Janeway lesions are painless, erythematous, or hemorrhagic lesions found on the palms and soles. They are associated with:

Correct Answer: C

Rationale: Janeway lesions are associated with endocarditis due to septic emboli reaching the small vessels in the palms and soles. Endocarditis causes bacterial or fungal infection of the heart valves, leading to systemic emboli formation. These emboli can travel to various organs, including the skin, causing Janeway lesions. CAD (A) is not directly related to Janeway lesions. Hyperlipidemia (B) is a risk factor for CAD but not specifically associated with Janeway lesions. CHF (D) is a condition of the heart's inability to pump effectively and does not directly cause Janeway lesions.

Correct Answer: C

Rationale: The correct answer is C: Cardiac murmurs. Cardiac valve problems can cause abnormal blood flow, leading to turbulent flow and producing murmurs. Murmurs are often auscultated using a stethoscope. Incorrect Choices: A: Arterial bruit is associated with vascular abnormalities, not specifically cardiac valve problems. B: Pulsus alternans is a pulse pattern, not a sound auscultated from the heart. D: Third heart sound (S3) is associated with heart failure or volume overload, not specifically valve problems.

Correct Answer: B

Rationale: Step 1: Prazosin is an alpha-adrenergic blocker that can cause orthostatic hypotension. Step 2: Adding prazosin to the regimen can further lower the patient's blood pressure. Step 3: Changing position slowly and avoiding prolonged standing helps prevent dizziness and falls. Step 4: Teaching the patient to change positions slowly is crucial to prevent orthostatic hypotension. Step 5: This education is essential for the patient's safety and well-being.

Correct Answer: C

Rationale: The correct answer is C: Lactic acid accumulation during anaerobic metabolism. During myocardial ischemia, there is a decrease in blood flow leading to insufficient oxygen supply to the heart muscle. This results in anaerobic metabolism, causing lactic acid accumulation. Lactic acid buildup leads to tissue acidosis, which is sensed as pain by nerve endings in the heart. Incorrect choices: A: Death of myocardial tissue - This is the result of prolonged ischemia leading to irreversible damage, not the direct cause of pain. B: Dysrhythmias caused by cellular irritability - Dysrhythmias can occur with ischemia, but they are not the primary cause of pain. D: Elevated pressure in the ventricles and pulmonary vessels - While elevated pressure can be a consequence of ischemia, it is not the direct cause of pain.

Correct Answer: C

Rationale: The correct answer is C: Percutaneous coronary intervention (PCI). PCI is the preferred treatment to open a blocked artery in a patient with a confirmed MI within 90 minutes as it is a minimally invasive procedure that can quickly restore blood flow. Stent placement (A) is part of PCI and can be performed during the procedure. Coronary artery bypass graft (CABG) (B) is a more invasive surgery usually done in stable patients, not in emergency situations like an acute MI. Transmyocardial laser revascularization (TMR) (D) is not a first-line treatment for acute MI and is typically used in specific cases where other treatments have failed.