room is incorrect as it does not directly address the physiological needs of a patient with acute myocarditis. Option B) Keeping a nutritional intake record on him, while important for overall health, is not the most critical action in this acute situation. Option D) Telling him not to worry, he will recover soon, is incorrect as it does not provide the necessary medical intervention required for acute myocarditis. In an educational context, it is important for healthcare providers to understand the specific management strategies for different cardiovascular conditions. Understanding the rationale behind the importance of bed rest in acute myocarditis can help healthcare professionals provide optimal care and support for patients like Mr. Johnson, ultimately leading to better outcomes and improved patient well-being.